Cited 38 times in
Additional value of left atrial appendage geometry and hemodynamics when considering anticoagulation strategy in patients with atrial fibrillation with low CHA2DS2-VASc scores
DC Field | Value | Language |
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dc.contributor.author | 박희남 | - |
dc.contributor.author | 엄재선 | - |
dc.contributor.author | 이문형 | - |
dc.contributor.author | 정보영 | - |
dc.date.accessioned | 2018-07-20T07:58:53Z | - |
dc.date.available | 2018-07-20T07:58:53Z | - |
dc.date.issued | 2017 | - |
dc.identifier.issn | 1547-5271 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/160726 | - |
dc.description.abstract | BACKGROUND: Strokes occur in some patients with atrial fibrillation (AF), even when the CHA2DS2-VASc (congestive heart failure, hypertension, age >75 years, diabetes mellitus, prior stroke or transient ischemic attack, vascular disease, age>65 years, female sex) score is low. OBJECTIVE: We sought to determine the factors defining the residual stroke risk in patients with AF and low CHA2DS2-VASc scores, with a particular focus on the hemodynamics and geometry of the left atrial appendage (LAA). METHODS: From February 1, 2008 to December 31, 2012, 66 consecutive patients with nonvalvular AF and a CHA2DS2-VASc score of 0 or 1 (except a point for the female sex) were enrolled. All patients were admitted with a diagnosis of acute ischemic stroke. The control group consisted of patients with nonvalvular AF without a history of stroke. RESULTS: The LAA orifice area was larger (4.35 ± 1.51 cm2 vs 2.83 ± 0.9 cm2; P < .001) and the LAA flow velocity was lower (41.9 ± 22.7 cm/s vs 54.4 ± 19.9 cm/s; P < .001) in the stroke group than in the control group. Low LAA flow velocity (<40 cm/s) and large LAA orifice area (>4 cm2) were independent predictors of stroke. Patients with an LAA flow velocity of <40 cm/s and an LAA orifice of >4.0 cm2 had a markedly higher odds ratio (odds ratio 10.9; 95% confidence interval 3.0-40.0; P < .001) of stroke than did those with preserved LAA flow velocity and smaller LAA orifice.CLUSION: Even in patients with low CHA2DS2-VASc scores, the presence of both decreased LAA flow velocity and increased LAA orifice size was associated with a high odds ratio of stroke. Future large prospective studies are needed to assess whether these patients should receive anticoagulants. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | Elsevier | - |
dc.relation.isPartOf | HEART RHYTHM | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.rights | https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ | - |
dc.subject.MESH | Aged | - |
dc.subject.MESH | Anticoagulants/therapeutic use* | - |
dc.subject.MESH | Atrial Appendage/diagnostic imaging* | - |
dc.subject.MESH | Atrial Fibrillation/drug therapy | - |
dc.subject.MESH | Atrial Fibrillation/physiopathology* | - |
dc.subject.MESH | Atrial Fibrillation/surgery | - |
dc.subject.MESH | Brain/diagnostic imaging | - |
dc.subject.MESH | Brain Ischemia/epidemiology | - |
dc.subject.MESH | Brain Ischemia/etiology | - |
dc.subject.MESH | Brain Ischemia/prevention & control* | - |
dc.subject.MESH | Catheter Ablation | - |
dc.subject.MESH | Echocardiography, Transesophageal | - |
dc.subject.MESH | Female | - |
dc.subject.MESH | Follow-Up Studies | - |
dc.subject.MESH | Hemodynamics/physiology* | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Incidence | - |
dc.subject.MESH | Male | - |
dc.subject.MESH | Middle Aged | - |
dc.subject.MESH | Multidetector Computed Tomography | - |
dc.subject.MESH | Prognosis | - |
dc.subject.MESH | Prospective Studies | - |
dc.subject.MESH | Republic of Korea/epidemiology | - |
dc.subject.MESH | Retrospective Studies | - |
dc.subject.MESH | Risk Assessment* | - |
dc.subject.MESH | Risk Factors | - |
dc.title | Additional value of left atrial appendage geometry and hemodynamics when considering anticoagulation strategy in patients with atrial fibrillation with low CHA2DS2-VASc scores | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine | - |
dc.contributor.department | Dept. of Internal Medicine | - |
dc.contributor.googleauthor | Jung Myung Lee MD | - |
dc.contributor.googleauthor | Jin-Bae Kim | - |
dc.contributor.googleauthor | Jae-Sun Uhm | - |
dc.contributor.googleauthor | Hui-Nam Pak | - |
dc.contributor.googleauthor | Moon-Hyoung Lee | - |
dc.contributor.googleauthor | Boyoung Joung | - |
dc.identifier.doi | 10.1016/j.hrthm.2017.05.034 | - |
dc.contributor.localId | A01776 | - |
dc.contributor.localId | A02337 | - |
dc.contributor.localId | A02766 | - |
dc.contributor.localId | A03609 | - |
dc.relation.journalcode | J00980 | - |
dc.identifier.eissn | 1556-3871 | - |
dc.identifier.pmid | 28559088 | - |
dc.identifier.url | https://www.sciencedirect.com/science/article/pii/S1547527117306483 | - |
dc.subject.keyword | Atrial fibrillation | - |
dc.subject.keyword | Flow velocity | - |
dc.subject.keyword | Left atrial appendage size | - |
dc.subject.keyword | Low CHA(2)DS(2)-VASc score | - |
dc.subject.keyword | Risk factors for stroke | - |
dc.contributor.alternativeName | Pak, Hui Nam | - |
dc.contributor.alternativeName | Uhm, Jae Sun | - |
dc.contributor.alternativeName | Lee, Moon Hyoung | - |
dc.contributor.alternativeName | Joung, Bo Young | - |
dc.contributor.affiliatedAuthor | Pak, Hui Nam | - |
dc.contributor.affiliatedAuthor | Uhm, Jae Sun | - |
dc.contributor.affiliatedAuthor | Lee, Moon Hyoung | - |
dc.contributor.affiliatedAuthor | Joung, Bo Young | - |
dc.citation.volume | 14 | - |
dc.citation.number | 9 | - |
dc.citation.startPage | 1297 | - |
dc.citation.endPage | 1301 | - |
dc.identifier.bibliographicCitation | HEART RHYTHM, Vol.14(9) : 1297-1301, 2017 | - |
dc.identifier.rimsid | 43228 | - |
dc.type.rims | ART | - |
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