Left atrial enlargement and non-paroxysmal atrial fibrillation as risk factors for left atrial thrombus/spontaneous Echo contrast in patients with atrial fibrillation and low CHA2DS2-VASc score

作     者：Wei-Dong LIN Yu-Mei XUE Fang-Zhou LIU Xian-Hong FANG Xian-Zhang ZHAN Hong-Tao LIAO Gary Tse Shu-Lin WU Wei-Dong LIN;Yu-Mei XUE;Fang-Zhou LIU;Xian-Hong FANG;Xian-Zhang ZHAN;Hong-Tao LIAO;Gary Tse;Shu-Lin WU

作者机构：Guangdong Cardiovascular InstituteGuangdong General HospitalGuangzhouChina Department of Medicine and TherapeuticsFaculty of MedicineChinese University of Hong KongHong KongChina Li Ka Shing Institute of Health SciencesFaculty of MedicineChinese University of Hong KongHong KongChina 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2020年第17卷第3期

页      面：155-159页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：This work was supported by National Key R&D Program of China(No.2018YFC1312501 and No.2018YFC1312502) Key R&D Program of Guangdong Province,China(No.2019B020230004) 

主　　题：Atrial fibrillation Left atrial diameter Left atrial spontaneous echo contrast Left atrial thrombus 

摘      要：Objective To determine the risk factors for thromboembolism in lower risk patients with non-valvular atrial fibrillation(AF)and low CHA2DS2-VASc scores,which remain *** We retrospectively analyzed the baseline clinical characteristics,routine laboratory parameters,and echocardiographic measurements of 705 patients(71.1%male;mean age:52.10±9.64 years)with low CHA2DS2-VASc score(0 or 1;1 point for female sex)out of 1346 consecutive patients with non-valvular AF who underwent transesophageal echocardiography(TEE)at Guangdong Cardiovascular Institute between January 2013 and December *** Patients with left atrial thrombus(LAT)or spontaneous echo contrast(SEC)on TEE(24/705,4%)showed a higher incidence rate of vascular disease(54.2%vs.32.9%,P=0.045)and non-paroxysmal AF(79.2%vs.29.4%,P0.001),larger left atrial diameter(43.08±4.59 vs.36.02±5.53 mm,P0.001),and lower left ventricular ejection fraction(58.23±8.82%vs.64.15±7.14%,P0.001)than those *** logistic regression analysis identified left atrial diameter[odds ratio(OR)=1.171,95%confidence interval(CI):1.084–1.265,P0.001]and non-paroxysmal AF(OR=3.766,95%CI:1.282–11.061,P=0.016)as independent risk factors for LAT/*** ROC curve analysis,a left atrial dimeter cutoff of 37.5 mm yielded 95.0%sensitivity and 62.7%specificity(AUC:0.847,P0.0001,95%CI:0.793–0.914).Conclusion In patients with non-valvular AF with low CHA2DS2-VASc score,the presence of LAT or SEC was associated with left atrial enlargement,which had moderate predictive value,and non-paroxysmal AF.