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Published on: July 20, 2022
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.
Abstract:
Cardioembolic events are accompanied by left atrial appendage (LAA) in patients suffering from atrial fibrillation (AF); therefore, the LAA closure is implemented as a preventive strategy. The detection of LAA morphologies and function is a paramount step before establishing the LAA closure. Herein, we sought to determine the morphologic features of the LAA in an Iranian population using echocardiographic evaluation. Seventy-two near-normal heart patients were investigated by conducting a cross-sectional study. All patients were examined using the 2-dimensional and 3-dimensional transesophageal echocardiography (2D- and 3D-TEE) method. The anatomical features and functions of LAA were examined. All images were stored and analyzed offline. The patients' mean age was 39 ± 15.5 year and 33 (45.8%) were female. The most frequent shape of LAA was wind sock . More LAA lobes was observed in patients with AF compared to those with NSR. In comparison with AF group, the NSR had higher LAA flow velocity (P < 0.01). The paroxysmal AF had greater LAA flow velocity and LAA ejection fraction in comparison with the chronic AF (39 ± 19 vs. 75 ± 22, P < 0.01; and 49±4 vs. 72±14, P < 0.003; respectively). The paroxysmal AF had smaller systolic LAA orifice area in comparison with the chronic AF (P < 0.02). The morphologic features of LAA in Iranian population were within the range of other studies and LAA length and orifice diameters in 2D- and 3D-TEE were consistent. In addition, AF influenced the morphologies and functions of LAA compared to sinus rhythm.
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