TY - JOUR
T1 - Characteristics of pulmonary vein enlargement in non-valvular atrial fibrillation patients with stroke
AU - Lee, Jung Myung
AU - Kim, Jong Youn
AU - Shim, Jaemin
AU - Uhm, Jae Sun
AU - Kim, Young Jin
AU - Lee, Hye Jeong
AU - Pak, Hui Nam
AU - Lee, Moon Hyoung
AU - Joung, Boyoung
N1 - Publisher Copyright:
© Yonsei University College of Medicine 2014.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Purpose: The association between pulmonary vein (PV) dilatation and stroke in non-valvular atrial fibrillation (AF) patients remains unknown.Materials and Methods: We examined the left atrium (LA) and PV in control (n=138) and non-valvular AF patients without (AF group, n=138) and with non-hemorrhagic stroke (AF with stroke group, n=138) using computed tomography.Results: The LA, LA appendage (LAA), and all PVs were larger in the AF than control patients. The orifice areas of the LAA (5.6±2.2 cm2 vs. 4.7±1.7 cm2, p<0.001), left superior PV (3.8±1.5 cm2 vs. 3.4±1.2 cm2, p=0.019), and inferior PV (2.3±1.0 cm2 vs. 1.8±0.7 cm2, p<0.001) were larger in the AF with stroke than in the AF only group. However, right PVs were not different between the two groups. In a multivariate analysis, the orifice areas of the left superior PV [odds ratio (OR) 1.25, 95% confidence interval (CI) 1.03–1.51, p=0.02], left inferior PV (OR 1.97, 95% CI 1.41–2.75, p<0.001), and LAA (OR 1.30, 95% CI 1.13–1.50, p<0.001) were independent predictors of stroke.Conclusion: Compared to the right PVs, the left PVs and LAA exhibited more significant enlargement in patients with AF and stroke than in patients with AF only. This finding suggests that the remodeling of left-sided LA structures might be related to stroke.
AB - Purpose: The association between pulmonary vein (PV) dilatation and stroke in non-valvular atrial fibrillation (AF) patients remains unknown.Materials and Methods: We examined the left atrium (LA) and PV in control (n=138) and non-valvular AF patients without (AF group, n=138) and with non-hemorrhagic stroke (AF with stroke group, n=138) using computed tomography.Results: The LA, LA appendage (LAA), and all PVs were larger in the AF than control patients. The orifice areas of the LAA (5.6±2.2 cm2 vs. 4.7±1.7 cm2, p<0.001), left superior PV (3.8±1.5 cm2 vs. 3.4±1.2 cm2, p=0.019), and inferior PV (2.3±1.0 cm2 vs. 1.8±0.7 cm2, p<0.001) were larger in the AF with stroke than in the AF only group. However, right PVs were not different between the two groups. In a multivariate analysis, the orifice areas of the left superior PV [odds ratio (OR) 1.25, 95% confidence interval (CI) 1.03–1.51, p=0.02], left inferior PV (OR 1.97, 95% CI 1.41–2.75, p<0.001), and LAA (OR 1.30, 95% CI 1.13–1.50, p<0.001) were independent predictors of stroke.Conclusion: Compared to the right PVs, the left PVs and LAA exhibited more significant enlargement in patients with AF and stroke than in patients with AF only. This finding suggests that the remodeling of left-sided LA structures might be related to stroke.
KW - Atrial appendage
KW - Atrial fibrillation
KW - Multidetector computed tomography
KW - Pulmonary veins
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=84908229699&partnerID=8YFLogxK
U2 - 10.3349/ymj.2014.55.6.1516
DO - 10.3349/ymj.2014.55.6.1516
M3 - Article
C2 - 25323887
AN - SCOPUS:84908229699
SN - 0513-5796
VL - 55
SP - 1516
EP - 1525
JO - Yonsei Medical Journal
JF - Yonsei Medical Journal
IS - 6
ER -