| Left Atrial Appendage Dimensions Predict the Risk of Stroke/TIA in Patients With Atrial Fibrillation. | |
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MedLine Citation:
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PMID: 20662984 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Risk of Stroke/TIA in Patients With Atrial Fibrillation. Introduction: Most strokes in patients with atrial fibrillation (AF) arise from thrombus formation in left atrial appendage (LAA). Our aim was to identify LAA features associated with a higher stroke risk in patients with AF using magnetic resonance imaging and angiography (MRI/MRA). Methods: The study included 144 patients with nonvalvular AF who were not receiving warfarin and who underwent MRI/MRA prior to catheter ablation for AF. LAA volume, LAA depth, short and long axes of LAA neck, and numbers of lobes were measured. Results: Of the 144 patients, 18 had a prior stroke or transient ischemic attack (TIA) (13 and 5, respectively). Compared with patients who had no history of stroke/TIA, these patients were older, had higher prevalence of hypertension and hyperlipidemia and had higher LAA volume (22.9 ± 9.6 cm(3) vs. 14.5 ± 7.1 cm(3) , P < 0.001). Their LAA depth (3.76 ± 0.9 cm vs. 3.21 ± 0.8 cm, P = 0.006) and the long and short axes of the LAA neck (3.12 ± 0.7 cm vs. 2.08 ± 0.7 cm, P < 0.001; 2.06 ± 0.5 cm vs. 1.37 ± 0.4 cm, P < 0.001, respectively) were larger. Using stepwise logistic regression model, the only statistically significant multivariable predictors of events were age (OR = 1.21 per year, 95% CI 1.06-1.38, P = 0.004), aspirin use (OR = 0.039, 95% CI 0.005-0.28, P = 0.001), and LAA neck dimensions (short axis × long axis) (OR = 3.59 per cm(2) , 95% CI 1.93-6.69, P < 0.001). Conclusion: LAA dimensions predict strokes/TIAs in patients with AF. LAA assessment by MRI/MRA can potentially be used as an adjunctive tool for risk stratification for embolic events in AF patients. (J Cardiovasc Electrophysiol, Vol. 22, pp. 10-15, January 2011). |
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Authors:
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Roy Beinart; E Kevin Heist; John B Newell; Godtfred Holmvang; Jeremy N Ruskin; Moussa Mansour |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of cardiovascular electrophysiology Volume: 22 ISSN: 1540-8167 ISO Abbreviation: J. Cardiovasc. Electrophysiol. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-01-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9010756 Medline TA: J Cardiovasc Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 10-5 Citation Subset: IM |
Copyright Information:
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© 2010 Wiley Periodicals, Inc. |
Affiliation:
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Heart Center, Massachusetts General Hospital, Boston, Massachusetts, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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