The effect of obstructive sleep apnea hypopnea syndrome on left atrial appendage thrombus in patients with nonvalvular atrial fibrillation
Bai Zhong-le
Ma Yan-qiu
Tao Hai-long
Qin Fen
Meng Zhe
Zhu Ji-fa
Li Ling
Abstract：Objective This study sought to assess the impact of obstructive sleep apnea hypopnea syndrome (OSAHS) on the risk of left atrial appendage (LAA) thrombus in patients with nonvalvular atrial fibrillation (AF). Method From March 2013 to March 2015, 95 consecutive patients with refractory AF who underwent transesophageal echocardiography (TEE) before AF ablation were included. The patients were divided into two groups according to the presence (n=28) or absence (n=67) of LAA thrombus. Clinical characteristics, echocardiographic measures and biochemical parameters were compared to determine variables predicting LAA thrombus. Multivariate Logistic regression analysis was used to analyze the independent risk factors for LAA thrombus. Results LAA thrombus was observed in 28 (29.5%) patients. Patients with thrombus exhibited higher rate of OSAHS (75.0% vs. 46.3%, P=0.011), nonparoxysmal AF (67.9% vs. 44.8%, P=0.015) and diabetes mellitus (39.3% vs. 11.9%, P=0.003), higher CHA2DS2-VASc score [2(1,3) vs. 1(1,2), P=0.016] and left atrium diameter [40(38,43) mm vs. 37(34,40) mm, P=0.008] compared with those without thrombus. Multivariate Logistic regression analysis revealed OSAHS (OR:4.94, 95%CI:1.49~16.41, P=0.009), diabetes mellitus (OR:3.36, 95%CI:1.00~11.28, P=0.048), CHA2DS2-VASc score (OR:1.77, 95%CI:1.11~2.82, P=0.016) and left atrium diameter (OR:1.12, 95%CI:1.02~1.64, P=0.023) to be independently associated with thrombus formation. Conclusions OSAHS was associated with the presence of LAA thrombus in nonvalvular AF patients independently of diabetes mellitus, CHA2DS2-VASc score and left atrium diameter.
Keywords：Obstructive sleep apnea hypopnea syndromeAtrial fibrillationLeft atrial appendage thrombus
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 583-586,589 )