Left atrial appendage orifice morphology in sickness and in health.

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Herz Pub Date : 2024-10-16 DOI:10.1007/s00059-024-05277-8

Akbulut Muge, Tan Kürklü Seda, Gulyigit Halil, Ozerdem Emre, Kozluca Volkan, Esenboga Kerim, Baskovski Emir, Demirtola Ayse Irem, Tekin Cemre, Dincer Irem

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引用次数: 0

Abstract

Background: The left atrial appendage (LAA) is the primary site of embolism in individuals with atrial fibrillation (AF). We aimed to evaluate the morphological features of the LAA orifice in patients with sinus rhythm, paroxysmal AF, and persistent AF using three-dimensional (3D) transesophageal echocardiography (TOE). We also intended to identify morphometric parameters of the LAA orifice that may be potentially associated with an increased risk of ischemic stroke.

Methods: We prospectively enrolled 106 patients undergoing TOE. Patients were divided into three groups: group 1 (sinus rhythm), group 2 (persistent AF), and group 3 (paroxysmal AF). All patients underwent a comprehensive evaluation through transthoracic echocardiography (TTE) and TOE. Off-line analyses were performed of the recorded images.

Results: The LAA minor orifice area and minimal orifice diameter were greater in patients with persistent AF compared with individuals in sinus rhythm. Patients with persistent AF also had deeper LAAs compared with those in sinus rhythm. None of the LAA orifice morphometric measures were related to ischemic stroke risk. The only independent predictors of ischemic stroke were heart rhythm and the CHA₂DS₂VASc score.

Conclusion: Persistent AF is associated with LAA dilation, increased depth, and larger orifice size. To our knowledge, this is the first study to demonstrate LAA orifice structural remodeling in patients with AF using 3D TOE.

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疾病和健康状态下的左心房阑尾口形态。

背景：左心房阑尾（LAA）是心房颤动（AF）患者栓塞的主要部位。我们旨在使用三维（3D）经食道超声心动图（TOE）评估窦性心律、阵发性房颤和持续性房颤患者 LAA 孔口的形态特征。我们还打算确定可能与缺血性中风风险增加有关的 LAA 口形态参数：我们前瞻性地招募了 106 名接受 TOE 检查的患者。患者分为三组：第一组（窦性心律）、第二组（持续性房颤）和第三组（阵发性房颤）。所有患者都接受了经胸超声心动图 (TTE) 和 TOE 的全面评估。对记录的图像进行离线分析：结果：与窦性心律患者相比，持续性房颤患者的 LAA 小口面积和最小口直径更大。与窦性心律患者相比，持续性房颤患者的 LAA 也更深。LAA 孔口形态计量指标均与缺血性卒中风险无关。缺血性中风的唯一独立预测因素是心律和 CHA2DS2VASc 评分：结论：持续性房颤与 LAA 扩张、深度增加和孔径增大有关。据我们所知，这是第一项使用三维 TOE 显示房颤患者 LAA 腔口结构重塑的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Herz 医学-心血管系统

CiteScore

3.00

自引率

5.90%

发文量

审稿时长

4-8 weeks

期刊介绍： Herz is the high-level journal for further education for all physicians interested in cardiology. The individual issues of the journal each deal with specific topics and comprise review articles in English and German written by competent and esteemed authors. They provide up-to-date and comprehensive information concerning the speciality dealt with in the issue. Due to the fact that all relevant aspects of the pertinent topic of an issue are considered, an overview of the current status and progress in cardiology is presented. Reviews and original articles round off the spectrum of information provided.