Xiaodan Wu, Fan Sun, Shoucheng Ma, Zhichen Wang, Shenghai Xu
{"title":"计算机断层造影和超声心动图在预测非瓣膜性心房颤动患者左心耳血栓形成中的应用。","authors":"Xiaodan Wu, Fan Sun, Shoucheng Ma, Zhichen Wang, Shenghai Xu","doi":"10.5830/CVJA-2022-052","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>We aimed to explore the application of computed tomographic angiography (CTA) and echocardiography in predicting left atrial appendage (LAA) thrombosis in patients with non-valvular atrial fibrillation.</p><p><strong>Methods: </strong>The clinical data of 164 atrial fibrillation patients receiving cardiac CTA and real-time three-dimensional transoesophageal echocardiography (RT-3D-TEE) were retrospectively analysed. The patients were divided into group A (anticoagulant treatment group, <i>n</i> = 112) and group B (selective anticoagulant treatment group, <i>n</i> = 52) according to the CHA<sub>2</sub>DS<sub>2</sub>-VASc score, which scored for the presence or absence of congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke/transient ischaemic attack, vascular disease, age 65-74 years and gender (female). The CHA<sub>2</sub>DS<sub>2</sub>-VASc score was used to predict risk of thromboembolism from atrial fibrillation. The correlations of CHA<sub>2</sub>DS<sub>2</sub>-VASc score with CTA-based LAA classification and RT-3D-TEE measurement parameters were explored using Spearman's analysis. Receiver operating characteristic (ROC) curves were plotted to explore the predictive value of CTA and RT-3D-TEE for LAA thrombus.</p><p><strong>Results: </strong>There were significant differences in age, disease course, hypertension, diabetes mellitus, coronary heart disease, heart failure, stroke/transient ischaemic attack/thromboembolism, vascular disease, B-type natriuretic peptide and serum uric acid levels, CHA<sub>2</sub>DS<sub>2</sub>-VASc score, LAA classification, left ventricular ejection fraction (LVEF), left atrial diameter (LAD), maximum diameter of LAA orifice, minimum diameter of LAA orifice and LAA length (<i>p</i> < 0.05). CHA<sub>2</sub>DS<sub>2</sub>- VASc score was positively correlated with cauliflower LAA, LAD, maximum diameter of LAA orifice, minimum diameter of LAA orifice and LAA length, and negatively correlated with LVEF (<i>p</i> < 0.001). ROC curve analysis indicated that CTA, RT-3D-TEE and CHA<sub>2</sub>DS<sub>2</sub>-VASc score had similar predictive values for risk of LAA thrombosis in atrial fibrillation patients, with the areas under the curve being 0.778, 0.814 and 0.792, respectively.</p><p><strong>Conclusions: </strong>Both CTA and RT-3D-TEE had high predictive values for LAA thrombosis in atrial fibrillation patients.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":null,"pages":null},"PeriodicalIF":0.7000,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10870313/pdf/","citationCount":"0","resultStr":"{\"title\":\"Application of computed tomographic angiography and echocardiography in predicting left atrial appendage thrombosis in patients with non-valvular atrial fibrillation.\",\"authors\":\"Xiaodan Wu, Fan Sun, Shoucheng Ma, Zhichen Wang, Shenghai Xu\",\"doi\":\"10.5830/CVJA-2022-052\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>We aimed to explore the application of computed tomographic angiography (CTA) and echocardiography in predicting left atrial appendage (LAA) thrombosis in patients with non-valvular atrial fibrillation.</p><p><strong>Methods: </strong>The clinical data of 164 atrial fibrillation patients receiving cardiac CTA and real-time three-dimensional transoesophageal echocardiography (RT-3D-TEE) were retrospectively analysed. The patients were divided into group A (anticoagulant treatment group, <i>n</i> = 112) and group B (selective anticoagulant treatment group, <i>n</i> = 52) according to the CHA<sub>2</sub>DS<sub>2</sub>-VASc score, which scored for the presence or absence of congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke/transient ischaemic attack, vascular disease, age 65-74 years and gender (female). The CHA<sub>2</sub>DS<sub>2</sub>-VASc score was used to predict risk of thromboembolism from atrial fibrillation. The correlations of CHA<sub>2</sub>DS<sub>2</sub>-VASc score with CTA-based LAA classification and RT-3D-TEE measurement parameters were explored using Spearman's analysis. Receiver operating characteristic (ROC) curves were plotted to explore the predictive value of CTA and RT-3D-TEE for LAA thrombus.