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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Clinical characteristics of complex aortic plaque in patients with non-valvular atrial fibrillation

Pil-Sung Yang1, Tae-Hoon Kim1, Jae-Sun Uhm1

  • 1Yonsei University Health System, Seoul, Republic of Korea.

International Journal of Cardiology
|January 1, 2017
PubMed

Insights

Complex aortic plaque (CxAoP) is often missed in non-valvular atrial fibrillation (NVAF) patients, impacting stroke risk assessment. Detecting CxAoP improves thromboembolic risk stratification for better stroke prevention strategies.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Echocardiography

Background:

  • Complex aortic plaque (CxAoP) is a known risk factor in atrial fibrillation (AF) but often undetected by standard assessments.
  • Trans-esophageal echocardiogram (TEE) is crucial for identifying CxAoP, which may be underestimated in non-valvular AF (NVAF) patients.

Purpose of the Study:

  • To evaluate the incidence and clinical significance of CxAoP in patients with NVAF.
  • To determine the association between CxAoP and other risk factors for stroke.
  • To assess the impact of CxAoP detection on thromboembolic risk stratification.

Main Methods:

  • A cohort of 981 NVAF patients undergoing catheter ablation were included.
  • Pre-procedural TEE was performed to assess for CxAoP and left atrial (LA)-cardioembolic (CE) milieu.
  • Statistical analysis identified independent predictors of CxAoP and its association with clinical outcomes.

Main Results:

  • CxAoP was detected in 8.3% of NVAF patients, independently associated with older age, male sex, and higher CHA₂DS₂-VASc scores.
  • CxAoP presence only overlapped with LA-CE milieu in 11% of patients, suggesting distinct pathophysiological mechanisms.
  • Undetected CxAoP led to underestimation of thromboembolic risk in 11% of high-risk patients.

Conclusions:

  • CxAoP represents a distinct mechanism of stroke risk in NVAF patients compared to LA-CE milieu.
  • Routine TEE assessment for CxAoP is vital for accurate thromboembolic risk stratification and guiding stroke prevention in NVAF.
  • Identifying CxAoP can refine treatment decisions for stroke prevention in NVAF.
Abstract

Keywords:
Atrial fibrillationCHA(2)DS(2)-VASc scoreComplex aortic plaque

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