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J Cardiovasc Thorac Res. 2019;11(3):230-236. doi: 10.15171/jcvtr.2019.38. Epub 2019 Aug 29.

Morphologic and functional features of left atrial appendage in Iranian population: an echocardiographic study.

Author information

1
Echocardiography Research center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
2
Cardiac Electrophysiology Research Center, Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
3
Tehran University of Medical Sciences, Tehran, Iran.
4
Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: Cardioembolic events are accompanied by left atrial appendage (LAA) in patients suffering from atrial fibrillation (AF); therefore, the LAA closure is implemented as a preventive strategy. The detection of LAA morphologies and function is a paramount step before establishing the LAA closure. Herein, we sought to determine the morphologic features of the LAA in an Iranian population using echocardiographic evaluation. Methods: Seventy-two near-normal heart patients were investigated by conducting a cross-sectional study. All patients were examined using the 2-dimensional and 3-dimensional transesophageal echocardiography (2D- and 3D-TEE) method. The anatomical features and functions of LAA were examined. All images were stored and analyzed offline. Results: The patients' mean age was 39 ± 15.5 year and 33 (45.8%) were female. The most frequent shape of LAA was wind sock . More LAA lobes was observed in patients with AF compared to those with NSR. In comparison with AF group, the NSR had higher LAA flow velocity (P < 0.01). The paroxysmal AF had greater LAA flow velocity and LAA ejection fraction in comparison with the chronic AF (39 ± 19 vs. 75 ± 22, P < 0.01; and 49±4 vs. 72±14, P < 0.003; respectively). The paroxysmal AF had smaller systolic LAA orifice area in comparison with the chronic AF (P < 0.02). Conclusion: The morphologic features of LAA in Iranian population were within the range of other studies and LAA length and orifice diameters in 2D- and 3D-TEE were consistent. In addition, AF influenced the morphologies and functions of LAA compared to sinus rhythm.

KEYWORDS:

3-Dimensional Echocardiography; Atrial Fibrillation; Left Atrial Appendage; Transesophageal Echocardiography; Transthoracic Echocardiography

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