Current medical science · 2021
A Potential Novel Indication for Preventing Thromboembolism in Patients with Atrial Arrhythmias: Remodeling of the Left Atrium.
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Liu Chen, Liu Shuang, Li Hui, Guo Yu-Long
Аннотация
OBJECTIVE: Thrombosis in patients with atrial arrhythmias might be associated with remodeling of the left atrium (LA). We aimed to describe this relationship and identify a novel factor, in addition to the CHA2DS2-VASc score, to guide therapeutic strategies for preventing thromboembolism in the hope of improving the prognosis for such patients.
METHODS: Patients diagnosed with atrial arrhythmias and who met our inclusion criteria were enrolled in this study. Various clinical parameters were recorded; diameters reflecting remodeling of the LA were measured and thrombosis was diagnosed by enhanced CT.
RESULTS: Totally, 192 patients were enrolled in the study. The overall prevalence of left atrial thrombosis was 8.3%. Patients with persistent atrial fibrillation exhibited the highest anteroposterior diameter of the LA (45.1±7.2 mm) and prevalence of thrombosis (15.6%). An anteroposterior LA diameter of ≥50 mm was a strong independent impact risk factor for thrombosis (OR=10.1, 95%CI: 2.8-36.9, P<0.001). The prevalence of LA thrombosis in patients with and without anteroposterior LA diameter of ≥50 mm was 25.8% and 5.0%, respectively.
CONCLUSION: Marked remodeling of the LA characterized by an anteroposterior LA diameter of ≥50 mm is a strong independent risk factor of thrombosis, and should be considered for the prevention of thromboembolism through various strategies.
METHODS: Patients diagnosed with atrial arrhythmias and who met our inclusion criteria were enrolled in this study. Various clinical parameters were recorded; diameters reflecting remodeling of the LA were measured and thrombosis was diagnosed by enhanced CT.
RESULTS: Totally, 192 patients were enrolled in the study. The overall prevalence of left atrial thrombosis was 8.3%. Patients with persistent atrial fibrillation exhibited the highest anteroposterior diameter of the LA (45.1±7.2 mm) and prevalence of thrombosis (15.6%). An anteroposterior LA diameter of ≥50 mm was a strong independent impact risk factor for thrombosis (OR=10.1, 95%CI: 2.8-36.9, P<0.001). The prevalence of LA thrombosis in patients with and without anteroposterior LA diameter of ≥50 mm was 25.8% and 5.0%, respectively.
CONCLUSION: Marked remodeling of the LA characterized by an anteroposterior LA diameter of ≥50 mm is a strong independent risk factor of thrombosis, and should be considered for the prevention of thromboembolism through various strategies.