scholarly journals Left atrial enlargement is an independent predictor of stroke and systemic embolism in patients with non-valvular atrial fibrillation

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Yasuhiro Hamatani ◽  
Hisashi Ogawa ◽  
Kensuke Takabayashi ◽  
Yugo Yamashita ◽  
Daisuke Takagi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Independent Predictor ◽  
Systemic Embolism ◽  
Left Atrial Enlargement ◽  
Atrial Enlargement

Abstract 12799: Left Atrial Enlargement is an Independent Risk Factor of Stroke or Systemic Embolism in Atrial Fibrillation Patients: The Fushimi AF Registry

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yasuhiro Hamatani ◽  
Daisuke Takagi ◽  
Hisashi Ogawa ◽  
Masahiro Esato ◽  
Yeong-Hwa Chun ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Left Atrial ◽  
Systemic Embolism ◽  
Left Atrial Diameter ◽  
Left Atrial Enlargement ◽  
Valvular Heart Diseases ◽  
Increased Risk ◽  
Atrial Enlargement

Introduction: Atrial fibrillation (AF) is a common arrhythmic disorder and increasing significantly. Stroke or systemic embolism (SE) is a devastating complication of AF. Controversy exists regarding whether left atrial enlargement is a risk factor of stroke/SE in AF patients. Hypothesis: Left atrial enlargement might be associated with the incidence of stroke/SE. Methods: The Fushimi AF Registry, a community-based prospective survey, was designed to enroll all of the AF patients in Fushimi-ku, which represented a typical urban community in Japan. We started to enroll patients from March 2011, and follow-up data were available for 2,724 patients by April 2015 (median follow-up period 808 days). Left atrial enlargement (LAE) was diagnosed if the left atrial diameter measured by transthoracic echocardiography was >45 mm. We compared the backgrounds and incidences of events during follow-up period between those with LAE and those without it (non-LAE). Results: Backgrounds and incidences of events between LAE and non-LAE are shown in the Table. LAE group showed higher incidence of stroke/SE during follow-up period, compared with non-LAE group (hazard ratio (HR): 1.81, 95% confidence interval (CI): 1.29-2.57, p<0.01). After adjustment by the components of CHADS2 score and oral anticoagulant prescription, LAE was independently associated with higher risk for stroke/SE (HR: 1.70, 95% CI: 1.20-2.43, p<0.01). This was also the case when we defined cut-off as 40 mm (HR: 1.67, 95% CI: 1.12-2.55, p=0.01), and as 50 mm (HR: 1.58, 95% CI: 1.08-2.29, p=0.02), or we analyzed left atrial diameter as continuous variables (HR (per 1mm): 1.03, 95% CI: 1.01-1.05, p<0.01). Even after adjustment by type of AF (paroxysmal or sustained) and valvular heart diseases, LAE remained to be independently associated with the risk of stroke/SE (HR: 1.57, 95% CI: 1.08-2.31, p=0.02). Conclusion: Left atrial enlargement was independently associated with the increased risk of stroke/SE in AF patients.

scholarly journals The clinical and etiological profile of atrial fibrillation after echocardiography in a tertiary care centre from North India - a cross sectional observational study

2017 ◽  
Vol 5 (3) ◽  
pp. 847 ◽  
Author(s):  
Ranvijay Singh ◽  
Rajesh Kashyap ◽  
Rajeev Bhardwaj ◽  
Rajeev Marwaha ◽  
Manish Thakur ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Tertiary Care ◽  
Hypertensive Heart Disease ◽  
Atrial Appendage ◽  
North India ◽  
Left Atrial Enlargement ◽  
Atrial Enlargement

