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Characteristics of pulmonary vein enlargement in non-valvular atrial fibrillation patients with stroke.

Authors
 Jung Myung Lee  ;  Jong-Youn Kim  ;  Jaemin Shim  ;  Jae-Sun Uhm  ;  Young Jin Kim  ;  Hye-Jeong Lee  ;  Hui-Nam Pak Moon-Hyoung Lee  ;  Boyoung Joung 
Citation
 Yonsei Medical Journal, Vol.55(6) : 1516-1525, 2014 
Journal Title
 Yonsei Medical Journal 
ISSN
 0513-5796 
Issue Date
2014
MeSH
Aged ; Atrial Appendage/diagnostic imaging* ; Atrial Appendage/physiopathology ; Atrial Fibrillation/complications* ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/physiopathology ; Atrial Function, Right/physiology* ; Female ; Heart Atria ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography/methods* ; Multivariate Analysis ; Odds Ratio ; Predictive Value of Tests ; Prognosis ; Pulmonary Veins/diagnostic imaging* ; Pulmonary Veins/physiopathology ; Stroke/diagnosis ; Stroke/etiology* ; Tomography, X-Ray Computed/methods
Keywords
Atrial fibrillation ; atrial appendage ; multidetector computed tomography ; pulmonary veins ; stroke
Abstract
PURPOSE: The association between pulmonary vein (PV) dilatation and stroke in non-valvular atrial fibrillation (AF) patients remains unknown. MATERIALS AND METHODS: We examined the left atrium (LA) and PV in control (n=138) and non-valvular AF patients without (AF group, n=138) and with non-hemorrhagic stroke (AF with stroke group, n=138) using computed tomography. RESULTS: The LA, LA appendage (LAA), and all PVs were larger in the AF than control patients. The orifice areas of the LAA (5.6±2.2 cm² vs. 4.7±1.7 cm², p<0.001), left superior PV (3.8±1.5 cm² vs. 3.4±1.2 cm², p=0.019), and inferior PV (2.3±1.0 cm² vs. 1.8±0.7 cm², p<0.001) were larger in the AF with stroke than in the AF only group. However, right PVs were not different between the two groups. In a multivariate analysis, the orifice areas of the left superior PV [odds ratio (OR) 1.25, 95% confidence interval (CI) 1.03-1.51, p=0.02], left inferior PV (OR 1.97, 95% CI 1.41-2.75, p<0.001), and LAA (OR 1.30, 95% CI 1.13-1.50, p<0.001) were independent predictors of stroke. CONCLUSION: Compared to the right PVs, the left PVs and LAA exhibited more significant enlargement in patients with AF and stroke than in patients with AF only. This finding suggests that the remodeling of left-sided LA structures might be related to stroke.
Files in This Item:
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DOI
10.3349/ymj.2014.55.6.1516
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Shim, Jae Min(심재민)
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Lee, Moon Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Lee, Jung Myung(이정명)
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100267
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