التفاصيل البيبلوغرافية
العنوان: |
Impact of Left Atrial Appendage Flow Velocity on Thrombus Resolution and Clinical Outcomes in Patients with Atrial Fibrillation and Silent Left Atrial Thrombi: Insights from the LAT Study |
المؤلفون: |
Okada, Masato, Inoue, Koichi, Tanaka, Nobuaki, Tanaka, Koji, Hirao, Yuko, Iwakura, Katsuomi, Egami, Yasuyuki, Masuda, Masaharu, Watanabe, Tetsuya, Minamiguchi, Hitoshi, Oka, Takafumi, Hikoso, Shungo, Sunaga, Akihiro, Okada, Katsuki, Nakatani, Daisaku, Sotomi, Yohei, Sakata, Yasushi, Mano, Toshiaki, Matsumura, Yasushi, Kawasaki, Masato, Yamada, Takahisa, Miyoshi, Miwa, Kanda, Takashi, Makino, Nobuhiko, Higuchi, Yoshiharu, Matsunaga, Yasuharu, Nishino, Masami, Tanouchi, Jun, Sato, Taiki, Kida, Hirota, Nakano, Tomoaki, Ozu, Kentaro, Dohi, Tomoharu, Takeda, Toshihiro, Minamisaka, Tomoko |
المصدر: |
Europace ; ISSN 1099-5129 1532-2092 |
بيانات النشر: |
Oxford University Press (OUP) |
سنة النشر: |
2024 |
الوصف: |
Aims Blood stasis is crucial in developing left atrial (LA) thrombi. LA appendage peak flow velocity (LAAFV) is a quantitative parameter for estimating thromboembolic risk. However, its impact on LA thrombus resolution and clinical outcomes remains unclear. Methods and Results The LAT study was a multicenter observational study investigating patients with atrial fibrillation (AF) and silent LA thrombi detected by transesophageal echocardiography (TEE). Among 17,436 TEE procedures for patients with AF, 297 patients (1.7%) had silent LA thrombi. Excluding patients without follow-up examinations, we enrolled 169 whose baseline LAAFV was available. Oral anticoagulation use increased from 85.7% at baseline to 97.0% at the final follow-up (p < 0.001). During 1-year, LA thrombus resolution was confirmed in 130 (76.9%) patients within 76 (34–138) days. Conversely, 26 had residual LA thrombi, 8 had thromboembolisms, and 5 required surgical removal. These patients with failed thrombus resolution had lower baseline LAAFV than those with successful resolution (18.0 [15.8–22.0] vs. 22.2 [17.0–35.0], p = 0.003). Despite limited predictive power (area under the curve, 0.659; p = 0.001), LAAFV ≤20.0 cm/s (best cutoff) significantly predicted failed LA thrombus resolution, even after adjusting for potential confounders (odds ratio, 2.72; 95% confidence interval, 1.22–6.09; p = 0.015). The incidence of adverse outcomes including ischemic stroke/systemic embolism, major bleeding, or all-cause death was significantly higher in patients with reduced LAAFV than in those with preserved LAAFV (28.4% vs. 11.6%, log-rank p = 0.005). Conclusions Failed LA thrombus resolution was not rare in patients with AF and silent LA thrombi. Reduced LAAFV was associated with failed LA thrombus resolution and adverse clinical outcomes. |
نوع الوثيقة: |
article in journal/newspaper |
اللغة: |
English |
DOI: |
10.1093/europace/euae120 |
DOI: |
10.1093/europace/euae120/57368589/euae120.pdf |
الإتاحة: |
https://doi.org/10.1093/europace/euae120Test |
حقوق: |
https://creativecommons.org/licenses/by/4.0Test/ |
رقم الانضمام: |
edsbas.CAFEEB |
قاعدة البيانات: |
BASE |