Relationship between parameters of transthoracic echocardiography and left atrial appendage thrombus in patients with atrial fibrillation
Yu Zhisong
Zhang Wangdong
Wu Ke
Lin Genghai
Yang Peng
Dai Zenghuan
Abstract：Objective To analyze the relationship between parameters of transthoracic echocardiography(TTE)and left atrial appendage thrombus(LAAT)in patients with atrial fibrillation(AF).Methods The materials were retrospectively analyzed in AF patients hospitalized in Department of Cardiovascular Medicine in Dongnan Hospital affiliated to Xiamen University from Jan.2017 to Dec.2022.All patients were divided,according to whether they had LAAT or not,into LAAT group(n=49)and non-LAAT group(n=638).The differences in clinical biochemical data and echocardiography parameters were compared between 2 groups.The independent risk factors for LAAT thrombosis were analyzed by using multi-factor Logistic regression analysis.Results Compared with non-LAAT group,in LAAT group the average age was higher(P=0.040),percentage of paroxysmal atrial fibrillation(PAF)was higher(P=0.007),score of CHA2DS2-VASc was higher(P=0.004),percentage of treatment with novel oral anticoagulants(NOAC)was lower(P=0.004),and percentage of treatment with vitamin K antagonists(VKA)was higher(P=0.022),ventricular ejection fraction(LVEF)was lower(P=0.0001)and left atrial diameter(LAD)was larger(P=0.001).The multi-factor binary Logistic regression analysis showed that aging(OR=1.126,95%CI:1.006～1.259,P<0.001),increased score of CHA2DS2-VASc(OR=2.154,95%CI:1.170～3.962,P=0.014),VKA treatment(OR=1.984,95%CI:1.611～2.442,P<0.001)and LAD increase(OR=1.363,95%CI:1.068～1.737,P=0.013)were independent factors for LAAT thrombosis,and PAF(OR=0.528,95%CI:0.379～0.735,P<0.001)and LVEF decrease(OR=0.874,95%CI:0.787～0.969,P=0.011)were protective factors for LAAT thrombosis.Conclusion This study confirms that decreased LVEF and increased LAD are independent risk factors for LAAT thrombosis in AF patients.In clinical practice,even with appropriate anticoagulation therapy,for patients with decreased LVEF and enlarged left atrium,especially when other thromboembolic risk factors coexist,the risk should be carefully evaluated before cardioversion or ablation.
Keywords：Atrial fibrillationLeft atrial appendageEchocardiographyLeft ventricular ejection fraction
Publication Date：2024-01-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 65-68 )