Left Atrial Appendage Morphology Determined by Computed Tomography Can Predict High Risk Patient for Embolism with Atrial Fibrillation

概要

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Left atrial appendage (LAA) flow velocity (LAAV) evaluated by transesophageal-echocardiography (TEE) is one of promising factors to predict LAA thrombus. 64-multislice cardiac CT (CCT) can evaluate detailed LAA morphology, but the correlation between LAAV and LAA morphology is unknown. We investigated which of LAA morphologic parameters determined by CCT correlates with LAAV in patients with atrial fibrillation (AF). In 43 patients with AF, both TEE and CCT were performed. We measured LAAV by TEE and divided our patients into the two groups: low LAAV group whose LAAV <= 30 cm/sec and high LAAV group whose LAAV >30 cm/sec. We compared the various CCT parameters including left atrial volume, LAA volume, number of lobes and LAA morphologic type classified into the following two types: chicken wing type which showed LAA with sharp bend and non-chicken wing type which showed without sharp bend between the two groups. The incidence of chicken wing type in high LAAV group was significantly higher than that in low LAAV group (2(12%) vs. 11(42%) P=0.045) while there were no significant differences of the other parameters. The morphology of LAA determined by CCT, chicken wing or non-chicken wing type, can become a new marker to predict high risk patients for embolism with AF.