Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Keimyung University Dongsan Hospital, Keimyung University College of Medicine, Daegu, Korea.
Sci Rep. 2021 Dec 10;11(1):23808. doi: 10.1038/s41598-021-03266-z.
We sought to evaluate the clinical implication of LAE based on left atrial anterior-posterior (LA AP) dimension or LA volume index (LAVI) in Korean patients with atrial fibrillation (AF). We enrolled 8159 AF patients from the CODE-AF registry. The primary outcome was rate of stroke or systemic embolism (SSE). The prevalence of mild, moderate, and severe LAE by LA AP dimension was 30.6%, 18.5%, and 21.4%, and by LAVI (available in 5808 patients) was 15.7%, 12.5% and 37.8%, respectively. Compared with no or mild LAE, patients with significant LAE (moderate to severe LAE, n = 3258, 39.9%) were associated with a higher rate of SSE (2.5% vs. 1.4%, P = 0.001). Multivariable analysis suggested presence of significant LAE by LA AP dimension was associated with a higher risk of SSE in the overall population (HR 1.57, 95% CI: 1.14-2.17, P = 0.005) and in patients using anticoagulants (n = 5836, HR 1.79, 95% CI: 1.23-2.63, P = 0.002). Patients with significant LAE by LAVI were also at higher risk of SSE (HR 1.58, 95% CI: 1.09-2.29, P = 0.017). In conclusion, significant LAE by LA dimension or LAVI was present in 39.9% and 50.2% of AF patients, respectively, and was associated with a higher rate of SSE.
我们旨在评估基于左心房前后径（LA AP）或左心房容积指数（LAVI）的左心房扩大（LAE）对韩国心房颤动（AF）患者的临床意义。我们从 CODE-AF 登记处纳入了 8159 例 AF 患者。主要结局为卒中或全身性栓塞（SSE）的发生率。根据 LA AP 维度，轻度、中度和重度 LAE 的患病率分别为 30.6%、18.5%和 21.4%，根据 LAVI（在 5808 例患者中可用），轻度、中度和重度 LAE 的患病率分别为 15.7%、12.5%和 37.8%。与无或轻度 LAE 相比，存在显著 LAE（中重度 LAE，n=3258，39.9%）的患者 SSE 发生率更高（2.5%比 1.4%，P=0.001）。多变量分析表明，LA AP 维度存在显著 LAE 与全人群 SSE 风险增加相关（HR 1.57，95%CI：1.14-2.17，P=0.005）和使用抗凝剂的患者（n=5836，HR 1.79，95%CI：1.23-2.63，P=0.002）。LAVI 存在显著 LAE 的患者 SSE 风险也更高（HR 1.58，95%CI：1.09-2.29，P=0.017）。总之，LA 维度或 LAVI 的显著 LAE 在分别在 39.9%和 50.2%的 AF 患者中存在，且与 SSE 发生率增加相关。
