Computed tomography‐derived left atrial volume index, sex, and age to predict the presence and the extent of left atrial low‐voltage zones in patients with atrial fibrillation: The ZAQ score

2020 ◽  
Vol 31 (4) ◽  
pp. 895-902 ◽  
Author(s):  
Gabriele D'Ambrosio ◽  
Silvio Romano ◽  
Obaida Alothman ◽  
Markus Frommhold ◽  
Georgi Borisov ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Atrial Fibrillation ◽  
Left Atrial ◽  
Low Voltage ◽  
Left Atrial Volume ◽  
Volume Index ◽  
Atrial Volume ◽  
Left Atrial Volume Index

scholarly journals Predicting Left Atrial Appendage Thrombus from Left Atrial Volume and Confirmation by Computed Tomography with Delayed Enhancement

2020 ◽  
Vol 47 (2) ◽  
pp. 78-85
Author(s):  
Kazuhiro Osawa ◽  
Rine Nakanishi ◽  
Indre Ceponiene ◽  
Negin Nezarat ◽  
William J. French ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Cardiac Computed Tomography ◽  
Left Atrial Volume ◽  
Atrial Appendage ◽  
Volume Index ◽  
Atrial Volume ◽  
Left Atrial Appendage Thrombus

Assessing thromboembolic risk is crucial for proper management of patients with atrial fibrillation. Left atrial volume is a promising predictor of cardiac thrombosis. To determine whether left atrial volume can predict left atrial appendage thrombus in patients with atrial fibrillation, we conducted a prospective study of 73 patients. Left atrial and ventricular volumes were evaluated by cardiac computed tomography with retrospective electrocardiographic gating and then indexed to body surface area. Left atrial appendage thrombus was confirmed or excluded by cardiac computed tomography with delayed enhancement. Seven patients (9.6%) had left atrial appendage thrombus; 66 (90.4%) did not. Those with thrombus had a significantly higher mean left atrial end-systolic volume index (139 ± 55 vs 101 ± 35 mL/m2; P =0.0097) and mean left atrial end-diastolic volume index (122 ± 45 vs 84 ± 34 mL/m2; P =0.0077). On multivariate logistic regression analysis, left atrial end-systolic volume index (per 10 mL/m2 increase) was significantly associated with left atrial appendage thrombus (odds ratio [OR]=1.24; 95% CI, 1.03–1.50; P =0.02); so too was the left atrial end-diastolic volume index (per 10 mL/m2 increase) (OR=1.29; 95% CI, 1.05–1.60; P =0.02). These findings suggest that increased left atrial volume increases the risk of left atrial appendage thrombus. Therefore, patients with atrial fibrillation and an enlarged left atrium should be considered for cardiac computed tomography with delayed enhancement to confirm whether thrombus is present.

Very Small Left Atrial Volume as a Marker for Mortality in Patients Undergoing Nongated Computed Tomography Pulmonary Angiography

Cardiology ◽  
2017 ◽  
Vol 139 (1) ◽  
pp. 62-69 ◽  
Author(s):  
Zach Rozenbaum ◽  
Yoav Granot ◽  
Paul Turkeltaub ◽  
Dotan Cohen ◽  
Tomer Ziv-Baran ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Volumetric Analysis ◽  
Pulmonary Angiography ◽  
Volume Index ◽  
Study Cohort ◽  
Atrial Volume ◽  
Computed Tomography Pulmonary Angiography ◽  
Left Atrial Volume Index

Objectives: To evaluate the association between very small left atria (VSLA) on nongated computed tomography pulmonary angiography (CTPA) and mortality in patients without pulmonary embolism (PE). Methods: Patients who underwent nongated CTPA between 2011 and 2015 in order to rule out PE, and had an echocardiogram within 24 h of the CTPA, were retrospectively identified. The left atrial volume of nongated CTPA was calculated using automatic 4-chamber volumetric analysis software. The association between the lowest 5th percentile of the left atrial volume index, referred to as the VSLA group, and mortality was investigated after adjustment for age, gender, background diseases, and laboratory values. Results: The study cohort included 241 patients. Patients with VSLA had a left atrial volume index <24 mL/m2 (n = 11). Demographics and background diseases did not differ between the study groups. The median follow-up was 22.7 months (IQR 0.03-54.3). VSLA was an independent predictor of mortality (HRadj = 3.6; 95% CI 1.46-8.87; p = 0.005), along with malignancy (HRadj = 2.28; 95% CI 1.32-3.93; p = 0.003) and lower hemoglobin (HRadj = 0.86; 95% CI 0.76-0.99; p = 0.032). Conclusions: Our findings suggest that VSLA on nongated CTPA may serve as a marker for mortality. The use of CTPA volumetric analysis can help risk stratification in patients with dyspnea and no PE.

scholarly journals ASSOCIATION OF ATRIAL FIBRILLATION AND LEFT ATRIAL VOLUME INDEX WITH MORTALITY IN PATIENTS WITH COVID-19 PNEUMONIA

2020 ◽  
Author(s):  
Antonello D Andrea ◽  
Vincenzo Russo ◽  
Gianluca Manzo ◽  
Valerio Giordano ◽  
Marco Di Maio ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Volume Index ◽  
Atrial Volume ◽  
Left Atrial Volume Index

Abstract 15589: Relationship Between Left Atrial Volume Index and Left Atrial Appendage Function in Patients With Non-Valvular Atrial Fibrillation and a Cha2ds2-vasc Score of 0-1

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Keisuke Minami ◽  
Masaki Izumo ◽  
Kihei Yoneyama ◽  
Yoshihiro J Akashi
Keyword(s):  
Atrial Fibrillation ◽  
Flow Velocity ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Low Risk ◽  
Low Flow ◽  
Volume Index ◽  
Atrial Volume ◽  
Left Atrial Volume Index ◽  
Flow Group

Introduction: The management of patients with non-valvular atrial fibrillation (NVAF) and low CHA2DS2-VASc scores remains controversial. Left atrial appendage (LAA) function is a known risk factor for embolisms. Hypothesis: In this study, we aimed to investigate the value of the relationship between transthoracic echocardiography (TTE) parameters and LAA function in low-risk (CHA2DS2-VASc score, 0-1) patients with NVAF. Methods: This retrospective study included 370 consecutive patients with NVAF who underwent both TTE and transesophageal echocardiography (TEE). The LAA emptying flow velocity was assessed using TEE. We established that an LAA emptying flow velocity of <25 cm/s was associated with a high risk of thrombus formation. Results: Of the 370 patients, 146 (40%) had a CHA2DS2-VASc score of 0-1. These patients with low-risk NVAF were further stratified into the low-flow (LAA emptying flow velocity < 25 cm/s, n = 19) and normal-flow (LAA emptying flow velocity ≥ 25 cm/s, n = 127) groups according to LAA function (atrial fibrillation during TEE: n = 63). The age, gender, CHA2DS2-VASc score, and left ventricular ejection fraction did not differ between the two groups. The low-flow group had a significantly greater left atrial volume index (LAVI) than the normal-flow group (51.6 ± 19.8 vs. 32.3 ± 12.1 ml/m2, p < 0.01). A LAVI of 37.8 ml/m2 predicted a LAA emptying flow velocity of <25 cm/s with a sensitivity of 73% and specificity of 83% among patients with low-risk atrial fibrillation (area under the curve, 0.818, p < 0.001, Figure). Conclusions: Approximately 13% of patients with NVAF and CHA2DS2-VASc score of 0-1 had reduced LAA emptying flow velocity as well as left atrial enlargement. The use of LAVI may improve the current embolism risk stratification system among these patients.

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