Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
J Int Med Res. 2022 Jan;50(1):3000605221074520. doi: 10.1177/03000605221074520.
To investigate the risk factors of left atrial thrombus (LAT)/spontaneous echo contrast (SEC) in patients with nonvalvular atrial fibrillation (AF).
This retrospective study analysed the data from consecutive patients with nonvalvular AF that underwent transoesophageal echocardiography. Logistic regression analysis was performed to identify risk factors of LAT/SEC. Receiver operating characteristic curve analysis was undertaken compare the new scales with CHADS2 and CHA2DS2-VASc scores.
A total of 558 patients with AF were included in the study. LAT/SEC was detected in 137 (24.6%) patients. The independent risk factors of LAT/SEC beyond CHADS2 or CHA2DS2-VASc scores included non-paroxysmal AF and left atrial diameter >37.5 mm. These two variables were added into the CHADS2 or CHA2DS2-VASc score to build new scales. Areas under the curve for the new scales based on CHADS2 and CHA2DS2-VASc scores were significantly higher than the CHADS2 or CHA2DS2-VASc score both in the overall study cohort and in patients at a high risk of thromboembolism.
Non-paroxysmal AF and increased left atrial diameter beyond the CHADS2 or CHA2DS2-VASc score were independent risk factors of LAT/SEC and may help to improve the current risk stratification, especially for patients with nonvalvular AF at a high risk of thromboembolism.
探讨非瓣膜性心房颤动（AF）患者左心房血栓（LAT）/自发性回声对比（SEC）的危险因素。
本回顾性研究分析了连续接受经食管超声心动图检查的非瓣膜性 AF 患者的数据。采用 logistic 回归分析确定 LAT/SEC 的危险因素。进行受试者工作特征曲线分析，比较新量表与 CHADS2 和 CHA2DS2-VASc 评分。
共纳入 558 例 AF 患者。137 例（24.6%）患者检测到 LAT/SEC。LAT/SEC 的独立危险因素除 CHADS2 或 CHA2DS2-VASc 评分外，还包括非阵发性 AF 和左心房直径>37.5mm。这两个变量被添加到 CHADS2 或 CHA2DS2-VASc 评分中，以建立新的量表。基于 CHADS2 和 CHA2DS2-VASc 评分的新量表的曲线下面积明显高于 CHADS2 或 CHA2DS2-VASc 评分，无论是在整个研究队列还是在血栓栓塞高危患者中。
非阵发性 AF 和左心房直径增加超过 CHADS2 或 CHA2DS2-VASc 评分是非 LAT/SEC 的独立危险因素，可能有助于改善目前的风险分层，特别是对于血栓栓塞高危的非瓣膜性 AF 患者。
