Abstract:

Objective   To compare the incidences of left atrial appendage (LAA) prothrombotic state, LAA thrombus and ischemic stroke of persistent atrial fibrillation (AF) patients with different pathogenesis. Methods   One hundred and forty patients with persistent AF were divided into atherosclerosis related group (AS group) and non-atherosclerosis related group (NAS group). Transthoracic echocardiography (TTE) and transesophageal (TEE) echocardiography evaluation were performed to measure cardiac structure, cardiac function, LAA flow velocity, LAA spontaneous echo contrast (SEC) and LAA thrombus. The medical history of stroke was recorded. Results   Compared with the NAS group, the incidences of LAA SEC (71.6% vs 47.0%), LAA thrombus (35.1% vs 16.7%) and ischemic stroke (19.8% vs 9.9%) of the AS group significantly increased (P<0.05). There were no differences in left ventricular systolic function, left atrial (LA) internal diameter, LA area, LAA area, and LAA flow velocity between the two groups (P>0.05). Conclusion   The incidences of LAA prothrombotic state, LAA thrombus and ischemic stroke of AF patients with AS-related diseases were higher compared with patients without AS-related diseases, indicating that the management of the AF patients with AS-related diseases need special strategies. Our study contributed to the individualized-treatment evidence of the anticoagulation therapy of AF patients.

Key words: Atrial fibrillation; Atherosclerosis related diseases; Embolism; Echocardiography