Correlation between left atrial appendage morphology and flow velocity in patients with paroxysmal atrial fibrillation
Reduction of left atrial appendage (LAA) flow velocity (FV) is a risk factor for thrombus formation and increases the risk of stroke in patients with atrial fibrillation (AF). Furthermore, LAA morphology is correlated with stroke in patients with AF. The aim of this study was to correlate LAAFV with...
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| Veröffentlicht in: | European heart journal cardiovascular imaging 2016-01, Vol.17 (1), p.59-66 |
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| creator | Fukushima, Keiko Fukushima, Noritoshi Kato, Ken Ejima, Koichiro Sato, Hiroki Fukushima, Kenji Saito, Chihiro Hayashi, Keiko Arai, Kotaro Manaka, Tetsuyuki Ashihara, Kyomi Shoda, Morio Hagiwara, Nobuhisa |
| description | Reduction of left atrial appendage (LAA) flow velocity (FV) is a risk factor for thrombus formation and increases the risk of stroke in patients with atrial fibrillation (AF). Furthermore, LAA morphology is correlated with stroke in patients with AF. The aim of this study was to correlate LAAFV with LAA morphology in patients with AF.
We studied 96 patients (age 59.0 ± 10.2 years, 75% male) referred for radiofrequency catheter ablation for paroxysmal AF. All patients underwent computed tomography (CT) and transthoracic and transoesophageal echocardiography during sinus rhythm. LAA morphology was classified as one of the four types (chicken wing, windsock, cactus, and cauliflower) on CT images. There were significant differences in LAAFV among LAA morphologies (chicken wing 73.7 ± 21.9 cm/s, windsock 61.9 ± 19.6 cm/s, cactus 55.3 ± 14.1 cm/s, cauliflower 52.7 ± 18.1 cm/s, P = 0.008). Post hoc multiple comparisons showed that LAAFV was higher in patients with chicken wing than in those with cactus (P = 0.006, vs. chicken wing) and cauliflower (P = 0.006, vs. chicken wing), but not with windsock (P = 0.102). After adjustment for clinical and LAA anatomical covariates (orifice area, volume, and trabeculation), multiple linear regression analyses revealed that LAA morphology was an independent determinant of LAAFV [chickens wing: standardized partial regression coefficients (β) = 0.317, P = 0.0014; windsock: β = 0.303, P = 0.038].
LAA morphology is a significant determinant of LAAFV, suggesting an underlying mechanism for the association between LAA morphology and embolic events. |
| doi_str_mv | 10.1093/ehjci/jev117 |
| format | Article |
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We studied 96 patients (age 59.0 ± 10.2 years, 75% male) referred for radiofrequency catheter ablation for paroxysmal AF. All patients underwent computed tomography (CT) and transthoracic and transoesophageal echocardiography during sinus rhythm. LAA morphology was classified as one of the four types (chicken wing, windsock, cactus, and cauliflower) on CT images. There were significant differences in LAAFV among LAA morphologies (chicken wing 73.7 ± 21.9 cm/s, windsock 61.9 ± 19.6 cm/s, cactus 55.3 ± 14.1 cm/s, cauliflower 52.7 ± 18.1 cm/s, P = 0.008). Post hoc multiple comparisons showed that LAAFV was higher in patients with chicken wing than in those with cactus (P = 0.006, vs. chicken wing) and cauliflower (P = 0.006, vs. chicken wing), but not with windsock (P = 0.102). After adjustment for clinical and LAA anatomical covariates (orifice area, volume, and trabeculation), multiple linear regression analyses revealed that LAA morphology was an independent determinant of LAAFV [chickens wing: standardized partial regression coefficients (β) = 0.317, P = 0.0014; windsock: β = 0.303, P = 0.038].
LAA morphology is a significant determinant of LAAFV, suggesting an underlying mechanism for the association between LAA morphology and embolic events.</description><identifier>ISSN: 2047-2404</identifier><identifier>EISSN: 2047-2412</identifier><identifier>DOI: 10.1093/ehjci/jev117</identifier><identifier>PMID: 25944049</identifier><language>eng</language><publisher>England</publisher><subject>Aged ; Atrial Appendage - pathology ; Atrial Appendage - physiopathology ; Atrial Fibrillation - surgery ; Blood Flow Velocity ; Catheter Ablation - methods ; Echocardiography - methods ; Echocardiography, Transesophageal - methods ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Sensitivity and Specificity ; Severity of Illness Index ; Stroke - diagnosis ; Stroke - physiopathology ; Tomography, X-Ray Computed - methods</subject><ispartof>European heart journal cardiovascular imaging, 2016-01, Vol.17 (1), p.59-66</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c329t-850a199fa4957dabc9ea640407c0163ad6d4199d84ad5380fa53f1ccb9ccd1363</citedby><cites>FETCH-LOGICAL-c329t-850a199fa4957dabc9ea640407c0163ad6d4199d84ad5380fa53f1ccb9ccd1363</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25944049$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fukushima, Keiko</creatorcontrib><creatorcontrib>Fukushima, Noritoshi</creatorcontrib><creatorcontrib>Kato, Ken</creatorcontrib><creatorcontrib>Ejima, Koichiro</creatorcontrib><creatorcontrib>Sato, Hiroki</creatorcontrib><creatorcontrib>Fukushima, Kenji</creatorcontrib><creatorcontrib>Saito, Chihiro</creatorcontrib><creatorcontrib>Hayashi, Keiko</creatorcontrib><creatorcontrib>Arai, Kotaro</creatorcontrib><creatorcontrib>Manaka, Tetsuyuki</creatorcontrib><creatorcontrib>Ashihara, Kyomi</creatorcontrib><creatorcontrib>Shoda, Morio</creatorcontrib><creatorcontrib>Hagiwara, Nobuhisa</creatorcontrib><title>Correlation between left atrial appendage morphology and flow velocity in patients with paroxysmal atrial fibrillation</title><title>European heart journal cardiovascular imaging</title><addtitle>Eur Heart J Cardiovasc Imaging</addtitle><description>Reduction of left atrial appendage (LAA) flow velocity (FV) is a risk factor for thrombus formation and increases the risk of stroke in patients with atrial fibrillation (AF). Furthermore, LAA morphology is correlated with stroke in patients with AF. The aim of this study was to correlate LAAFV with LAA morphology in patients with AF.
