Chamberlin Jordan H, Smith Carter D, Gowani Zain, Elsayed Mina Gad, Owji Shahin C, Friedman Brandon, Maisuria Dhruw, Berrios Carly, Baruah Dhiraj, Schoepf Uwe Joseph, Kabakus Ismail M
Division of Cardiothoracic Imaging, Department of Radiology and Radiologic Sciences, Medical University of South Carolina, Charleston, SC, USA.
Pol J Radiol. 2023 Sep 14;88:e423-e429. doi: 10.5114/pjr.2023.131214. eCollection 2023.
Left atrial calcification (LAC), a primarily radiologic diagnosis, has been associated with rheumatic heart disease (RHD) and rheumatic fever (RF). However, left atrial calcification continues to be observed despite a significant decrease in the prevalence of rheumatic heart disease. The purpose of this study was to investigate other possible etiologies of left atrial calcification.
This retrospective, observational single-center study included patients from 2017 to 2022 identified as having left atrial calcification as well as age- and sex-matched controls. The prevalence of rheumatic heart disease, atrial ablation, and mitral valve disease was compared, and odds ratios were calculated for each independent variable.
Sixty-two patients with left atrial calcifications were included and compared with 62 controls. 87.1% of patients in the left atrial calcifications cohort had a history of atrial fibrillation compared with 21% in the control cohort ( < 0.001). 16.1% of patients in the calcifications cohort presented a history of rheumatic fever compared with zero in the control cohort ( = 0.004). 66.1% of the left atrial calcifications cohort had a history of atrial ablation compared with 6.5% of the control group ( < 0.001). The odds ratio for left atrial calcification was 19.0 vs. 4.8 for rheumatic fever (comparative odds = 4.0 for atrial ablation vs. rheumatic fever). Multivariable log model found atrial ablation to explain 79.8% of left atrial calcifications identified.
Our study found a 4-fold higher association between history of atrial ablation and left atrial calcification compared with rheumatic heart disease, suggesting a potential shift in etiology.
左心房钙化（LAC）主要是一种影像学诊断，与风湿性心脏病（RHD）和风湿热（RF）相关。然而，尽管风湿性心脏病的患病率显著下降，但左心房钙化仍持续被观察到。本研究的目的是调查左心房钙化的其他可能病因。
这项回顾性、观察性单中心研究纳入了2017年至2022年被确定为有左心房钙化的患者以及年龄和性别匹配的对照组。比较了风湿性心脏病、心房消融和二尖瓣疾病的患病率，并计算了每个独立变量的比值比。
纳入了62例左心房钙化患者并与62例对照进行比较。左心房钙化队列中87.1%的患者有房颤病史，而对照队列中为21%（<0.001）。钙化队列中16.1%的患者有风湿热病史，而对照队列中为零（=0.004）。左心房钙化队列中66.1%的患者有心房消融病史，而对照组为6.5%（<0.001）。左心房钙化的比值比为19.0，而风湿热为4.8（心房消融与风湿热的比较比值为4.0）。多变量对数模型发现心房消融可解释所确定的左心房钙化的79.8%。
我们的研究发现，与风湿性心脏病相比，心房消融病史与左心房钙化之间的关联高4倍，提示病因可能发生了转变。
