Michałowska Ilona, Dudzińska Katarzyna, Kowalik Ilona, Kwiatek Paweł, Piotrowski Roman, Kułakowski Piotr, Baran Jakub
Department of Radiology, National Institute of Cardiology.
Department of Cardiology, Division of Clinical Electrophysiology, Centre of Postgraduate Medical Education, Grochowski Hospital.
J Thorac Imaging. 2022 May 1;37(3):168-172. doi: 10.1097/RTI.0000000000000582. Epub 2021 Feb 15.
The atrial septal pouch is an anatomic variant of the interatrial septum caused by incomplete fusion of the septum primum and secundum. It is debatable whether coexistence of septal pouch and atrial fibrillation (AF) increases the risk of stroke. Thus, the aim of the study was to evaluate the coexistence of left atrial septal pouch (LASP) and AF in patients with a history of stroke in comparison with those without an earlier history of stroke.
We analyzed 145 patients with AF (68 in the study group, 77 in the control group). The study group consisted of patients with previous stroke and AF; control group consisted of patients scheduled for AF ablation. All patients underwent computed tomography with the assessment of atrial septum morphology and presence of LASP. The study was a subanalysis of the ASSAM (AssesSment of the left atrial appendage morphoLogy in patients aAfter ischaeMic Stroke) study.
The prevalence of LASP in the entire group was 38.6%. There were no significant differences in the prevalence of LASP between the study and control groups (33.8% vs. 42.9%, P=0.265). Mean longitudinal and transverse dimensions of LASP were 9.34±3.27 and 2.4±0.6 mm, respectively, and there was no significant difference between the study and controls. Patients from the stroke group were older (P<0.0001), had a higher CHA2DS2-VASc score (5.41±1.93 vs. 1.62±1.46, P<0.0001) compared with controls.
Presence of LASP is not more prevalent in patients with a history of stroke. Additional information on the presence of LASP do not improve accuracy of risk stratification for stroke in patients with AF.
房间隔袋是由原发隔和继发隔不完全融合导致的房间隔解剖变异。房间隔袋与心房颤动（AF）并存是否会增加中风风险尚无定论。因此，本研究的目的是比较有中风病史的患者与无中风病史的患者中左心房隔袋（LASP）与AF并存的情况。
我们分析了145例AF患者（研究组68例，对照组77例）。研究组由既往有中风和AF的患者组成；对照组由计划进行AF消融的患者组成。所有患者均接受计算机断层扫描，评估房间隔形态和LASP的存在情况。本研究是ASSAM（缺血性中风后患者左心耳形态评估）研究的亚分析。
整个组中LASP的患病率为38.6%。研究组和对照组之间LASP的患病率无显著差异（33.8%对42.9%，P = 0.265）。LASP的平均纵向和横向尺寸分别为9.34±3.27和2.4±0.6毫米，研究组和对照组之间无显著差异。与对照组相比，中风组患者年龄更大（P < 0.0001），CHA2DS2-VASc评分更高（5.41±1.93对1.62±1.46，P < 0.0001）。
有中风病史的患者中LASP的存在并不更普遍。关于LASP存在的额外信息并不能提高AF患者中风风险分层的准确性。
