Document Detail


Left atrial appendage dimensions predict the risk of stroke/TIA in patients with atrial fibrillation.
MedLine Citation:
PMID:  20662984     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Roy Beinart; E Kevin Heist; John B Newell; Godtfred Holmvang; Jeremy N Ruskin; Moussa Mansour
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  22     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-17     Completed Date:  2011-05-17     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  10-5     Citation Subset:  IM    
Copyright Information:
© 2010 Wiley Periodicals, Inc.
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MeSH Terms
Descriptor/Qualifier:
Atrial Appendage / pathology*
Atrial Fibrillation / diagnosis,  epidemiology*
Comorbidity
Female
Humans
Ischemic Attack, Transient / diagnosis*,  epidemiology*
Magnetic Resonance Angiography / statistics & numerical data*
Male
Massachusetts
Middle Aged
Reproducibility of Results
Risk Assessment / methods
Risk Factors
Sensitivity and Specificity
Stroke / diagnosis*,  epidemiology*

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


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