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Are left atrial diverticula and left-sided septal pouches relevant additional findings in cardiac CT? Correlation

Erkan Celik1, Lenhard Pennig1, Kai Roman Laukamp1

  • 1Department of Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany.

International Journal of Cardiology
|May 29, 2020
PubMed
Abstract

Insights

Left-sided septal pouches (LSSP) are common in the left atrium and significantly increase the risk of ischemic brain alterations. These pouches should be noted in cardiac CT reports as a potential stroke risk factor.

Area of Science:

  • Cardiology
  • Neurology
  • Radiology

Background:

  • Left atrial diverticula (LAD) and left-sided septal pouches (LSSP) are anatomical variations within the left atrium.
  • Their association with ischemic brain alterations requires further investigation.

Purpose of the Study:

  • To evaluate the correlation between LAD and LSSP and ischemic brain alterations.
  • To determine if these anatomical variations are independent risk factors for stroke.

Main Methods:

  • Retrospective analysis of 174 patients with cardiac CT angiography (CCTA) and brain MRI.
  • Independent review of CCTA and MRI by two radiologists to identify LAD, LSSP, and ischemic brain alterations.
  • Multivariate logistic regression analysis to assess correlations and adjust for risk factors.

Main Results:

  • LAD prevalence was 41% and LSSP prevalence was 37%; combined prevalence was 10%.
  • Ischemic brain alterations were more frequent in patients with LSSP (64.6%) compared to those without (39.4%).
  • LSSP presence was associated with a 3.5-fold increased risk of ischemic brain alterations (OR = 3.57, p < .01).

Conclusions:

  • LAD and LSSP are highly prevalent in the left atrium.
  • LSSP is a significant, independent risk factor for ischemic brain alterations.
  • LSSP should be reported in cardiac CT findings due to its association with cardioembolic stroke risk.

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