TY - JOUR
T1 - Regional function analysis of left atrial appendage using motion estimation CT and risk of stroke in patients with atrial fibrillation
AU - Al-Issa, Abdullah
AU - Inoue, Yuko
AU - Cammin, Jochen
AU - Tang, Qiulin
AU - Nazarian, Saman
AU - Calkins, Hugh
AU - Fishman, Elliot K.
AU - Taguchi, Katsuyuki
AU - Ashikaga, Hiroshi
N1 - Funding Information:
This work was partially supported by the Saudi Arabian Cultural Mission (to A.A.-I.), the Magic that Matters Fund for Cardiovascular Research (to H.A.), and the National Institutes of Health R01-HL087918 (to K.T.)
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Aims The aim of this article is to determine the association between left atrial appendage (LAA) regional dysfunction using image-based motion-estimation computed tomography (CT) (iME) and a prior history of stroke or transient ischaemic attack (TIA) in patients with atrial fibrillation (AF). Methods and results In this single-centre retrospective case-control study, among patients referred for AF ablation who underwent preablation cardiac CT with retrospective ECG gating, we identified 18 patients with a prior history of stroke or TIA at the time of CT scan and 18 age- and gender-matched controls. All the patients were in sinus rhythm at the time of CT scan. Four-dimensional motion vector field was estimated from the CT images using iME. To assess myocardial deformation, area change ratio (A) and area change rate (AR) were calculated over the endocardial surface of the LAA. There was no significant difference in the baseline patient characteristics between the stroke/TIA group and the control group (67.6±8.1 years old, 66.7% male, 16.7% persistent AF). LAA maximum (Amax; 23.8±33.0 vs. 52.9±41.2%, P = 0.02) and pre-atrial contraction area change ratio (ApreA; 13.7±17.7 vs. 30.9±29.2%, P = 0.04) were significantly lower in the stroke/TIA group than in the control group, respectively. The difference in LAA Amax and ApreA remained significant in multivariate analysis (P = 0.03 and P = 0.04, respectively). Conclusion LAA regional dysfunction is associated with stroke/TIA in AF patients. Our results offer a basis for a prospective study to determine the role of LAA regional dysfunction by iME in predicting cerebrovascular events such as stroke or TIA. Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2015.
AB - Aims The aim of this article is to determine the association between left atrial appendage (LAA) regional dysfunction using image-based motion-estimation computed tomography (CT) (iME) and a prior history of stroke or transient ischaemic attack (TIA) in patients with atrial fibrillation (AF). Methods and results In this single-centre retrospective case-control study, among patients referred for AF ablation who underwent preablation cardiac CT with retrospective ECG gating, we identified 18 patients with a prior history of stroke or TIA at the time of CT scan and 18 age- and gender-matched controls. All the patients were in sinus rhythm at the time of CT scan. Four-dimensional motion vector field was estimated from the CT images using iME. To assess myocardial deformation, area change ratio (A) and area change rate (AR) were calculated over the endocardial surface of the LAA. There was no significant difference in the baseline patient characteristics between the stroke/TIA group and the control group (67.6±8.1 years old, 66.7% male, 16.7% persistent AF). LAA maximum (Amax; 23.8±33.0 vs. 52.9±41.2%, P = 0.02) and pre-atrial contraction area change ratio (ApreA; 13.7±17.7 vs. 30.9±29.2%, P = 0.04) were significantly lower in the stroke/TIA group than in the control group, respectively. The difference in LAA Amax and ApreA remained significant in multivariate analysis (P = 0.03 and P = 0.04, respectively). Conclusion LAA regional dysfunction is associated with stroke/TIA in AF patients. Our results offer a basis for a prospective study to determine the role of LAA regional dysfunction by iME in predicting cerebrovascular events such as stroke or TIA. Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2015.
KW - Atrial fibrillation
KW - Cardiac function
KW - Computed tomography
KW - Left atrial appendage
KW - Stroke
KW - Transient ischaemic attack
UR - http://www.scopus.com/inward/record.url?scp=84988811962&partnerID=8YFLogxK
U2 - 10.1093/ehjci/jev207
DO - 10.1093/ehjci/jev207
M3 - Article
C2 - 26341293
AN - SCOPUS:84988811962
SN - 2047-2404
VL - 17
SP - 788
EP - 796
JO - European heart journal cardiovascular Imaging
JF - European heart journal cardiovascular Imaging
IS - 7
ER -