The predictive value of a concise classification of left atrial appendage morphology to thrombosis in non-valvular atrial fibrillation patients.

BACKGROUND

The complexity of left atrial appendage (LAA) in patients with nonvalvular atrial fibrillation (NVAF) is closely related to LAA thrombosis and stroke incidence. But the classification of LAA morphology is not uniform and controversial.

HYPOTHESIS

This study divided the LAA into two categories according to the LAA morphology to investigate the risk of thrombosis related to the LAA structural complexity in NVAF patients.

METHODS

A total of 336 NVAF patients were enrolled continuously in this study. The patients were divided into thrombosis group and non-thrombosis group according to whether the thrombus presence in LAA. Through computer LAA three-dimensional reconstruction, LAA morphology was divided into the complex type and simple type according to with or without the clearly lobulated structure judged by imaging experts. The relationship between LAA thrombosis and various potential risk factors was analyzed.

RESULTS

A total of 19 potential risk factors for LAA thrombosis in NVAF patients were enrolled into statistical analysis. The coincidence rate of LAA morphology classification was 96.4% (324/336) between two imaging experts. Multivariate logistic regression analysis showed that complex LAA morphology (OR 4.168, 95% CI 1.871-9.288, P < .001) was associated with the presence of LAA thrombus, independently of other enrolled risks.

CONCLUSIONS

It is a concise and reliable method to divide the LAA morphology into complex type and simple type according to whether with the clearly lobulated structure. The complex LAA is an independent risk factor for LAA thrombosis in NVAF patients.