Correlation analysis for thrombosis risk in patients with paroxysmal atrial fibrillation by cardiac CT left atrial function parameters
ZHAO Tong
HUANG Jin-huan
LI Shi-xing
LI Jian
SHI Xiang-min
GUO Jian-ping
YUAN Hong-tao
SHAN Zhao-liang
Abstract：Objective To analyze the correlation between left atrial functional parameters measured by cardiac computed tomography(CT)and left atrial appendage(LAA)thrombus in patients with paroxysmal atrial fibrillation(PAF).Methods A total of 457 consecutive PAF patients scheduled for catheter ablation at Chinese PLA General Hospital from March 2016 to June 2020 were enrolled.According to the results of transesophageal echocardiography(TEE),the patients were divided into the LAA thrombus group(32 cases)and the non-thrombus group(425 cases).The clinical characteristics and the left cardiac functional parameters obtained by cardiac CT were statistically compared between the two groups.Logistic regression analysis was used to screen the influencing factors of LAA thrombus formation,and the receiver operating characteristic(ROC)curve was applied to evaluate their predictive efficacy.Results In terms of the clinical characteristics,compared with the non-thrombus group,the patients in the thrombus group were older and had a higher prevalence of chronic heart failure,with statistically significant differences.Regarding left cardiac functional parameters,the thrombus group had significantly larger values in left ventricular diameter(LVD)[(45.76±4.48)mm vs.(47.59±4.49)mm,P=0.026],left atrial diameter(LAD)[(36.72±4.22)mm vs.(41.66±3.97)mm,P<0.001],maximum left atrial volume(LAVmax)[(111.27±32.93)ml vs.(193.72±60.67)ml,P<0.001],minimum left atrial volume(LAVmin)[(95.86±30.63)ml vs.(183.01±53.76)ml,P<0.001],maximum left atrial appendage volume(LAAVmax)[(9.47±4.50)ml vs.(14.94±7.02)ml,P<0.001]and minimum left atrial appendage volume(LAAVmin)[(8.05±3.88)ml vs.(13.38±6.19)ml,P<0.001].In contrast,the thrombus group had significantly smaller values in left ventricular ejection fraction(LVEF)[(60.02±5.17)%vs.(58.19±4.00)%,P=0.050],left atrial ejection volume(LAEV)[(15.41±7.79)ml vs.(10.70±8.88)ml,P=0.001],left atrial ejection fraction(LAEF)[(0.14±0.07)vs.(0.05±0.03),P<0.001]and left atrial appendage ejection fraction(LAAEF)[(0.15±0.08)vs.(0.10±0.05),P=0.003];all these differences were statistically significant.Logistic regression analysis showed that age[odds ratio(OR)=1.096,95%confidence interval(CI)1.008-1.192,P=0.032],LAD(OR=1.504,95%CI 1.205-1.876,P<0.001)and LAEF(OR=0.886,95%CI 0.803-0.966,P=0.003)were the independent risk factors for LAA thrombus formation in PAF patients.ROC curve analysis revealed the following:when age was used with a cutoff value of 73.5 years[area under the curve(AUC)=0.739],the sensitivity and specificity for predicting thrombus formation were 62.5%and 92.5%respectively;when LAD was used with a cutoff value of 41.5 mm(AUC=0.800),the sensitivity and specificity were 68.8%and 85.6%respectively;when LAEF was used with a cutoff value of 0.109(AUC=0.896),the sensitivity and specificity were 100%and 68.2%respectively.Conclusion The age,LAD and LAEF are all associated with left atrial appendage thrombosis in patients with PAF,among which LAD and LAEF are important influencing factors of left atrial appendage thrombosis in PAF patients.
Keywords：Atrial fibrillationCardiac CTThrombotic riskPredictive factorsLeft atrial function
Publication Date：2025-10-20
Online Publishing Date：2025-10-30(First online date of this platform, not the publication date of the document)
Pages：6( 924-929 )