scholarly journals Clinical Significance of the Left Atrial Appendage Orifice Area

2022 ◽  
Author(s):  
Yusuke Miki ◽  
Yasuhiro Uchida ◽  
Akihito Tanaka ◽  
Akihiro Tobe ◽  
Keisuke Sakakibara ◽  
...  
Keyword(s):  
Clinical Significance ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Orifice Area

scholarly journals Left atrial appendage orifice area and morphology is closely associated with flow velocity in patients with nonvalvular atrial fibrillation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lei Chen ◽  
Changjiang Xu ◽  
Wensu Chen ◽  
Chaoqun Zhang
Keyword(s):  
Atrial Fibrillation ◽  
Flow Velocity ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Linear Regression Analysis ◽  
Left Ventricular ◽  
Atrial Appendage ◽  
Mechanical Function ◽  
Orifice Area ◽  
The Relationship

Abstract Background Thromboembolic events are the most serious complication of atrial fibrillation (AF), and the left atrial appendage (LAA) is the most important site of thrombosis in patients with AF. During the period of COVID-19, a non-invasive left atrial appendage detection method is particularly important in order to reduce the exposure of the virus. This study used CT three-dimensional reconstruction methods to explore the relationship between LAA morphology, LAA orifice area and its mechanical function in patients with non-valvular atrial fibrillation (NVAF). Methods A total of 81 consecutive patients with NVAF (36 cases of paroxysmal atrial fibrillation and 45 cases of persistent atrial fibrillation) who were planned to undergo catheter radiofrequency ablation were enrolled. All patients were examined by transthoracic echocardiography (TTE), TEE, and computed tomography angiography (CTA) before surgery. The LAA orifice area was obtained according to the images of CTA. According to the left atrial appendage morphology, it was divided into chicken wing type and non-chicken wing type. At the same time, TEE was performed to determine left atrial appendage flow velocity (LAAFV), and the relationship between the left atrial appendage orifice area and LAAFV was analyzed. Results The LAAFV in Non-chicken wing group was lower than that in Chicken wing group (36.2 ± 15.0 cm/s vs. 49.1 ± 22.0 cm/s, p-value < 0.05). In the subgroup analysis, the LAAFV in Non-chicken wing group was lower than that in Chicken wing group in the paroxysmal AF (44.0 ± 14.3 cm/s vs. 60.2 ± 22.8 cm/s, p-value < 0.05). In the persistent AF, similar results were observed (29.7 ± 12.4 cm/s vs. 40.8 ± 17.7 cm/s, p-value < 0.05). The LAAFV in persistent AF group was lower than that in paroxysmal AF group (34.6 ± 15.8 cm/s vs. 49.9 ± 20.0 cm/s, p-value < 0.001). The LAAFV was negatively correlated with left atrial dimension (R = − 0.451, p-value < 0.001), LAA orifice area (R= − 0.438, p-value < 0.001) and left ventricular mass index (LVMI) (R= − 0.624, p-value < 0.001), while it was positively correlated with LVEF (R = 0.271, p-value = 0.014). Multiple linear regression analysis showed that LAA morphology (β = − 0.335, p-value < 0.001), LAA orifice area (β = −  0.185, p-value = 0.033), AF type (β = − 0.167, p-value = 0.043) and LVMI (β = − 0.465, p-value < 0.001) were independent factors of LAAFV. Conclusions The LAA orifice area is closely related to the mechanical function of the LAA in patients with NVAF. The larger LAA orifice area and LVMI, Non-chicken wing LAA and persistent AF are independent predictors of decreased mechanical function of LAA, and these parameters might be helpful for better management of LA thrombosis.

scholarly journals Peri-Device Leaks after Percutaneous Left Atrial Appendage Closure: Clinical Significance and Unmet Diagnostic Needs

2020 ◽  
Vol 4 (6) ◽  
pp. 475-481
Author(s):  
Mazen Albaghdadi ◽  
Andrew Kadlec ◽  
Andrew Adler ◽  
Usman Siddiqui ◽  
Alexander Romanov ◽  
...  
Keyword(s):  
Clinical Significance ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Left Atrial Appendage Closure

scholarly journals Multimodality imaging and clinical significance of severe left atrial appendage hypoplasia

