Morphologic and functional features of left atrial appendage in Iranian population: an echocardiographic study

Roghayeh Pourkia1, Mahsa Panahi1, Zahra Emkanjoo2

  • 1Echocardiography Research center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

Insights

Left atrial appendage (LAA) morphology and function differ in patients with atrial fibrillation (AF). Echocardiography revealed distinct LAA features in an Iranian population, influencing closure strategies.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Anatomy

Background:

  • Cardioembolic events are linked to the left atrial appendage (LAA) in atrial fibrillation (AF) patients.
  • LAA closure is a preventive strategy, requiring detailed LAA morphology and function assessment.
  • Understanding ethnic-specific LAA characteristics is crucial for effective interventions.

Purpose of the Study:

  • To investigate the morphologic and functional characteristics of the LAA in an Iranian population.
  • To compare LAA features between patients with AF and normal sinus rhythm (NSR).
  • To evaluate differences in LAA morphology and function between paroxysmal and chronic AF.

Main Methods:

  • A cross-sectional study involving 72 patients with near-normal hearts.
  • Utilized 2D and 3D transesophageal echocardiography (TEE) for LAA assessment.
  • Analyzed anatomical features, function, LAA lobes, shape, flow velocity, and ejection fraction.

Main Results:

  • The most common LAA shape was 'wind sock'.
  • Patients with AF exhibited more LAA lobes than those with NSR.
  • NSR patients had higher LAA flow velocity compared to AF patients.
  • Paroxysmal AF showed greater LAA flow velocity and ejection fraction but a smaller systolic orifice area than chronic AF.

Conclusions:

  • LAA morphologic features in the Iranian population align with international findings.
  • Atrial fibrillation significantly influences LAA morphology and function compared to sinus rhythm.
  • Echocardiographic evaluation provides consistent LAA measurements for clinical decision-making.