We studied 96 patients (age 59.0 ± 10.2 years, 75% male) referred for radiofrequency catheter ablation for paroxysmal AF. All patients underwent computed tomography (CT) and transthoracic and transoesophageal echocardiography during sinus rhythm. LAA morphology was classified as one of the four types (chicken wing, windsock, cactus, and cauliflower) on CT images. There were significant differences in LAAFV among LAA morphologies (chicken wing 73.7 ± 21.9 cm/s, windsock 61.9 ± 19.6 cm/s, cactus 55.3 ± 14.1 cm/s, cauliflower 52.7 ± 18.1 cm/s, P = 0.008). Post hoc multiple comparisons showed that LAAFV was higher in patients with chicken wing than in those with cactus (P = 0.006, vs. chicken wing) and cauliflower (P = 0.006, vs. chicken wing), but not with windsock (P = 0.102). After adjustment for clinical and LAA anatomical covariates (orifice area, volume, and trabeculation), multiple linear regression analyses revealed that LAA morphology was an independent determinant of LAAFV [chickens wing: standardized partial regression coefficients (β) = 0.317, P = 0.0014; windsock: β = 0.303, P = 0.038].
LAA morphology is a significant determinant of LAAFV, suggesting an underlying mechanism for the association between LAA morphology and embolic events.</description><subject>Aged</subject><subject>Atrial Appendage - pathology</subject><subject>Atrial Appendage - physiopathology</subject><subject>Atrial Fibrillation - surgery</subject><subject>Blood Flow Velocity</subject><subject>Catheter Ablation - methods</subject><subject>Echocardiography - methods</subject><subject>Echocardiography, Transesophageal - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>Severity of Illness Index</subject><subject>Stroke - diagnosis</subject><subject>Stroke - physiopathology</subject><subject>Tomography, X-Ray Computed - methods</subject><issn>2047-2404</issn><issn>2047-2412</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kD1PwzAQhi0EolXpxow8MlBqx05Sj6jiS6rEAnPk2JfWVRIH223Jv8clpbf4rHv13OlB6JaSR0oEm8Nmq8x8C3tK8ws0TgjPZwmnyeW5J3yEpt5vSayUZzyh12iUpILHiRij_dI6B7UMxra4hHAAaHENVcAyOCNrLLsOWi3XgBvruo2t7brHstW4qu0B76G2yoQemxZ3EQJt8Phgwib-nP3pfXNEDKTKlM7Uw6obdFXJ2sP09E7Q18vz5_Jttvp4fV8-rWaKJSLMFimRVIhKcpHmWpZKgMzi4SRXhGZM6kzzONcLLnXKFqSSKauoUqVQSlOWsQm6H7ids9878KFojFcQr2jB7nxB85RwlmXR5QQ9DFHlrPcOqqJzppGuLygpjrKLP9nFIDvG707kXdmAPof_1bJfnF9_Dg</recordid><startdate>20160101</startdate><enddate>20160101</enddate><creator>Fukushima, Keiko</creator><creator>Fukushima, Noritoshi</creator><creator>Kato, Ken</creator><creator>Ejima, Koichiro</creator><creator>Sato, Hiroki</creator><creator>Fukushima, Kenji</creator><creator>Saito, Chihiro</creator><creator>Hayashi, Keiko</creator><creator>Arai, Kotaro</creator><creator>Manaka, Tetsuyuki</creator><creator>Ashihara, Kyomi</creator><creator>Shoda, Morio</creator><creator>Hagiwara, Nobuhisa</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160101</creationdate><title>Correlation between left atrial appendage morphology and flow velocity in patients with paroxysmal atrial fibrillation</title><author>Fukushima, Keiko ; Fukushima, Noritoshi ; Kato, Ken ; Ejima, Koichiro ; Sato, Hiroki ; Fukushima, Kenji ; Saito, Chihiro ; Hayashi, Keiko ; Arai, Kotaro ; Manaka, Tetsuyuki ; Ashihara, Kyomi ; Shoda, Morio ; Hagiwara, Nobuhisa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c329t-850a199fa4957dabc9ea640407c0163ad6d4199d84ad5380fa53f1ccb9ccd1363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Atrial Appendage - pathology</topic><topic>Atrial Appendage - physiopathology</topic><topic>Atrial Fibrillation - surgery</topic><topic>Blood Flow Velocity</topic><topic>Catheter Ablation - methods</topic><topic>Echocardiography - methods</topic><topic>Echocardiography, Transesophageal - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Sensitivity and Specificity</topic><topic>Severity of Illness Index</topic><topic>Stroke - diagnosis</topic><topic>Stroke - physiopathology</topic><topic>Tomography, X-Ray Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fukushima, Keiko</creatorcontrib><creatorcontrib>Fukushima, Noritoshi</creatorcontrib><creatorcontrib>Kato, Ken</creatorcontrib><creatorcontrib>Ejima, Koichiro</creatorcontrib><creatorcontrib>Sato, Hiroki</creatorcontrib><creatorcontrib>Fukushima, Kenji</creatorcontrib><creatorcontrib>Saito, Chihiro</creatorcontrib><creatorcontrib>Hayashi, Keiko</creatorcontrib><creatorcontrib>Arai, Kotaro</creatorcontrib><creatorcontrib>Manaka, Tetsuyuki</creatorcontrib><creatorcontrib>Ashihara, Kyomi</creatorcontrib><creatorcontrib>Shoda, Morio</creatorcontrib><creatorcontrib>Hagiwara, Nobuhisa</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal cardiovascular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fukushima, Keiko</au><au>Fukushima, Noritoshi</au><au>Kato, Ken</au><au>Ejima, Koichiro</au><au>Sato, Hiroki</au><au>Fukushima, Kenji</au><au>Saito, Chihiro</au><au>Hayashi, Keiko</au><au>Arai, Kotaro</au><au>Manaka, Tetsuyuki</au><au>Ashihara, Kyomi</au><au>Shoda, Morio</au><au>Hagiwara, Nobuhisa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Correlation between left atrial appendage morphology and flow velocity in patients with paroxysmal atrial fibrillation</atitle><jtitle>European heart journal cardiovascular imaging</jtitle><addtitle>Eur Heart J Cardiovasc Imaging</addtitle><date>2016-01-01</date><risdate>2016</risdate><volume>17</volume><issue>1</issue><spage>59</spage><epage>66</epage><pages>59-66</pages><issn>2047-2404</issn><eissn>2047-2412</eissn><abstract>Reduction of left atrial appendage (LAA) flow velocity (FV) is a risk factor for thrombus formation and increases the risk of stroke in patients with atrial fibrillation (AF). Furthermore, LAA morphology is correlated with stroke in patients with AF. The aim of this study was to correlate LAAFV with LAA morphology in patients with AF.
We studied 96 patients (age 59.0 ± 10.2 years, 75% male) referred for radiofrequency catheter ablation for paroxysmal AF. All patients underwent computed tomography (CT) and transthoracic and transoesophageal echocardiography during sinus rhythm. LAA morphology was classified as one of the four types (chicken wing, windsock, cactus, and cauliflower) on CT images. There were significant differences in LAAFV among LAA morphologies (chicken wing 73.7 ± 21.9 cm/s, windsock 61.9 ± 19.6 cm/s, cactus 55.3 ± 14.1 cm/s, cauliflower 52.7 ± 18.1 cm/s, P = 0.008). Post hoc multiple comparisons showed that LAAFV was higher in patients with chicken wing than in those with cactus (P = 0.006, vs. chicken wing) and cauliflower (P = 0.006, vs. chicken wing), but not with windsock (P = 0.102). After adjustment for clinical and LAA anatomical covariates (orifice area, volume, and trabeculation), multiple linear regression analyses revealed that LAA morphology was an independent determinant of LAAFV [chickens wing: standardized partial regression coefficients (β) = 0.317, P = 0.0014; windsock: β = 0.303, P = 0.038].
LAA morphology is a significant determinant of LAAFV, suggesting an underlying mechanism for the association between LAA morphology and embolic events.</abstract><cop>England</cop><pmid>25944049</pmid><doi>10.1093/ehjci/jev117</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Atrial Appendage - pathology Atrial Appendage - physiopathology Atrial Fibrillation - surgery Blood Flow Velocity Catheter Ablation - methods Echocardiography - methods Echocardiography, Transesophageal - methods Female Humans Male Middle Aged Predictive Value of Tests Retrospective Studies Risk Assessment Risk Factors Sensitivity and Specificity Severity of Illness Index Stroke - diagnosis Stroke - physiopathology Tomography, X-Ray Computed - methods |
| title | Correlation between left atrial appendage morphology and flow velocity in patients with paroxysmal atrial fibrillation |
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