Left atrial appendage morphology predicts the formation of left atrial appendage thrombus

Autor:	Mohamed Metawee, Michael T Baker, Geoffrey Chidsey, Gregory F. Michaud, Christopher R. Ellis, Ricardo M. Lugo, Moore Benjamin Shoemaker, Arvindh Kanagasundram, Sara Negrotto, Robert N. Piana
Rok vydání:	2021
Předmět:	medicine.medical_specialty 030204 cardiovascular system & hematology Transesophageal echocardiogram Lower risk Ventricular Function Left 03 medical and health sciences 0302 clinical medicine Windsock Physiology (medical) Internal medicine Atrial Fibrillation medicine Humans Atrial Appendage cardiovascular diseases 030212 general & internal medicine Thrombus Stroke Ejection fraction medicine.diagnostic_test business.industry Stroke Volume Thrombosis Atrial fibrillation Odds ratio medicine.disease Cross-Sectional Studies cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Echocardiography Transesophageal
Zdroj:	Journal of Cardiovascular Electrophysiology. 32:1044-1052
ISSN:	1540-8167 1045-3873
DOI:	10.1111/jce.14922
Popis:	BACKGROUND Nonchicken wing left atrial appendage (LAA) morphology is associated with higher risk for stroke in patients with atrial fibrillation (AF) than chicken wing (CW) morphology. OBJECTIVE Assess whether LAA morphology predicts the formation of LAA thrombus independent of age, sex, presenting rhythm, left ventricular ejection fraction (LVEF), or anticoagulant use. METHODS A cross-sectional analysis was performed on patients prospectively enrolled in the Vanderbilt LAA Registry or presenting for transesophageal echocardiogram (TEE) between January 1, 2015, and November 1, 2017 (n = 306). Two physicians independently reviewed TEEs interpreted as having LAA thrombus. Determination of LAA morphology, ejection velocity, and presence of thrombus (n = 102) were based on 0°, 45°, 90°, and 135° TEE views. The control cohort (n = 204) included consecutive AF patients undergoing TEE without LAA thrombus. RESULTS LAA morphology in patients with LAA thrombus was: 35% windsock, 47% broccoli, and 12% CW. Windsock (odds ratio [OR], 4.0; 95% confidence interval [CI]: 1.7-9.3, p = .001) and broccoli (OR, 6.6; 95% CI: 2.6-16.6; p
Databáze:	OpenAIRE
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