Open AccessTransesophageal echocardiographic thromboembolic risk is associated with smoking status in patients with atrial fibrillation
Author(s) -
Inao Kyoko,
Hirai Tadakazu,
Nakagawa Keiko,
Numa Satoshi,
Ohara Kazumasa,
Fukuda Nobuyuki,
Kinugawa Koichiro,
Inoue Hiroshi
Publication year - 2017
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/j.joa.2017.07.012
Subject(s) - medicine , atrial fibrillation , cardiology , stroke (engine) , risk factor , catheter ablation , engineering , mechanical engineering
Background Smoking is a risk factor for cardiovascular diseases, but it is unclear whether smoking status, including environmental tobacco smoke, increases stroke risk in patients with atrial fibrillation (AF). Abnormalities of the left atrium (LA) and aortic atherosclerosis, as detected by transesophageal echocardiography (TEE), are risk factors for stroke and thromboembolism in AF patients. We investigated the impact of smoking status on thromboembolic risk by TEE in patients with nonvalvular AF. Methods In 122 patients with AF (mean age, 63 years; chronic AF 50%) who underwent TEE before catheter ablation of AF or for detection of the potential cardioembolic source, urinary concentrations of cotinine and clinical variables including smoking status and the CHA 2 DS 2 ‐VASc score were determined. Results Severe aortic atherosclerosis and increased aortic wall thickness were more frequently detected by TEE in current smokers than in non‐smokers ( p <0.05), though these findings did not significantly differ between non‐smokers and environmental smokers. Patients in AF rhythm during TEE, who were environmental smokers and at relatively low risk, as stratified by their CHA 2 DS 2 ‐VASc score (≤ 2), showed lower LA appendage flow velocity than those without environmental smoking (47±22 vs. 34±13 cm/sec, p <0.05). Conclusions TEE findings indicated that smoking status could be associated with thromboembolic risk in patients with AF.