Document Detail


Advanced age, low left atrial appendage velocity, and factor V promoter sequence variation as predictors of left atrial thrombosis in patients with nonvalvular atrial fibrillation.
MedLine Citation:
PMID:  20082208     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Atrial fibrillation (AF) renders individual patients at risk for development of an atrial thrombus. The aim of this study was to determine clinical and echocardiographic factors influencing the risk of left atrial thrombosis (LAT) in patients with persistent nonvalvular AF. Genetic variants encoding haemostatic factors have been also assessed for putative association with LAT. In the cross-sectional study, a total of 212 patients (132 males and 80 females) with nonvalvular persistent AF (duration range 48 h-90 days) have been selected. LAT was visualized by transesophageal echocardiography. The FGB G(-455)A, PAI-1 4G/5G, F5 C(-224)T, and F5 R506Q genetic markers were tested using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) approach. To reveal independent factors contributing to the thromboembolic risk in AF, a multivariate logistic model was applied. LA thrombi were found in 44 out of 212 subjects (21%). LAT was more frequently observed in patients at age >75 years (P < 0.001) and those who had reduced left ventricular ejection fraction <40% (LVEF; P < 0.001) and decreased left atrial appendage velocity <20 cm/s (LAAV; P < 0.001). Logistic regression analysis showed that advanced age (OR = 1.64 per decade P < 0.001), LVEF < 40% (OR = 2.12, P < 0.001), LAAV (OR = 1.56, P = 0.007), and TT genotype of F5 C(-224)T (OR = 2.42, P = 0.041) are associated with higher risk of LAT. Age >75 years, LVEF < 40%, LAAV < 20 cm/s, and Factor V C(-224)T variant independently contribute to the thromboembolic risk in AF.
Authors:
Dmitry A Zateyshchikov; Alexey N Brovkin; Dimitry A Chistiakov; Valery V Nosikov
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of thrombosis and thrombolysis     Volume:  30     ISSN:  1573-742X     ISO Abbreviation:  J. Thromb. Thrombolysis     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-26     Completed Date:  2010-11-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9502018     Medline TA:  J Thromb Thrombolysis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  192-9     Citation Subset:  IM    
Affiliation:
Scientific-Educational Medical Center of the Department of General Management of Russian President, Moscow, Russia.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Atrial Appendage / physiopathology*,  ultrasonography
Atrial Fibrillation / complications*,  physiopathology,  ultrasonography
Atrial Function, Left*
Chi-Square Distribution
Cross-Sectional Studies
Echocardiography, Transesophageal
Factor V / genetics*
Female
Genetic Predisposition to Disease
Humans
Logistic Models
Male
Middle Aged
Odds Ratio
Polymerase Chain Reaction
Polymorphism, Genetic*
Polymorphism, Restriction Fragment Length
Promoter Regions, Genetic*
Risk Assessment
Risk Factors
Russia
Stroke Volume
Thrombosis / etiology*,  genetics,  physiopathology
Ventricular Function, Left
Chemical
Reg. No./Substance:
9001-24-5/Factor V

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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