Difference in left atrial appendage remodeling between diabetic and nondiabetic patients with atrial fibrillation

Chaim Yosefy*, Marina Pery, Roman Nevzorov, Xavier Piltz, Azriel Osherov, Jamal Jafari, Ronen Beeri, Enrique Gallego-Colon, Aner Daum, Vladimir Khalameizer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


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.

Original languageAmerican English
Pages (from-to)71-77
Number of pages7
JournalClinical Cardiology
Issue number1
StatePublished - 1 Jan 2020

Bibliographical note

Publisher Copyright:
© 2019 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc.


  • atrial fibrillation
  • diabetes mellitus
  • left atrial appendage
  • left atrium
  • real-time 3-dimensional transesophageal echocardiography
  • stroke


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