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Assessment of normal left atrial appendage anatomy and function over gender and ages by dynamic cardiac CT

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Abstract

Objectives

The aim of this study was to evaluate variations in anatomy and function according to age and gender using cardiac computed tomography (CT) in a large prospective cohort of healthy patients.

Background

The left atrial appendage (LAA) is considered the most frequent site of intracardiac thrombus formation. However, variations in normal in vivo anatomy and function according to age and gender remain largely unknown.

Methods

Three-dimensional (3D) cardiac reconstructions of the LAA were performed from CT scans of 193 consecutive patients. Parameters measured included LAA number of lobes, anatomical position of the LAA tip, angulation measured between the proximal and distal portions, minimum (iVolmin) and maximum (iVolmax) volumes indexed to body surface area (BSA), and ejection fraction (LAAEF). Relationship with age was assessed for each parameter.

Results

We found that men had longer and wider LAAs. The iVolmin and iVolmax increased by 0.23 and 0.19 ml per decade, respectively, while LAAEF decreased by 2 % per decade in both sexes.

Conclusions

Although LAA volumes increase, LAAEF decreases with age in both sexes.

Key Points

• Variations in normal left atrial appendage in vivo anatomy and function remain largely unknown.

• Cardiac CT is reliable for left atrial appendage volume measurements.

• Although LAA volumes increase, LAAEF decreases with age in both sexes.

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Abbreviations

AF:

Atrial fibrillation

BSA:

Body surface area

CT:

Computed tomography

EF:

Ejection fraction

iVolmax :

Maximum volume indexed to the body surface area

iVolmin :

Minimum volume indexed to the body surface area

LAA:

Left atrial appendage

LAAd:

Distal LAA

LAAEF:

Left atrial appendage ejection fraction

LLAp:

Proximal LAA

LV:

Left ventricle

LSPV:

Left superior pulmonary vein

TEE:

Transoesophageal echocardiography

Volmax :

Maximum volume

Volmin :

Minimum volume

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Acknowledgments

The scientific guarantor of this publication is Pr Jean-Pierre Tasu. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional review board approval was not required because this was an observational study, with no change for patients who were enrolled in this study.

Written informed consent was obtained from all patients in this study. Methodology: prospective, observational study, performed at one institution.

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Authors and Affiliations

  1. University Hospital, Department of Radiology, University of Poitiers, Poitiers, France

    Samy Boucebci, Stéphane Velasco, Pier-Olivier Duboe & Jean-Pierre Tasu

  2. University Hospital, Department of Cardiology, University of Poitiers, Poitiers, France

    Thomas Pambrun

  3. University Institute of Public Health, University of Poitiers, Poitiers, France

    Pierre Ingrand

Authors
  1. Samy Boucebci
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Correspondence to Samy Boucebci.

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Boucebci, S., Pambrun, T., Velasco, S. et al. Assessment of normal left atrial appendage anatomy and function over gender and ages by dynamic cardiac CT. Eur Radiol 26, 1512–1520 (2016). https://doi.org/10.1007/s00330-015-3962-2

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  • DOI: https://doi.org/10.1007/s00330-015-3962-2

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