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Updated: Jun 12, 2026
08:10
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Risk Factors for Left Atrial Thrombus in Patients with Hypertrophic Cardiomyopathy and Atrial Fibrillation
Raghav R Julakanti1, Kendra Gilreath2, Julia Debertin2
1Minneapolis Heart Institute, St. Paul, Minnesota.
Summary
In hypertrophic cardiomyopathy (HCM) patients with atrial fibrillation (AF), reduced left atrial appendage emptying velocity (LAAEV) is linked to a higher risk of left atrial (LA) thrombus. This finding is crucial for managing anticoagulation and preventing thromboembolism.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Thrombosis Research
Background:
- Patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AF) face an elevated risk of left atrial (LA) thrombus.
- The presence of LA thrombus complicates management, especially for interventions like cardioversion, due to increased thromboembolism risk.
Purpose of the Study:
- To investigate predictors of LA thrombus in patients with HCM and AF.
- To identify factors associated with LA thrombus presence despite anticoagulation therapy.
Main Methods:
- Retrospective analysis of 693 patients with HCM and AF.
- Inclusion of transesophageal echocardiogram (TEE) and transthoracic echocardiogram (TTE) data within one year.
- Statistical analysis including univariate and multivariable logistic regression.
Main Results:
- Left atrial appendage emptying velocity (LAAEV) was the only significant independent predictor of LA thrombus (OR 1.05; 95% CI 1.01-1.12, p=0.035).
- Lower LAAEV was associated with a higher likelihood of LA thrombus.
- Higher CHA2DS2-VASc score, lower left ventricular ejection fraction, and lower left ventricular outflow tract gradient were associated with LA thrombus on univariate analysis but not in multivariable analysis.
Conclusions:
- Reduced LAAEV is a significant predictor of LA thrombus in patients with HCM and AF, even with appropriate anticoagulation.
- These findings highlight the importance of assessing LAA function in this patient population.
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