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice. In western countries, rheumatic heart disease (RHD) is a rare cause of atrial fibrillation but in developing countries like India it is one of the commonest cause of atrial fibrillation. We studied etiology, left atrial size and the incidence of left atrial appendage clot in patients with atrial fibrillation at our institution so that guidelines could be formulated to manage the patients of AF in the hours of emergency.Methods: 110 consecutive patients of atrial fibrillation coming to emergency, cardiology and medicine outpatient department over a period of one year were enrolled for the study. Ethical committee clearance was taken. Detailed history were taken, clinical presentation reviewed  and examination were carried out. All patients were subjected to transthoracic echocardiography and for transesophageal echocardiography if required.Results: The mean age of patients in the study was 58.42±14.27 years (range 22-90 years). Maximum numbers of patients were in the age group of 61-70 years (26.37%). Out of 110 patients with atrial fibrillation, 72 patients (65.46%) were females and 38 patients (34.54%) were males. Majority of patients presented with more than one symptom. Out of 110, 66 patients (60%) had RHD. Among RHD patients, 50 patients (45.55%) were females and 16 patients (14.55%) were males. Next common causes were hypertensive heart disease and degenerative valvular heart disease.Conclusions: In our study RHD was the most common cause of atrial fibrillation, followed by hypertensive heart disease and degenerative valvular heart disease. Mitral valve involvement was seen in all patients of RHD. Left atrial enlargement was seen in majority of patients, so left atrial enlargement could be a predictor of atrial fibrillation. Patients of left atrial enlargement are more prone to develop left atrial appendage clot.

P5658Incorporation of severity of left atrial enlargement in clinical risk factors improves identification of patients at risk for development of atrial fibrillation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Chawla ◽  
S Olet ◽  
M E Mortada ◽  
J Zilinski ◽  
K A Ammar ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
At Risk ◽  
Left Atrial ◽  
Roc Analysis ◽  
Roc Curves ◽  
Volume Index ◽  
Clinical Predictors ◽  
Left Atrial Enlargement ◽  
Patients At Risk ◽  
Atrial Enlargement

Abstract Background Early identification of patients at risk for atrial fibrillation (AF) is desirable to prevent its development and complications. Clinical predictors have been recognized but need refinement to improve predictability. We evaluated whether severity of left atrial enlargement (LAE) added to a scoring system (CHA2DS2VASC) in an unselected non-AF population improves risk stratification for incident AF. Purpose To assess the incremental benefit of LAE severity added to CHA2DS2VASc in predicting future AF in non-AF patients. Methods From 2012–2017, consecutive adult patients with an echocardiogram and no prior AF were identified. CHA2DS2VASc was used to define baseline AF risk, and the incremental risk of AF with addition of LAE was assessed through increased LA volume index (LAVI; moderate 42–48 ml/m2, severe >48 ml/m2). To quantify improvement in risk prediction, logistic regression model was fitted and odds ratios (OR) and ROC curves obtained. Results Out of 155,597 patients with no prior AF, 13.8% developed AF over 1.5±1.3 years. OR for AF with CHA2DS2VASc was 1.68 (95% CI 1.66–1.69). With addition of moderately or severely increased LAVI to the model, OR for AF increased to 2.3 (2.2–2.5) and 3.8 (3.6–4.0), respectively. ROC analysis showed c-statistics of 0.66 with CHA2DS2VASc, 0.63 with LAVI, and 0.71 with incorporation of both (Fig). AF CHAD score Conclusion(s) In non-AF patients, predictability for future AF can be improved by using clinical factors (CHA2DS2VASc) and increased LAVI. This information may guide closer monitoring and initiation of therapies to prevent progression to AF or stroke. Acknowledgement/Funding None

scholarly journals CHA2DS2-VASc Scores are Proportionally Associated with Left Atrial Enlargement and Serum D-dimer Levels in Patients with Non-valvular Atrial Fibrillation

2016 ◽  
Vol 9 (2) ◽  
pp. 139-143 ◽  
Author(s):  
Taewon Kim ◽  
Sung-Woo Jung ◽  
Kwang-Soo Lee ◽  
Hun-Jun Park ◽  
Joong-Seok Kim ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Enlargement ◽  
Atrial Enlargement ◽  
D Dimer

scholarly journals Left atrial enlargement in patients with paroxysmal atrial fibrillation.

1982 ◽  
Vol 23 (5) ◽  
pp. 677-683 ◽  
Author(s):  
Nobuo TAKAHASHI ◽  
Kouji IMATAKA ◽  
Akira SEKI ◽  
Jun FUJII
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Enlargement ◽  
Atrial Enlargement
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