Does the left atrial appendage morphology correlate with the risk of thrombus and transient ischemic attack in patients with atrial fibrillation?

doi:10.3969/j.issn.1006-7795.2019.05.021

Abstract

Abstract: Objective To investigate the relationship between left atrial appendage morphology and thrombus formation and transient ischemic attack (TIA) in patients with atrial fibrillation. Methods Totally 687 patients with atrial fibrillation scheduled for radiofrequency ablation from August 2013 to June 2017 were selected and divided into left atrial thrombosis group and non-thrombosis group according to esophageal ultrasonography. All patients received pre-operative pulmonary vein and left atrium enhancement scans. All CT scans were reconstructed by post-processing image reconstruction and left atrial appendage anatomical classification. The Pearson χ^t est was used for comparison among the enumeration data groups, and the unconditional Logistic regression model was used for multivariate analysis. Results 687 patients were enrolled, 135 patients (19.65%) were cactus type, 275 patients (40.03%) were chicken wing type, 80 patients (11.64%) were windsock type and 197 patients (28.68%) were cauliflower type. Univariate and multivariate analysis showed that chicken wing left atrial appendage was a protective factor for thrombosis (OR=0.323) and TIA (OR=0.254) (P<0.05); cauliflower left atrial appendage was a risk factor for thrombosis (OR=3.116) and TIA (OR=2.391) (P<0.05). Conclusion The morphological characteristics of left atrial appendage can be divided into four types:cactus type, chicken wing type, windsock type and cauliflower type. The proportion of chicken wing type is the highest, while the risk of thrombosis and TIA is the lowest. Cauliflower type is the risk factor of thrombosis and TIA. Therefore, the detection of left atrial appendage morphology may have certain clinical significance in evaluating the possibility of thrombosis and TIA, guiding treatment and evaluating prognosis.

Key words: atrial fibrillation, left atrial appendage thrombus, transient ischemic attack (TIA)

CLC Number:

Zhang Yang, Ma Zhanhong, Jiang Tao. Does the left atrial appendage morphology correlate with the risk of thrombus and transient ischemic attack in patients with atrial fibrillation?[J]. Journal of Capital Medical University, 2019, 40(5): 776-780.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2019.05.021

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2019/V40/I5/776

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