TY - JOUR
T1 - Difference in left atrial appendage remodeling between diabetic and nondiabetic patients with atrial fibrillation
AU - Yosefy, Chaim
AU - Pery, Marina
AU - Nevzorov, Roman
AU - Piltz, Xavier
AU - Osherov, Azriel
AU - Jafari, Jamal
AU - Beeri, Ronen
AU - Gallego-Colon, Enrique
AU - Daum, Aner
AU - Khalameizer, Vladimir
N1 - Publisher Copyright:
© 2019 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Background: Diabetes mellitus (DM) is a common and increasingly prevalent condition in patients with atrial fibrillation (AFib). The left atrium appendage (LAA), a small outpouch from the LA, is the most common location for thrombus formation in patients with AFib. Hypothesis: In this study, we examined LAA remodeling differences between diabetic and nondiabetic patients with AFib. Methods: This retrospective study analyzed data from 242 subjects subdivided into two subgroups of 122 with DM (diabetic group) and 120 without DM (nondiabetic group). The study group underwent real-time 3-dimensional transesophageal echocardiography (RT3DTEE) for AFib ablation, cardioversion, or LAA device closure. The LAA dimensions were measured using the “Yosefy rotational 3DTEE method.”. Results: The RT3DTEE analysis revealed that diabetic patients display larger LAA diameters, D1-lengh (2.09 ± 0.50 vs 1.88 ± 0.54 cm, P =.003), D2-width (1.70 ± 0.48 vs 1.55 ± 0.55 cm, P =.024), D3-depth (2.21 ± 0.75 vs 1.99 ± 0.65 cm, P =.017), larger orifice areas (2.8 ± 1.35 and 2.3 ± 1.49 cm2, P =.004), and diminished orifice flow velocity (37.3 ± 17.6 and 43.7 ± 19.5 cm/sec, P =.008). Conclusions: Adverse LAA remodeling in DM patients with AFib is characterized by significantly LAA orifice enlargement and reduced orifice flow velocity. Analysis of LAA geometry and hemodynamics may have clinical implications in thrombotic risk assessment and treatment of DM patients with AFib.
AB - Background: Diabetes mellitus (DM) is a common and increasingly prevalent condition in patients with atrial fibrillation (AFib). The left atrium appendage (LAA), a small outpouch from the LA, is the most common location for thrombus formation in patients with AFib. Hypothesis: In this study, we examined LAA remodeling differences between diabetic and nondiabetic patients with AFib. Methods: This retrospective study analyzed data from 242 subjects subdivided into two subgroups of 122 with DM (diabetic group) and 120 without DM (nondiabetic group). The study group underwent real-time 3-dimensional transesophageal echocardiography (RT3DTEE) for AFib ablation, cardioversion, or LAA device closure. The LAA dimensions were measured using the “Yosefy rotational 3DTEE method.”. Results: The RT3DTEE analysis revealed that diabetic patients display larger LAA diameters, D1-lengh (2.09 ± 0.50 vs 1.88 ± 0.54 cm, P =.003), D2-width (1.70 ± 0.48 vs 1.55 ± 0.55 cm, P =.024), D3-depth (2.21 ± 0.75 vs 1.99 ± 0.65 cm, P =.017), larger orifice areas (2.8 ± 1.35 and 2.3 ± 1.49 cm2, P =.004), and diminished orifice flow velocity (37.3 ± 17.6 and 43.7 ± 19.5 cm/sec, P =.008). Conclusions: Adverse LAA remodeling in DM patients with AFib is characterized by significantly LAA orifice enlargement and reduced orifice flow velocity. Analysis of LAA geometry and hemodynamics may have clinical implications in thrombotic risk assessment and treatment of DM patients with AFib.
KW - atrial fibrillation
KW - diabetes mellitus
KW - left atrial appendage
KW - left atrium
KW - real-time 3-dimensional transesophageal echocardiography
KW - stroke
UR - http://www.scopus.com/inward/record.url?scp=85075468595&partnerID=8YFLogxK
U2 - 10.1002/clc.23292
DO - 10.1002/clc.23292
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C2 - 31755572
AN - SCOPUS:85075468595
SN - 0160-9289
VL - 43
SP - 71
EP - 77
JO - Clinical Cardiology
JF - Clinical Cardiology
IS - 1
ER -
