Related Experiment Video
Updated: Nov 26, 2025
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Left Atrial Appendage Morphology and Left Atrial Wall Thickness Are Associated with Cardio-Embolic Stroke
Agne Adukauskaite1, Fabian Barbieri1, Thomas Senoner1
1Department of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
Insights
New markers for stroke risk stratification in patients with atrial fibrillation (AF) are needed. Left atrial appendage (LAA) and left atrium (LA) morphology on cardiac computed tomography angiography (CTA) are associated with cardio-embolic (CE) stroke.
Area of Science:
- Cardiology
- Radiology
- Neurology
Background:
- Risk stratification for stroke in atrial fibrillation (AF) patients requires novel markers.
- Left atrial appendage (LAA) and left atrium (LA) morphology may influence cardio-embolic (CE) stroke risk.
Purpose of the Study:
- To investigate the association between LAA and LA morphological parameters and CE stroke in AF patients.
- To identify potential imaging biomarkers for stroke risk in AF.
Main Methods:
- Retrospective analysis of 158 AF patients (56 with CE stroke, 102 controls) who underwent cardiac computed tomography angiography (CTA).
- Morphological parameters of LAA and LA were analyzed.
- Multivariable regression analysis adjusted for CHA₂DS₂-VASc score and LA diameter.
Main Results:
- Windsock LAA type, increased LAA lobe number, larger LAA ostium area, and greater left atrium wall thickness (LAWT) were independently associated with CE stroke.
- These associations remained significant after adjusting for CHA₂DS₂-VASc score and LA diameter.
Conclusions:
- Specific LAA and LA morphological features, identifiable via CTA, are associated with an increased risk of CE stroke in AF patients.
- These CTA-derived parameters may enhance the risk stratification of thromboembolic stroke in this population.
Background:
New markers for stroke risk stratification in patients with atrial fibrillation (AF) are on demand. Hence, we aimed to investigate the association of left atrial appendage (LAA) and left atrium (LA) morphological parameters in patients with cardio-embolic (CE) stroke due to AF in comparison to controls without stroke.
Methods:
A retrospective analysis of cardiac computed tomography angiography (CTA) examinations performed between 2006 and 2017 for clinical indications in 158 patients (median age 65 (54-73) years, 48.7% females) was conducted: 56 patients with CE stroke were compared to 102 controls not differing in gender, body mass index (BMI) and CHA2DS2-VASc score.
Results:
On multivariable regression analysis adjusted for CHA2DS2-VASc score and LA diameter CE stroke was independently associated with the following parameters: windsock LAA type (OR 2.55; CI: 1.04-6.26, p = 0.041), a greater lobe number (OR 1.54; CI: 1.13-2.10, p = 0.006), a greater LAA ostium area (OR 1.88; CI: 1.38-2.55, p < 0.001) and a greater left atrium wall thickness (LAWT) in the middle and right part, measured along the anterior LA wall in the axial plane (respectively, OR 1.94; CI: 1.26-3.0, p = 0.003 and OR 1.57; CI: 1.07-2.31, p = 0.021).
Conclusions:
The windsock LAA type, a greater LAA lobe number, a larger LAA ostium and a greater LAWT are associated with CE stroke. These CTA parameters could improve risk stratification for thromboembolic stroke.
More Related Videos
08:10Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
28:13Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Related Concept Videos
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
01:24Cardiac Catheterization III: Left Heart Catheterization