2020 ◽  
Vol 21 (8) ◽  
pp. 936-936
Author(s):  
Alberto Cresti ◽  
Mario Stricagnoli ◽  
Pasquale Baratta ◽  
Marco Solari ◽  
Ugo Limbruno
Keyword(s):  
Clinical Significance ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Multimodality Imaging ◽  
Atrial Appendage

scholarly journals Left Atrial Appendage Morphology and Function Show an Association with Stroke and Transient Ischemic Attack in Patients with Atrial Fibrillation

2021 ◽  
Author(s):  
Judit Simon ◽  
Jeff M. Smit ◽  
Mohamed El Mahdiui ◽  
Lili Száraz ◽  
Alexander R. van Rosendael ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Flow Velocity ◽  
Transient Ischemic Attack ◽  
Left Atrial ◽  
Cardiac Ct ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Orifice Area ◽  
Ischemic Attack ◽  
And Function

Abstract BackgroundWe aimed to correlate left atrial appendage (LAA) structure and function with the history of stroke/transient ischemic attack (TIA) in patients with atrial fibrillation (AF).MethodsWe analyzed data of 649 patients with AF who were scheduled for catheter ablation. Patients underwent cardiac CT and transesophageal echocardiography prior to ablation. LAA morphologies depicted by cardiac CT were categorized into four groups: cauliflower, chicken wing, swan and windsock shapes. ResultsMean age was 61.3±10.5 years, 33.9% were female. Prevalence of stroke/TIA was 7.1%. After adjustment for the main risk factors, LAA flow velocity ≤35.3 cm/sec (OR=2.18; 95%CI=1.09-4.61; p=0.033) and swan LAA shape (OR=2.69; 95%CI=0.96-6.86; p=0.047) independently associated with higher, while windsock LAA morphology with lower risk of stroke/TIA (OR=0.32; 95%CI=0.12-0.77; p=0.017) as compared to cauliflower LAA shape. When comparing the differences between LAA morphology groups, we measured significantly smaller LAA orifice area (389.3±137.7 mm2 in windsock vs 428.3±158.9 ml in cauliflower, p=0.021) and LAA volume (7.4±3.0 mm2 in windsock vs 8.5±4.8 mm2 in cauliflower, p=0.012) in patients with windsock LAA morphology, while LAA flow velocity did not differ significantly. ConclusionReduced LAA function and swan LAA morphology were independently associated with higher, while windsock LAA shape with lower prevalence of stroke/TIA. When comparing the differences between the various LAA morphology types, significantly lower LAA volume and LAA orifice area were measured in windsock LAA shape as compared to cauliflower LAA shape.

scholarly journals Left Atrial Appendage Orifice Area and Morphology is Closely Associated with Flow Velocity in Patients with Nonvalvular Atrial Fibrillation

2021 ◽  
Author(s):  
Lei Chen ◽  
Changjiang Xu ◽  
Wensu Chen ◽  
Chaoqun Zhang
Keyword(s):  
Atrial Fibrillation ◽  
Flow Velocity ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Linear Regression Analysis ◽  
Atrial Appendage ◽  
Mechanical Function ◽  
Orifice Area ◽  
Reconstruction Methods ◽  
The Relationship

