Left Atrial Appendage Depth and Tachycardia Bradycardia Syndrome as Important Predictors of Left Atrial Appendage Thrombus in Patients with Nonvalvular Atrial Fibrillation

Abstract

Background. Atrial fibrillation (AF) is the most common heart rhythm disorder that has been shown to be associated with a significant increase in stroke and systemic embolism risk. The left atrial appendage (LAA) is a finger-like extension originating from the left atrium; the formation of thrombus in LAA is the main reason of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (NVAF). This study is aimed at finding out the risk of left atrial appendage thrombus (LAAT) in patients with nonvalvular atrial fibrillation (NVAF). Method. We retrospectively examined the clinic and left atrial computer tomography angiography (CTA) features of patients assessed in Zhengzhou No. 7 People’s Hospital between January 2020 and January 2021 derivation. Student’s t -test, chi-square test, receiver operating characteristics (ROC) curves, and logistic regression analysis were used to identify predictors of LAAT. Result. Of 480 patients included in the analysis, LAAT was found in approximately 9.2% of all patients. Univariate demographic predictors of LAAT included left atrium top and bottom diameter (LTD), left atrial appendage depth (LAAD), CHA2DS2-VASc, tachycardia bradycardia syndrome (TBS), and nonparoxysmal atrial fibrillation (PAF). In a multiple logistic regression analysis, the independent predictors of thrombus were LAAD > 23.45 mm (odds ratio: 4.216, 95% CI: 1.869-9.510, P = 0.001 ), TBS (odds ratio: 4.076, 95% CI: 1.655-10.038, P = 0.002 ), and non-PAF (odds ratio: 2.896, 95% CI: 1.183-7.094, P = 0.02 ). Conclusion. In NVAF patients with LAAT, evidence suggested that larger LAAD, non-PAF, and TBS present a high risk of LAAT. This is the first report demonstrating that the LAAD and TBS are associated with LAAT in patients with NVAF.

Finding low CHA2DS2-VASc scores unreliable? Why not give morphological and hemodynamic methods a try?

“…The C-statistics of it for ischemic stroke only ranged from 0.57 to 0.67 across multiple cohorts ( 37 ). In some of these cases, the relatively higher AUC was obtained from a high specificity at the cost of sensitivity, which drops to 10.80% ( 38 ).…”

“…Left atrial appendage depth (LAAD) was found to be related to thrombus risk with an OR of 4.216. Its predictive value is considerable, having an AUC of 0.735, with a sensitivity of 75.7% and a specificity of 74.9%, and the cutoff point was more than 23.45 mm ( 38 ). An LAA end-systolic volume and an end-diastolic volume larger than 18.45 and 9.49 mL were believed to be critical values ( 47 ).…”

Prediction of Left and Right Atrials Appendage Thrombosis in Patient with Non-Valvular Atrial Fibrillation

“…Анатомические 23,45 мм (ОР 4,216, 95% ДИ: 1,869-9,510, P=0,001) и площадь уЛП, величина которой обратно пропорциональна скорости кровотока в уЛП (β=-0,185, P=0,033) [27,108].…”

Retracted: Left Atrial Appendage Depth and Tachycardia Bradycardia Syndrome as Important Predictors of Left Atrial Appendage Thrombus in Patients with Nonvalvular Atrial Fibrillation

“…This article has been retracted by Hindawi following an investigation undertaken by the publisher [ 1 ] This investigation has uncovered evidence of one or more of the following indicators of systematic manipulation of the publication process: Discrepancies in scope Discrepancies in the description of the research reported Discrepancies between the availability of data and the research described Inappropriate citations Incoherent, meaningless and/or irrelevant content included in the article Peer-review manipulation …”

“…This article has been retracted by Hindawi following an investigation undertaken by the publisher [1] This investigation has uncovered evidence of one or more of the following indicators of systematic manipulation of the publication process:…”