Document Detail


Severity of pseudofilling defect in the left atrial appendage on cardiac computed tomography is a simple predictor of the degree of left atrial emptying dysfunction in patients with chronic atrial fibrillation.
MedLine Citation:
PMID:  22805676     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of our study was to investigate the clinical relevance of a pseudofilling defect in the left atrial appendage (LAA) detected on coronary computed tomography (CT) angiography (CCTA) as an indicator of impaired left atrial (LA) volumetric function in patients with chronic atrial fibrillation (CAF).
METHODS: Forty-two patients with CAF underwent CCTA. Quantitative and visual measurements of contrast enhancement of the LAA were performed, and they were correlated with results of CT volumetric functional analysis of the LA. Four volumetric parameters representing LA function were measured: maximum (LAVmax) and minimum volumes of the LA (LAVmin) through the entire cardiac cycle; LA emptying volume (LAEV); and LA emptying fraction (LAEF). All volumetric parameters were standardized by body surface area to adjust for variation in LA size among patients. For quantitative measurement, the CT attenuation was measured at the LAA and the LA to calculate an LAA/LA attenuation ratio. For visual measurement, contrast enhancement of the LAA was categorized into 3 groups; no filling defect, mild-to-moderate pseudofilling defect, and severe pseudofilling defect group. The Spearman correlation coefficient and the Kruskal-Wallis test were used for statistical analysis.
RESULTS: The LAA/LA ratio showed a strong positive correlation with LAEV (r = 0.52; P < 0.001) and LAEF (r = 0.69; P < 0.001). The LAEV in the no pseudofilling defect group and the mild-to-moderate and severe pseudofilling defect groups were 16.1 ± 8.4, 10.8 ± 3.1, and 6.7 ± 4.9 mL/m², respectively (P < 0.001). The LAEF in each group were 24.2 ± 13.8%, 12.0 ± 3.4%, and 6.9 ± 3.1%, respectively (P < 0.001).
CONCLUSIONS: The severity of pseudofilling defect in the LAA on CCTA could predict the degree of LA emptying dysfunction in patients with CAF.
Authors:
Mitsutomi Ishiyama; Gensuke Akaike; Masaki Matsusako; Takuya Ueda; Akari Makidono; Sachiko Ohde; Atsushi Mizuno; Shuzo Nishihara; Yukihisa Saida
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of computer assisted tomography     Volume:  36     ISSN:  1532-3145     ISO Abbreviation:  J Comput Assist Tomogr     Publication Date:    2012 Jul-Aug
Date Detail:
Created Date:  2012-07-18     Completed Date:  2012-09-25     Revised Date:  2013-07-18    
Medline Journal Info:
Nlm Unique ID:  7703942     Medline TA:  J Comput Assist Tomogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  450-4     Citation Subset:  IM    
Affiliation:
Department of Radiology, St. Luke's International Hospital, Tokyo, Japan. mitishi@luke.or.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Atrial Appendage / physiopathology*,  radiography*
Atrial Fibrillation / physiopathology*,  radiography*
Chronic Disease
Contrast Media / diagnostic use
Coronary Angiography / methods*
Electrocardiography
Female
Humans
Iopamidol / diagnostic use
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Radiographic Image Interpretation, Computer-Assisted
Severity of Illness Index
Tomography, X-Ray Computed / methods*
Chemical
Reg. No./Substance:
0/Contrast Media; 62883-00-5/Iopamidol

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