Characteristics of pulmonary vein enlargement in non-valvular atrial fibrillation patients with stroke

Jung Myung Lee, Jong Youn Kim, Jaemin Shim, Jae Sun Uhm, Young Jin Kim, Hye Jeong Lee, Hui Nam Pak, Moon Hyoung Lee, Boyoung Joung

Research output: Contribution to journalArticle

Abstract

Purpose: The association between pulmonary vein (PV) dilatation and stroke in non-valvular atrial fibrillation (AF) patients remains unknown.

Materials and Methods: We examined the left atrium (LA) and PV in control (n=138) and non-valvular AF patients without (AF group, n=138) and with non-hemorrhagic stroke (AF with stroke group, n=138) using computed tomography.

Results: The LA, LA appendage (LAA), and all PVs were larger in the AF than control patients. The orifice areas of the LAA (5.6±2.2 cm2 vs. 4.7±1.7 cm2, p<0.001), left superior PV (3.8±1.5 cm2 vs. 3.4±1.2 cm2, p=0.019), and inferior PV (2.3±1.0 cm2 vs. 1.8±0.7 cm2, p<0.001) were larger in the AF with stroke than in the AF only group. However, right PVs were not different between the two groups. In a multivariate analysis, the orifice areas of the left superior PV [odds ratio (OR) 1.25, 95% confidence interval (CI) 1.03–1.51, p=0.02], left inferior PV (OR 1.97, 95% CI 1.41–2.75, p<0.001), and LAA (OR 1.30, 95% CI 1.13–1.50, p<0.001) were independent predictors of stroke.

Conclusion: Compared to the right PVs, the left PVs and LAA exhibited more significant enlargement in patients with AF and stroke than in patients with AF only. This finding suggests that the remodeling of left-sided LA structures might be related to stroke.

Original languageEnglish
Pages (from-to)1516-1525
Number of pages10
JournalYonsei Medical Journal
Volume55
Issue number6
DOIs
Publication statusPublished - 2014 Jan 1
Externally publishedYes

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Pulmonary Veins
Atrial Fibrillation
Stroke
Heart Atria
Odds Ratio
Confidence Intervals
Atrial Appendage
Dilatation
Multivariate Analysis
Tomography

Keywords

  • Atrial appendage
  • Atrial fibrillation
  • Multidetector computed tomography
  • Pulmonary veins
  • Stroke

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Characteristics of pulmonary vein enlargement in non-valvular atrial fibrillation patients with stroke. / Lee, Jung Myung; Kim, Jong Youn; Shim, Jaemin; Uhm, Jae Sun; Kim, Young Jin; Lee, Hye Jeong; Pak, Hui Nam; Lee, Moon Hyoung; Joung, Boyoung.

In: Yonsei Medical Journal, Vol. 55, No. 6, 01.01.2014, p. 1516-1525.

Research output: Contribution to journalArticle

Lee, Jung Myung ; Kim, Jong Youn ; Shim, Jaemin ; Uhm, Jae Sun ; Kim, Young Jin ; Lee, Hye Jeong ; Pak, Hui Nam ; Lee, Moon Hyoung ; Joung, Boyoung. / Characteristics of pulmonary vein enlargement in non-valvular atrial fibrillation patients with stroke. In: Yonsei Medical Journal. 2014 ; Vol. 55, No. 6. pp. 1516-1525.
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abstract = "Purpose: The association between pulmonary vein (PV) dilatation and stroke in non-valvular atrial fibrillation (AF) patients remains unknown.Materials and Methods: We examined the left atrium (LA) and PV in control (n=138) and non-valvular AF patients without (AF group, n=138) and with non-hemorrhagic stroke (AF with stroke group, n=138) using computed tomography.Results: The LA, LA appendage (LAA), and all PVs were larger in the AF than control patients. The orifice areas of the LAA (5.6±2.2 cm2 vs. 4.7±1.7 cm2, p<0.001), left superior PV (3.8±1.5 cm2 vs. 3.4±1.2 cm2, p=0.019), and inferior PV (2.3±1.0 cm2 vs. 1.8±0.7 cm2, p<0.001) were larger in the AF with stroke than in the AF only group. However, right PVs were not different between the two groups. In a multivariate analysis, the orifice areas of the left superior PV [odds ratio (OR) 1.25, 95{\%} confidence interval (CI) 1.03–1.51, p=0.02], left inferior PV (OR 1.97, 95{\%} CI 1.41–2.75, p<0.001), and LAA (OR 1.30, 95{\%} CI 1.13–1.50, p<0.001) were independent predictors of stroke.Conclusion: Compared to the right PVs, the left PVs and LAA exhibited more significant enlargement in patients with AF and stroke than in patients with AF only. This finding suggests that the remodeling of left-sided LA structures might be related to stroke.",
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T1 - Characteristics of pulmonary vein enlargement in non-valvular atrial fibrillation patients with stroke

