Premium
Why Is Left Atrial Appendage Morphology Related to Strokes? An Analysis of the Flow Velocity and Orifice Size of the Left Atrial Appendage
Author(s) -
LEE JUNG MYUNG,
SEO JIWON,
UHM JAESUN,
KIM YOUNG JIN,
LEE HYEJEONG,
KIM JONGYOUN,
SUNG JUNGHOON,
PAK HUINAM,
LEE MOONHYOUNG,
JOUNG BOYOUNG
Publication year - 2015
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12710
Subject(s) - medicine , atrial fibrillation , cardiology , appendage , stroke (engine) , odds ratio , atrial appendage , confidence interval , body orifice , anatomy , mechanical engineering , sinus rhythm , engineering
Why Is Left Atrial Appendage Morphology Related to Strokes? Background A specific morphology of left atrial appendage (LAA) has been reported to be related to stroke in nonvalvular atrial fibrillation (AF) patients. However, the mechanism is not completely understood. This study evaluated whether a specific LAA morphology was related to stroke, and whether it was related to the change of flow velocity and size of LAA in AF patients. Methods The morphology, size, and flow velocity of LAA were evaluated in AF patients with ischemic strokes (stroke, n = 160) and age‐matched AF patients without ischemic strokes (control, n = 200). Results Compared with control, the stroke group had a larger LA dimension (4.5 ± 0.7 vs. 4.2 ± 0.6 cm, P < 0.001), larger LAA orifice area (5.3 ± 2.1 vs. 4.1 ± 1.7 cm 2 , P < 0.001), and slower LAA flow velocity (37 ± 19 vs. 51 ± 20 cm/s, P < 0.001). The stroke group had the chicken wing type less frequently than the control (34% vs. 50%, P = 0.003). After an adjustment for multiple potential confounding factors, the chicken wing type LAA had a decreased stroke risk (odds ratio 0.34, 95% confidence interval 0.14–0.84, P = 0.020). Patients with a chicken wing LAA had a smaller LAA orifice area (4.4 ± 1.6 vs. 4.9 ± 2.2 cm 2 , P = 0.013) and higher LAA velocity (55 ± 19 vs. 41 ± 20 cm/s, P < 0.001) than those with non‐chicken wing LAA. Conclusion A chicken wing type of LAA was related to the less incidence of stroke. Our results suggest that the relationship between a specific LAA morphology and stroke might be partially explained by the change of the size and flow velocity of LAA.