Body mass index and risk of left atrial thrombus in patients with atrial fibrillation.
Body mass index and risk of left atrial thrombus in patients with atrial fibrillation.
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DOI：
10.1016/j.amjcard.2009.07.054
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发表时间：
2009-12-15
影响因子：
2.8
通讯作者：
Ma, Chang-Sheng
中科院分区：
文献类型：
--
作者：
Tang, Ri-Bo;Liu, Xiao-Hui;Kalifa, Jerome;Li, Zhi-An;Dong, Jian-Zeng;Yang, Ya;Liu, Xing-Peng;Long, De-Yong;Yu, Rong-Hui;Ma, Chang-Sheng
本研究旨在评估体重指数（BMI）对房颤（AF）患者导管消融术前左心房（LA）/左心耳（LAA）血栓风险的影响。从2007年1月至2008年3月，入组了433例连续的非瓣膜性房颤患者。排除了心脏瓣膜病、深静脉血栓形成或肺栓塞患者。所有患者均接受经食管超声心动图检查。433例患者中有26例（6.0%）患有LA/LAA血栓，血栓患者的BMI显著较高（27.9 ± 3.1 vs 26.0 ± 3.3 kg/m2，p = 0.005）。BMI预测血栓的受试者工作特征曲线下面积为0.662。以27.0 kg/m2为临界点，BMI诊断血栓的敏感性和特异性分别为69.2%和83.1%。BMI >27.0 kg/m2的患者LA/LAA血栓的发生率为10.6%，而BMI <27.0 kg/m2的患者仅为3.0%（p = 0.001）。在多变量分析中，BMI ≥27.0 kg/m2（比值比4.02，95%置信区间1.19 - 13.55，p = 0.025）、心力衰竭、高血压、年龄、糖尿病、卒中加倍评分≥2和非阵发性AF是LA/LAA血栓的独立风险因素。总之，BMI ≥27.0 kg/m2是AF患者LA/LAA血栓的独立危险因素。
This study sought to assess the impact of body mass index (BMI) on the risk of left atrial (LA)/left atrial appendage (LAA) thrombus in patients with atrial fibrillation (AF) before catheter ablation. From January 2007 to March 2008, 433 consecutive patients with nonvalvular AF were enrolled. Patients with valvular heart disease, deep vein thrombosis, or pulmonary embolism were excluded. All patients underwent transesophageal echocardiography. Twenty-six of 433 patients (6.0%) had LA/LAA thrombus and the patients with thrombus had a significantly higher BMI (27.9 ± 3.1 vs 26.0 ± 3.3 kg/m2, p = 0.005). The area under the receiver operating characteristic curve of BMI predicting thrombus was 0.662. With a cut-off point of 27.0 kg/m2, the sensitivity and specificity of BMI for the diagnosis of thrombus were 69.2% and 83.1%, respectively. The incidence of LA/LAA thrombus was 10.6% in patients with BMI >27.0 kg/m2 versus only 3.0% for patients with BMI <27.0 kg/m2 (p = 0.001). In multivariable analysis, BMI ≥27.0 kg/m2 (odds ratio 4.02, 95% confidence interval 1.19 to 13.55, p = 0.025), Cardiac Failure, Hypertension, Age, Diabetes, Stroke Doubled score ≥2, and nonparoxysmal AF were independent risk factors of LA/LAA thrombus. In conclusion, BMI ≥27.0 kg/m2 is an independent risk factor of LA/LAA thrombus in patients with AF.
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影响因子：
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