</p><p><strong>Results: </strong>There were significant differences in age, disease course, hypertension, diabetes mellitus, coronary heart disease, heart failure, stroke/transient ischaemic attack/thromboembolism, vascular disease, B-type natriuretic peptide and serum uric acid levels, CHA<sub>2</sub>DS<sub>2</sub>-VASc score, LAA classification, left ventricular ejection fraction (LVEF), left atrial diameter (LAD), maximum diameter of LAA orifice, minimum diameter of LAA orifice and LAA length (<i>p</i> < 0.05). CHA<sub>2</sub>DS<sub>2</sub>- VASc score was positively correlated with cauliflower LAA, LAD, maximum diameter of LAA orifice, minimum diameter of LAA orifice and LAA length, and negatively correlated with LVEF (<i>p</i> < 0.001). ROC curve analysis indicated that CTA, RT-3D-TEE and CHA<sub>2</sub>DS<sub>2</sub>-VASc score had similar predictive values for risk of LAA thrombosis in atrial fibrillation patients, with the areas under the curve being 0.778, 0.814 and 0.792, respectively.</p><p><strong>Conclusions: </strong>Both CTA and RT-3D-TEE had high predictive values for LAA thrombosis in atrial fibrillation patients.</p>\",\"PeriodicalId\":9434,\"journal\":{\"name\":\"Cardiovascular Journal of Africa\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.7000,\"publicationDate\":\"2023-09-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10870313/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cardiovascular Journal of Africa\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5830/CVJA-2022-052\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/11/16 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular Journal of Africa","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5830/CVJA-2022-052","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/11/16 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Application of computed tomographic angiography and echocardiography in predicting left atrial appendage thrombosis in patients with non-valvular atrial fibrillation.
Aim: We aimed to explore the application of computed tomographic angiography (CTA) and echocardiography in predicting left atrial appendage (LAA) thrombosis in patients with non-valvular atrial fibrillation.
Methods: The clinical data of 164 atrial fibrillation patients receiving cardiac CTA and real-time three-dimensional transoesophageal echocardiography (RT-3D-TEE) were retrospectively analysed. The patients were divided into group A (anticoagulant treatment group, n = 112) and group B (selective anticoagulant treatment group, n = 52) according to the CHA2DS2-VASc score, which scored for the presence or absence of congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke/transient ischaemic attack, vascular disease, age 65-74 years and gender (female). The CHA2DS2-VASc score was used to predict risk of thromboembolism from atrial fibrillation. The correlations of CHA2DS2-VASc score with CTA-based LAA classification and RT-3D-TEE measurement parameters were explored using Spearman's analysis. Receiver operating characteristic (ROC) curves were plotted to explore the predictive value of CTA and RT-3D-TEE for LAA thrombus.
Results: There were significant differences in age, disease course, hypertension, diabetes mellitus, coronary heart disease, heart failure, stroke/transient ischaemic attack/thromboembolism, vascular disease, B-type natriuretic peptide and serum uric acid levels, CHA2DS2-VASc score, LAA classification, left ventricular ejection fraction (LVEF), left atrial diameter (LAD), maximum diameter of LAA orifice, minimum diameter of LAA orifice and LAA length (p < 0.05). CHA2DS2- VASc score was positively correlated with cauliflower LAA, LAD, maximum diameter of LAA orifice, minimum diameter of LAA orifice and LAA length, and negatively correlated with LVEF (p < 0.001). ROC curve analysis indicated that CTA, RT-3D-TEE and CHA2DS2-VASc score had similar predictive values for risk of LAA thrombosis in atrial fibrillation patients, with the areas under the curve being 0.778, 0.814 and 0.792, respectively.
Conclusions: Both CTA and RT-3D-TEE had high predictive values for LAA thrombosis in atrial fibrillation patients.
期刊介绍：
The Cardiovascular Journal of Africa (CVJA) is an international peer-reviewed journal that keeps cardiologists up to date with advances in the diagnosis and treatment of cardiovascular disease. Topics covered include coronary disease, electrophysiology, valve disease, imaging techniques, congenital heart disease (fetal, paediatric and adult), heart failure, surgery, and basic science.
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