Abstract Background Thromboembolic events are the most serious complication of atrial fibrillation (AF), and the left atrial appendage (LAA) is the most important site of thrombosis in patients with atrial fibrillation. During the period of COVID-19, a non-invasive left atrial appendage detection method is particularly important in order to reduce the exposure of the virus. This study used CT three-dimensional reconstruction methods to explore the relationship between LAA morphology, LAA orifice area and its mechanical function in patients with non-valvular atrial fibrillation(NVAF).Methods A total of 81 consecutive patients with NVAF (36 cases of paroxysmal atrial fibrillation and 45 cases of persistent atrial fibrillation) who were planned to undergo catheter radiofrequency ablation were enrolled. All patients were examined by transthoracic echocardiography (TTE), TEE, and computed tomography angiography (CTA) before surgery. The LAA orifice area was obtained according to the images of CTA. According to the left atrial appendage morphology, it was divided into chicken wing type and non-chicken wing type. At the same time, TEE was performed to determine left atrial appendage flow velocity (LAAFV), and the relationship between the left atrial appendage orifice area and LAAFV was analyzed.Results The LAAFV in Non-chicken wing group was lower than that in Chicken wing group (36.2±15.0cm/s vs. 49.1±22.0 cm/s, P<0.05). In the subgroup analysis, the LAAFV in Non-chicken wing group was lower than that in Chicken wing group in the paroxysmal AF (44.0±14.3cm/s vs. 60.2±22.8cm/s, P<0.05); In the persistent AF, similar results were observed (29.7±12.4 cm/s vs. 40.8±17.7 cm/s, P<0.05). The LAAFV in persistent AF group was lower than that in paroxysmal AF group (34.6±15.8 cm/s vs. 49.9±20.0 cm/s, P<0.001). The LAAFV was negatively correlated with left atrial dimension (R=-0.451, P<0.001) and LAA orifice area (R=-0.438, P<0.001), while it was positively correlated with LVEF (R=0.271, P<0.001). Multiple linear regression analysis showed that LAA morphology (β=-0.319, P<0.001), LAA orifice area (β=-0.219, P=0.030), AF type ( β=-0.283, P=0.003) and left atrial diameter (LAD) (β=-0.241, P=0.018) were independent predictors of LAAFV.Conclusion The LAA orifice area is closely related to the mechanical function of the LAA in patients with NVAF. The larger LAA orifice area and LAD, Non-chicken wing LAA and persistent AF are independent predictors of decreased mechanical function of the left atrial appendage.

Abstract 1869: Real-Time Three-Dimensional Echocardiography of the Left Atrial Appendage: Initial Experience in Humans with Validation by 64-Slice Computed Tomography

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Sanjiv J Shah ◽  
Dianna M Bardo ◽  
Lynn Weinert ◽  
Lissa Sugeng ◽  
Bradley P Knight ◽  
...  
Keyword(s):  
Real Time ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Three Dimensional ◽  
Frame Rate ◽  
Atrial Appendage ◽  
Orifice Diameter ◽  
Orifice Area ◽  
2D And 3D ◽  
2D Images

Background: Real-time left atrial appendage (LAA) quantification is increasingly important with the advent of LAA occluder devices for stroke prevention. However, accurate quantification is difficult using 2D-TEE because measurements must be made in multiple views, and LAA orifice cannot be viewed directly. We aimed to determine the accuracy of LAA geometry measured by a new matrix-array (mTEE) probe which can provide unique real-time 3D (RT3D) views of the LAA. Methods: 29 consecutive patients (age 53±18) referred for 2D-TEE underwent additional RT3D-mTEE (Philips ie33; frame rate 8–10/s). The LAA orifice diameter and LAA depth were measured from biplane 2D images, and 2D LAA orifice area was calculated as an ellipse. LAA orifice area and LAA depth were measured in 3D and correlated to 2D. In 8 patients who had cardiac CT available, 2D- and 3D-TEE LAA measurements were correlated with 64-slice CT. All LAA measurements were made at atrial end-diastole. Results: All 29 patients underwent RT3D-mTEE without complication. The LAA was well-visualized in 3D in 26/29 (90%). Because the shape of the LAA orifice in 3D was an ellipsoid with an irregular contour, 2D images resulted in underestimation of area vs. 3D (3.0±1.2 vs. 4.2±2.2 cm 2 ). LAA depth by 2D and 3D correlated well (3.7±0.7 vs. 3.4±0.7; r=0.72, p=0.001). CT LAA orifice area correlated well with 3D-TEE (r=0.98, p<0.0001) but not with 2D-TEE (p=0.78). Conclusions: RT3D-TEE for analysis of LAA geometry is safe and feasible and appears to be more accurate than 2D-TEE. RT3D-TEE provides unique visualization of the LAA orifice in real-time, making it the ideal tool for intra-procedural sizing and placement of LAA occluder devices.

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