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Why Is Left Atrial Appendage Morphology Related to Strokes? An Analysis of the Flow Velocity and Orifice Size of the Left Atrial Appendage

Authors
 JUNG MYUNG LEE  ;  JIWON SEO  ;  JAE-SUN UHM  ;  YOUNG JIN KIM  ;  HYE-JEONG LEE  ;  JONG-YOUN KIM  ;  JUNG-HOON SUNG  ;  HUI-NAM PAK  ;  MOON-HYOUNG LEE  ;  BOYOUNG JOUNG 
Citation
 JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Vol.26(9) : 922-927, 2015 
Journal Title
 JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY 
ISSN
 1045-3873 
Issue Date
2015
Keywords
atrial fibrillation ; flow velocity ; left atrial appendage ; morphology ; stroke
Abstract
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 cm2 , 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 cm2 , 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.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/jce.12710/abstract
DOI
10.1111/jce.12710
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
Kim, Jong Youn(김종윤) ORCID logo https://orcid.org/0000-0001-7040-8771
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Seo, Jiwon(서지원) ORCID logo https://orcid.org/0000-0002-7641-3739
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/22282913/157103
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