Left Atrial Appendage Morphology and Left Atrial Wall Thickness Are Associated with Cardio-Embolic Stroke.
Left Atrial Appendage Morphology and Left Atrial Wall Thickness Are Associated with Cardio-Embolic Stroke.
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DOI：
10.3390/jcm9123944
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发表时间：
2020-12-05
影响因子：
3.9
通讯作者：
Dichtl W
中科院分区：
文献类型：
--
作者：
Adukauskaite A;Barbieri F;Senoner T;Plank F;Knoflach M;Boehme C;Hintringer F;Mueller S;Bauer A;Feuchtner G;Dichtl W
背景房颤（AF）患者卒中风险分层的新标志物正在需求中。因此，我们旨在研究与无卒中对照组相比，房颤所致心源性栓塞（CE）卒中患者左心耳（LAA）和左心房（LA）形态学参数的相关性。研究方法：对2006年至2017年期间在158例患者（中位年龄65（54-73）岁，48.7%为女性）中进行的临床适应症心脏计算机断层扫描血管造影（CTA）检查进行了回顾性分析：将56例CE卒中患者与102例在性别、体重指数（BMI）和CHA 2DS 2-VASc评分方面无差异的对照患者进行了比较。结果如下：在根据CHA 2DS 2-VASc评分和左心房直径调整的多变量回归分析中，CE卒中与以下参数独立相关：风向袋左心房类型（OR 2.55; CI：1.04-6.26，p = 0.041），更大的肺叶数量（OR 1.54; CI：1.13-2.10，p = 0.006），左心耳口面积较大（OR 1.88; CI：1.38-2.55，p < 0.001）和左心房壁厚度（LAWT）在中部和右侧较大，在轴向平面内沿左心房前壁沿着测量（分别为OR 1.94; CI：1.26-3.0，p = 0.003和OR 1.57; CI：1.07-2.31，p = 0.021）。结论：风向袋型LAA、较大LAA叶数、较大LAA口和较大LAWT与CE卒中相关。这些CTA参数可以改善血栓栓塞性卒中的风险分层。
Background. New markers for stroke risk stratification in patients with atrial fibrillation (AF) are on demand. Hence, we aimed to investigate the association of left atrial appendage (LAA) and left atrium (LA) morphological parameters in patients with cardio-embolic (CE) stroke due to AF in comparison to controls without stroke. Methods: A retrospective analysis of cardiac computed tomography angiography (CTA) examinations performed between 2006 and 2017 for clinical indications in 158 patients (median age 65 (54–73) years, 48.7% females) was conducted: 56 patients with CE stroke were compared to 102 controls not differing in gender, body mass index (BMI) and CHA2DS2-VASc score. Results: On multivariable regression analysis adjusted for CHA2DS2-VASc score and LA diameter CE stroke was independently associated with the following parameters: windsock LAA type (OR 2.55; CI: 1.04–6.26, p = 0.041), a greater lobe number (OR 1.54; CI: 1.13–2.10, p = 0.006), a greater LAA ostium area (OR 1.88; CI: 1.38–2.55, p < 0.001) and a greater left atrium wall thickness (LAWT) in the middle and right part, measured along the anterior LA wall in the axial plane (respectively, OR 1.94; CI: 1.26–3.0, p = 0.003 and OR 1.57; CI: 1.07–2.31, p = 0.021). Conclusions: The windsock LAA type, a greater LAA lobe number, a larger LAA ostium and a greater LAWT are associated with CE stroke. These CTA parameters could improve risk stratification for thromboembolic stroke.
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影响因子：
5.5
作者：
Kimura, Takehiro;Takatsuki, Seiji;Fukuda, Keiichi
通讯作者：
Fukuda, Keiichi
影响因子：
39.2
作者：
MANNING, WJ;WEINTRAUB, RM;DOUGLAS, PS
通讯作者：
DOUGLAS, PS
影响因子：
3.3
作者：
Nagashima, Koichi;Okumura, Yasuo;Hirayama, Atsushi
通讯作者：
Hirayama, Atsushi
影响因子：
37.8
作者：
Benjamin, Emelia J.;Virani, Salim S.;Muntner, Paul
通讯作者：
Muntner, Paul
影响因子：
8.3
作者：
Lang, Clemens;Seyfang, Leonhard;Knoflach, Michael
通讯作者：
Knoflach, Michael