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BIBTEX RIS

Left atrial appendage morphology and silent cerebral ischemia in patients with atrial fibrillation

2013; Elsevier BV; Volume: 11; Issue: 1 Linguagem: Inglês

10.1016/j.hrthm.2013.10.020

ISSN

1556-3871

Autores

Matteo Anselmino, Marco Scaglione, Luigi Di Biase, Sebastiano Gili, Pasquale Santangeli, Laura Corsinovi, Martina Pianelli, Federico Cesarani, Riccardo Faletti, Dorico Righi, Andrea Natale, Fiorenzo Gaïta,

Tópico(s)

Cardiac Imaging and Diagnostics

Resumo

Background.Left atrial appendage (LAA) is the major source of cardiac thrombi in atrial fibrillation (AF) and plays a major role in cardioembolic events.Objective.To investigate the correlation between LAA morphology and the burden of silent cerebral ischemia (SCI) as a new thromboembolic risk marker in AF patients.Methods: 348 AF patients undergoing trans-catheter ablation were enrolled.A cerebral MR was performed to assess SCI burden, while LAA morphology was studied by magnetic resonance (MR) or computed tomography (CT) and categorized as: Cactus in 52 (14.9%) patients, ChickenWing in 177 (50.9%),WindSock in 101 (29.0%), and Cauliflower in 18 (5.2%).Results: SCIs were detected in 274 (84.8%) patients, with a median number of lesions of 23.SCI burden related to LAA complexity: 30.8% and 17.3% patients with Cactus, 30.5% and 22.0% with ChickenWing, 13.9% and 27.7% with Windsock, and 16.7% and 38.9% with Cauliflower LAA were in the first and fourth quartile of number of SCI per patient, respectively (p=0.035).Following adjustment for potential confounders, only age (beta 0.12, 95% CI 0.08-0.16;p<0.001),ChickenWing (beta [-0.28], 95%CI [-0.51]-[-0.04];p=0.021),WindSock (beta 0.38, 95%CI 0.12-0.65;p=0.005) and Cauliflower (beta 0.61, 95%CI 0.07-1.14;p=0.026)LAA morphologies significantly related to SCI burden. Conclusion.LAA morphology relates to the burden of SCI in AF patients.Future research should corroborate if accessible methods (e.g.echocardiography) are able to describe LAA morphology permitting its use within universal thromboembolic risk predictors in AF patients.

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