分析非瓣膜性心房颤动患者左心房/左心耳血栓形成的危险因素。

Analysis of risk factors for thrombosis of the left atrium/left atrial appendage in patients with non-valvular atrial fibrillation.

机构信息

Department of Internal Medicine, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China.

Department of Oncology, Tongji University School of Medicine, Shanghai, China.

出版信息

Cardiovasc J Afr. 2021;32(3):116-122. doi: 10.5830/CVJA-2019-071. Epub 2021 Apr 16.

DOI:10.5830/CVJA-2019-071

PMID:33950066

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8756031/

Abstract

OBJECTIVES

Left atrial appendage (LAA) morphology is a powerful predictor of thrombogenesis of the left atrium (LA) in patients with non-valvular atrial fibrillation (NVAF). However, it remains unknown whether LAA morphology is useful for stroke risk stratification in patients with NVAF.

METHODS

A total of 555 atrial fibrillation patients were divided into thrombus and non-thrombus groups according to transoesophageal echocardiography. We analysed the correlation between LAA morphology and the CHADS score. We determined the LCHADS score and compared the ability to predict LA/LAA thrombosis of the CHADS, LCHADS and CHADS-VASc scores from the area under the curve (AUC).

RESULTS

The odds ratio of non-chicken wing LAA morphology was 11.48. Non-chicken wing LAA morphology was significantly correlated with LA/LAA thrombosis. We incorporated LAA morphology into the CHADS score and named it the LCHADS score. The AUC of the LCHADS score (0.767) in predicting LA/LAA thrombosis was significantly higher than that of the CHADS (0.558) or CHADS-VASc scores (0.557). The positive and negative predictive values of the LCHADS score (13.1 and 98.7%) were higher than those of the CHADS (8.7 and 94.2%) and CHADS-VASc scores (6.9 and 6.9%).

CONCLUSIONS

Non-chicken wing LAA morphology was a powerful predictor of LA/LAA thrombosis in NVAF patients. The AUC, sensitivity and specificity of the L CHADS score were higher than those of the CHADS and CHA DS -VASc scores.

摘要

目的

左心耳（LAA）形态是预测非瓣膜性心房颤动（NVAF）患者左心房（LA）血栓形成的有力指标。然而，LAA 形态是否有助于 NVAF 患者的卒中风险分层尚不清楚。

方法

根据经食管超声心动图，将 555 例房颤患者分为血栓组和非血栓组。我们分析了 LAA 形态与 CHADS 评分之间的相关性。我们确定了 LCHADS 评分，并比较了 CHADS、LCHADS 和 CHADS-VASc 评分预测 LA/LAA 血栓形成的能力，通过曲线下面积（AUC）来判断。

结果

非鸡翅样 LAA 形态的优势比为 11.48。非鸡翅样 LAA 形态与 LA/LAA 血栓形成显著相关。我们将 LAA 形态纳入 CHADS 评分，并将其命名为 LCHADS 评分。LCHADS 评分（0.767）预测 LA/LAA 血栓形成的 AUC 明显高于 CHADS（0.558）或 CHADS-VASc 评分（0.557）。LCHADS 评分的阳性预测值（13.1%）和阴性预测值（98.7%）均高于 CHADS（8.7%和 94.2%）和 CHADS-VASc 评分（6.9%和 6.9%）。