Abstract
The structural and functional characteristics of left atrial appendage (LAA) in patients with atrial fibrillation (AF) with previous stroke remain incompletely elucidated. This study investigated whether a larger LAA orifice is related to decreased LAA flow velocity and stroke in nonvalvular AF. The dimension, morphology, and flow velocity of LAA were compared in patients with nonvalvular AF with (stroke group, n = 67, mean age 66 ± 9 years) and without ischemic stroke (no-stroke group, n = 151, mean age 56 ± 10 years). Compared with no-stroke group, the stroke group had larger LA dimension (4.7 ± 0.8 vs 4.2 ± 0.6 cm, p <0.001), larger LAA orifice area (4.5 ± 1.5 vs 3.0 ± 1.1 cm2, p <0.001), and slower LAA flow velocity (36 ± 19 vs 55 ± 20 cm/s, p <0.001). LAA flow velocity was negatively correlated with LAA orifice size (R = -0.48, p <0.001). After adjustment for multiple potential confounding factors including CHA2DS2-VASc score, persistent AF, and LA dimension, large LAA orifice area (odds ratio 6.16, 95% confidence interval 2.67 to 14.18, p <0.001) and slow LAA velocity (odds ratio 3.59, 95% confidence interval 1.42 to 9.08, p = 0.007) were found to be significant risk factors of stroke. In patients with LAA flow velocity <37.0 cm/s, patients with large LAA orifice (>3.5 cm2) had greater incidence of stroke than those with LAA orifice of ≤3.5 cm2 (75% vs 23%, p <0.001). In conclusion, LAA orifice enlargement was related to stroke risk in patients with nonvalvular AF even after adjustment for other risk factors, and it could be the cause of decreased flow velocity in LAA.
| Original language | English |
|---|---|
| Pages (from-to) | 963-969 |
| Number of pages | 7 |
| Journal | American Journal of Cardiology |
| Volume | 113 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2014 Mar 15 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Impact of increased orifice size and decreased flow velocity of left atrial appendage on stroke in nonvalvular atrial fibrillation. / Lee, Jung Myung; Shim, Jaemin; Uhm, Jae Sun; Kim, Young Jin; Lee, Hye Jeong; Pak, Hui Nam; Lee, Moon Hyoung; Joung, Boyoung.
In: American Journal of Cardiology, Vol. 113, No. 6, 15.03.2014, p. 963-969.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Impact of increased orifice size and decreased flow velocity of left atrial appendage on stroke in nonvalvular atrial fibrillation
AU - Lee, Jung Myung
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 - 2014/3/15
Y1 - 2014/3/15
N2 - The structural and functional characteristics of left atrial appendage (LAA) in patients with atrial fibrillation (AF) with previous stroke remain incompletely elucidated. This study investigated whether a larger LAA orifice is related to decreased LAA flow velocity and stroke in nonvalvular AF. The dimension, morphology, and flow velocity of LAA were compared in patients with nonvalvular AF with (stroke group, n = 67, mean age 66 ± 9 years) and without ischemic stroke (no-stroke group, n = 151, mean age 56 ± 10 years). Compared with no-stroke group, the stroke group had larger LA dimension (4.7 ± 0.8 vs 4.2 ± 0.6 cm, p <0.001), larger LAA orifice area (4.5 ± 1.5 vs 3.0 ± 1.1 cm2, p <0.001), and slower LAA flow velocity (36 ± 19 vs 55 ± 20 cm/s, p <0.001). LAA flow velocity was negatively correlated with LAA orifice size (R = -0.48, p <0.001). After adjustment for multiple potential confounding factors including CHA2DS2-VASc score, persistent AF, and LA dimension, large LAA orifice area (odds ratio 6.16, 95% confidence interval 2.67 to 14.18, p <0.001) and slow LAA velocity (odds ratio 3.59, 95% confidence interval 1.42 to 9.08, p = 0.007) were found to be significant risk factors of stroke. In patients with LAA flow velocity <37.0 cm/s, patients with large LAA orifice (>3.5 cm2) had greater incidence of stroke than those with LAA orifice of ≤3.5 cm2 (75% vs 23%, p <0.001). In conclusion, LAA orifice enlargement was related to stroke risk in patients with nonvalvular AF even after adjustment for other risk factors, and it could be the cause of decreased flow velocity in LAA.
AB - The structural and functional characteristics of left atrial appendage (LAA) in patients with atrial fibrillation (AF) with previous stroke remain incompletely elucidated. This study investigated whether a larger LAA orifice is related to decreased LAA flow velocity and stroke in nonvalvular AF. The dimension, morphology, and flow velocity of LAA were compared in patients with nonvalvular AF with (stroke group, n = 67, mean age 66 ± 9 years) and without ischemic stroke (no-stroke group, n = 151, mean age 56 ± 10 years). Compared with no-stroke group, the stroke group had larger LA dimension (4.7 ± 0.8 vs 4.2 ± 0.6 cm, p <0.001), larger LAA orifice area (4.5 ± 1.5 vs 3.0 ± 1.1 cm2, p <0.001), and slower LAA flow velocity (36 ± 19 vs 55 ± 20 cm/s, p <0.001). LAA flow velocity was negatively correlated with LAA orifice size (R = -0.48, p <0.001). After adjustment for multiple potential confounding factors including CHA2DS2-VASc score, persistent AF, and LA dimension, large LAA orifice area (odds ratio 6.16, 95% confidence interval 2.67 to 14.18, p <0.001) and slow LAA velocity (odds ratio 3.59, 95% confidence interval 1.42 to 9.08, p = 0.007) were found to be significant risk factors of stroke. In patients with LAA flow velocity <37.0 cm/s, patients with large LAA orifice (>3.5 cm2) had greater incidence of stroke than those with LAA orifice of ≤3.5 cm2 (75% vs 23%, p <0.001). In conclusion, LAA orifice enlargement was related to stroke risk in patients with nonvalvular AF even after adjustment for other risk factors, and it could be the cause of decreased flow velocity in LAA.
UR - http://www.scopus.com/inward/record.url?scp=84896699192&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84896699192&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2013.11.058
DO - 10.1016/j.amjcard.2013.11.058
M3 - Article
C2 - 24462064
AN - SCOPUS:84896699192
VL - 113
SP - 963
EP - 969
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 6
ER -