AU - Lee, Jung Myung

AU - Kim, Jong Youn

AU - Shim, Jaemin

AU - Uhm, Jae Sun

AU - Kim, Young Jin

AU - Lee, Hye Jeong

AU - Pak, Hui Nam

AU - Lee, Moon Hyoung

AU - Joung, Boyoung

PY - 2014/1/1

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N2 - Purpose: The association between pulmonary vein (PV) dilatation and stroke in non-valvular atrial fibrillation (AF) patients remains unknown.Materials and Methods: We examined the left atrium (LA) and PV in control (n=138) and non-valvular AF patients without (AF group, n=138) and with non-hemorrhagic stroke (AF with stroke group, n=138) using computed tomography.Results: The LA, LA appendage (LAA), and all PVs were larger in the AF than control patients. The orifice areas of the LAA (5.6±2.2 cm2 vs. 4.7±1.7 cm2, p<0.001), left superior PV (3.8±1.5 cm2 vs. 3.4±1.2 cm2, p=0.019), and inferior PV (2.3±1.0 cm2 vs. 1.8±0.7 cm2, p<0.001) were larger in the AF with stroke than in the AF only group. However, right PVs were not different between the two groups. In a multivariate analysis, the orifice areas of the left superior PV [odds ratio (OR) 1.25, 95% confidence interval (CI) 1.03–1.51, p=0.02], left inferior PV (OR 1.97, 95% CI 1.41–2.75, p<0.001), and LAA (OR 1.30, 95% CI 1.13–1.50, p<0.001) were independent predictors of stroke.Conclusion: Compared to the right PVs, the left PVs and LAA exhibited more significant enlargement in patients with AF and stroke than in patients with AF only. This finding suggests that the remodeling of left-sided LA structures might be related to stroke.

AB - Purpose: The association between pulmonary vein (PV) dilatation and stroke in non-valvular atrial fibrillation (AF) patients remains unknown.Materials and Methods: We examined the left atrium (LA) and PV in control (n=138) and non-valvular AF patients without (AF group, n=138) and with non-hemorrhagic stroke (AF with stroke group, n=138) using computed tomography.Results: The LA, LA appendage (LAA), and all PVs were larger in the AF than control patients. The orifice areas of the LAA (5.6±2.2 cm2 vs. 4.7±1.7 cm2, p<0.001), left superior PV (3.8±1.5 cm2 vs. 3.4±1.2 cm2, p=0.019), and inferior PV (2.3±1.0 cm2 vs. 1.8±0.7 cm2, p<0.001) were larger in the AF with stroke than in the AF only group. However, right PVs were not different between the two groups. In a multivariate analysis, the orifice areas of the left superior PV [odds ratio (OR) 1.25, 95% confidence interval (CI) 1.03–1.51, p=0.02], left inferior PV (OR 1.97, 95% CI 1.41–2.75, p<0.001), and LAA (OR 1.30, 95% CI 1.13–1.50, p<0.001) were independent predictors of stroke.Conclusion: Compared to the right PVs, the left PVs and LAA exhibited more significant enlargement in patients with AF and stroke than in patients with AF only. This finding suggests that the remodeling of left-sided LA structures might be related to stroke.

KW - Atrial appendage

KW - Atrial fibrillation

KW - Multidetector computed tomography

KW - Pulmonary veins

KW - Stroke

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