Left atrial appendage morphology and cardiac function in patients with sinus rhythm
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The left atrial appendage (LAA) is one of the major sources of cardiac thrombus formation. The morphology of the LAA correlates with stroke in patients with atrial fibrillation. In this study, we evaluated the correlation between LAA morphology and cardiac function by transthoracic echocardiography in patients with sinus rhythm.
Methods and Results
We studied 55 patients (36 men, 70 ± 11 years) who underwent cardiac computed tomography and transthoracic echocardiography. The following 4 different morphologies were used to categorize LAA by computed tomography: chicken wing (CW), windsock, cactus, and cauliflower. These morphologies were also classified into CW and non-CW (nonCW) types. There were no significant differences in the left ventricular ejection fraction (63% vs 62%), left atrial (LA) volume (22.2 vs 25.5 ml/m2), and LAA volume (4.3 vs 4.7 ml/m2) between nonCW and CW. Patients with nonCW showed a lower A′ velocity (8.0 vs 9.3 cm/s, p < 0.01), worse global longitudinal strain (− 17.2 vs − 20.2%, p < 0.01), lower tissue mitral annular displacement (9.7 vs 11.1 mm, p = 0.01), and lower LAS strain (22.6 vs 34.5%, p < 0.01) by speckle tracking echocardiography than did those with CW. Multiple logistic analysis showed that nonCW LAA morphology was closely associated with lower LAS strain. Furthermore, a change in volume of the LAA during the cardiac cycle was lower in nonCW than in CW.
These findings suggest that impaired LA and LAA functions are related to changes of the LAA in patients with sinus rhythm.
KeywordsLeft atrial appendage Sinus rhythm Computed tomography Echocardiography Left atrial function
We thank Ellen Knapp, Ph.D., from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.
Compliance with ethical standards
Conflict of interest
Megumi Shimada, Makoto Akaishi, and Takayuki Kobayashi declare that they have no conflicts of interest.
Human rights statements and informed consent
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later revisions. This study was approved by the clinical trial review committee of the Kitasato Institute Hospital (No. 17082). Opt-out consent was used because this was a retrospective study.
- 3.Lee JM, Seo J, Uhm JS, et al. Why is left atrial appendage morphology related to strokes? An analysis of the flow velocity and orifice size of the left atrial appendage. J Cardiovasc Electrophysiol. 2015;1111:1–6.Google Scholar
- 20.Karabay CY, Zehir R, Guler A, et al. Left atrial deformation parameters predict left atrial appendage function and thrombus in patients in sinus rhythm with suspected cardioembolic stroke: a speckle tracking and transesophageal echocardiography study. Echocardiography. 2013;30:572–81.CrossRefGoogle Scholar