0 170

Cited 1 times in

Clinical characteristics of complex aortic plaque in patients with non-valvular atrial fibrillation

Authors
 Pil-Sung Yang  ;  Tae-Hoon Kim  ;  Jae-Sun Uhm  ;  Jong-Youn Kim  ;  Boyoung Joung  ;  Moon-Hyoung Lee  ;  Hui-Nam Pak 
Citation
 INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol.230 : 85-90, 2017 
Journal Title
 INTERNATIONAL JOURNAL OF CARDIOLOGY 
ISSN
 0167-5273 
Issue Date
2017
MeSH
Aged ; Aortic Valve Stenosis/complications* ; Aortic Valve Stenosis/diagnosis* ; Atrial Fibrillation/complications* ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/surgery ; Catheter Ablation ; Cohort Studies ; Echocardiography, Transesophageal ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Plaque, Atherosclerotic/complications* ; Plaque, Atherosclerotic/diagnosis* ; Risk Assessment
Keywords
Atrial fibrillation ; CHA(2)DS(2)-VASc score ; Complex aortic plaque
Abstract
BACKGROUND: Although complex aortic plaque (CxAoP) is a component of the CHA2DS2-VASc score in patients with atrial fibrillation (AF), it is underestimated without detection by trans-esophageal echocardiogram (TEE). We have evaluated the incidence and significance of CxAoP among patients with non-valvular AF (NVAF). METHODS: We included 981 patients with NVAF who underwent catheter ablation (59.1±11.1years old, 73.7% male, 70.2% paroxysmal AF). All of the patients underwent pre-procedural TEE evaluation. Left atrial (LA)-cardioembolic (CE) milieu was defined as a dense spontaneous echo-contrast or LA appendage flow velocity≤20cm/s. RESULTS: CxAoP was present in 8.3% of patients, and independently associated with age (OR 1.07, 95% CI 1.03-1.10, p<0.001), male sex (OR 2.34, 95% CI 1.29-4.24, p=0.005), and CHA2DS2-VASc score≥2 (OR 3.33, 95%CI 1.42-7.77, p=0.005). The presence of LA-CE milieu overlapped with CxAoP in only 11% of patients. Patients with CxAoP had a higher prevalence of hypertension (p=0.004), smoking history (p=0.008), paroxysmal AF (PAF, p<0.001), and a smaller LA volume index (p<0.001) than those with LA-CE milieu. The prevalence of persistent AF among patients with a history of stroke was significantly lower in the presence of CxAoP than in those with LA-CE milieu (p=0.014). CHA2DS2-VASc score was underestimated in 11% of high-risk patients (CHA2DS2-VASc score≥2) due to undetected CxAoP. CONCLUSIONS: CxAoP may contribute to the risk of stroke by a different mechanism than LA-CE milieu in patients with NVAF. Imaging assessment for CxAoP affects thromboembolic risk stratification and decision making for stroke prevention in patients with NVAF.
Full Text
http://www.sciencedirect.com/science/article/pii/S0167527316345648
DOI
10.1016/j.ijcard.2016.12.075
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jong Youn(김종윤) ORCID logo https://orcid.org/0000-0001-7040-8771
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Yang, Pil Sung(양필성)
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
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154311
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse