Skip to main content
SpringerLink
Log in

A Potential Novel Indication for Preventing Thromboembolism in Patients with Atrial Arrhythmias: Remodeling of the Left Atrium

  • Published:
Current Medical Science Aims and scope Submit manuscript

Abstract

Objective

Thrombosis in patients with atrial arrhythmias might be associated with remodeling of the left atrium (LA). We aimed to describe this relationship and identify a novel factor, in addition to the CHA2DS2-VASc score, to guide therapeutic strategies for preventing thromboembolism in the hope of improving the prognosis for such patients.

Methods

Patients diagnosed with atrial arrhythmias and who met our inclusion criteria were enrolled in this study. Various clinical parameters were recorded; diameters reflecting remodeling of the LA were measured and thrombosis was diagnosed by enhanced CT.

Results

Totally, 192 patients were enrolled in the study. The overall prevalence of left atrial thrombosis was 8.3%. Patients with persistent atrial fibrillation exhibited the highest anteroposterior diameter of the LA (45.1±7.2 mm) and prevalence of thrombosis (15.6%). An anteroposterior LA diameter of ≥50 mm was a strong independent impact risk factor for thrombosis (OR=10.1, 95%CI: 2.8–36.9, P<0.001). The prevalence of LA thrombosis in patients with and without anteroposterior LA diameter of ≥50 mm was 25.8% and 5.0%, respectively.

Conclusion

Marked remodeling of the LA characterized by an anteroposterior LA diameter of ≥50 mm is a strong independent risk factor of thrombosis, and should be considered for the prevention of thromboembolism through various strategies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg, 1996,61(2):755–759

    Article  CAS  PubMed  Google Scholar 

  2. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J, 2016,74(12):1359

    Google Scholar 

  3. Tze-Fan C, Laurent F. Stroke Prevention in Patients With Atrial Flutter: Many Questions Still Unanswered. Europace, 2019,21(2):186–187

    Article  Google Scholar 

  4. Boyaci A, Topaloglu S, Yilmaz S, et al. Regional left atrial coagulation and fibrinolytic activities in patients with mitral stenosis. Jpn Heart J, 2004,45(5):779–788

    Article  PubMed  Google Scholar 

  5. Zhang Q, Miao Y, Kang L, et al. Study of left atrial diameters and prothrombotic state in senile patients with hypertension and atrial fibrillation. Chin J Geriatr (Chinese), 2012,31(3):182–184

    Google Scholar 

  6. Healey JS, Connolly SJ. Atrial fibrillation: Hypertension as a causative agent, risk factor for complications, and potential therapeutic target. Am J Cardiol, 2003,91(10A): 9G–14G

    Article  PubMed  Google Scholar 

  7. Weijs B, Schotten U, Crijns HJ. Pathophysiology of idiopathic atrial fibrillation — prognostic and treatment implications. Curr Pharm Des, 2015,21(5):551–572

    Article  CAS  PubMed  Google Scholar 

  8. Umana E, Solares CA, Alpert MA. Tachycardia-induced cardiomyopathy. Am J Med, 2003,114(1):51–55

    Article  PubMed  Google Scholar 

  9. Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J, 2021,42(5):373–498

    Article  PubMed  Google Scholar 

  10. Wazni OM, Tsao HM, Chen SA, et al. Cardiovascular imaging in the management of atrial fibrillation. J Am Coll Cardiol, 2006,48(10):2077–2084

    Article  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. The authors contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiology, Fuwai Yunnan Cardiovascular Hospital, Kunming, 650000, China

    Chen Liu & Yu-long Guo

  2. Department of Rheumatology, First Affiliated Hospital of Kunming Medical University, Kunming, 650000, China

    Shuang Liu

  3. Department of Radiology, Fuwai Yunnan Cardiovascular Hospital, Kunming, 650000, China

    Hui Li

Authors
  1. Chen Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shuang Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hui Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yu-long Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yu-long Guo.

Additional information

Conflict of Interest Statement

We declare that there are no conflicts of interest in this article.

This project was supported by Yunnan Applied Basic Research Projects (Kunming Medical University Union Special Fund) [No. 2018FE001(-154)], Yunnan Provincial Fund for High Level Reserve Talents in Health Science (No. H-2018037), Scientific Research Fund Project of Fuwai Yunnan Cardiovascular Hospital (No. 2019YFKT-04) Young Scientists Fund (No. 81501406) and Yunnan Provincial Fund for High Level Reserve Talents in Health Science (No. H-2017068).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liu, C., Liu, S., Li, H. et al. A Potential Novel Indication for Preventing Thromboembolism in Patients with Atrial Arrhythmias: Remodeling of the Left Atrium. CURR MED SCI 41, 1187–1191 (2021). https://doi.org/10.1007/s11596-021-2449-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11596-021-2449-4

Key words

Search

Navigation