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Left Atrial Diameter and the Risk of Thromboembolism in Patients with Left Ventricular Noncompaction

Aims: Patients with left ventricular noncompaction (LVNC) are at risk of thromboembolism. The relationship between left atrial diameter (LAD), a robust predictor for thrombosis, and LVNC is unclear. The purpose of this study was to explore the effect of LAD on the thrombotic risk in LVNC. Methods: I...

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Autores principales: Xu, Wei, Yang, Yanmin, Zhu, Jun, Tan, Jiangshan, Wang, Jingyang, Wang, Lulu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9788599/
https://www.ncbi.nlm.nih.gov/pubmed/36547423
http://dx.doi.org/10.3390/jcdd9120426
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author Xu, Wei
Yang, Yanmin
Zhu, Jun
Tan, Jiangshan
Wang, Jingyang
Wang, Lulu
author_facet Xu, Wei
Yang, Yanmin
Zhu, Jun
Tan, Jiangshan
Wang, Jingyang
Wang, Lulu
author_sort Xu, Wei
collection PubMed
description Aims: Patients with left ventricular noncompaction (LVNC) are at risk of thromboembolism. The relationship between left atrial diameter (LAD), a robust predictor for thrombosis, and LVNC is unclear. The purpose of this study was to explore the effect of LAD on the thrombotic risk in LVNC. Methods: In this retrospective cohort study, 320 patients with imaging characteristics of LVNC were included for statistical analysis. The primary endpoint was a composite event of intracardiac thrombi and stroke or transient ischemic attack (TIA). The secondary endpoints were intracardiac thrombi and stroke/TIA. Results: The 320 included patients (211 [65.9%] men, median age: 45 years [interquartile range: 30–57]) were divided into LAD1 (<43 mm, n = 157) and LAD2 (≥43 mm, n = 163) groups based on the median LAD. Throughout the median follow-up of 34 months, the incidence of thromboembolism among them was 7.2%: 11 (3.4%) patients had stroke/TIA and 14 (4.4%) had intracardiac thrombi. The rate of thromboembolism in the LAD2 group was higher than that of patients in the LAD1 group (11.0% vs. 3.2%, p = 0.007). Kaplan–Meier survival curves suggested that a LAD ≥ 43 mm was associated with a higher risk of thromboembolism and intracardiac thrombi (log-rank test, all p < 0.05). After adjusting for potential risk factors, LAD ≥ 43 mm was found to be an independent risk factor for thromboembolism (p = 0.013) and stroke (p = 0.024). The area under the receiver operating characteristic curve of LAD for predicting thromboembolism reached 0.696 at 1 year, 0.635 at 2 years, and 0.660 at 3 years. Conclusions: A larger LAD was related to a higher risk of thromboembolism in patients with LVNC. The LAD may be a useful predictor for thrombotic risk stratification among such patients.
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spelling pubmed-97885992022-12-24 Left Atrial Diameter and the Risk of Thromboembolism in Patients with Left Ventricular Noncompaction Xu, Wei Yang, Yanmin Zhu, Jun Tan, Jiangshan Wang, Jingyang Wang, Lulu J Cardiovasc Dev Dis Article Aims: Patients with left ventricular noncompaction (LVNC) are at risk of thromboembolism. The relationship between left atrial diameter (LAD), a robust predictor for thrombosis, and LVNC is unclear. The purpose of this study was to explore the effect of LAD on the thrombotic risk in LVNC. Methods: In this retrospective cohort study, 320 patients with imaging characteristics of LVNC were included for statistical analysis. The primary endpoint was a composite event of intracardiac thrombi and stroke or transient ischemic attack (TIA). The secondary endpoints were intracardiac thrombi and stroke/TIA. Results: The 320 included patients (211 [65.9%] men, median age: 45 years [interquartile range: 30–57]) were divided into LAD1 (<43 mm, n = 157) and LAD2 (≥43 mm, n = 163) groups based on the median LAD. Throughout the median follow-up of 34 months, the incidence of thromboembolism among them was 7.2%: 11 (3.4%) patients had stroke/TIA and 14 (4.4%) had intracardiac thrombi. The rate of thromboembolism in the LAD2 group was higher than that of patients in the LAD1 group (11.0% vs. 3.2%, p = 0.007). Kaplan–Meier survival curves suggested that a LAD ≥ 43 mm was associated with a higher risk of thromboembolism and intracardiac thrombi (log-rank test, all p < 0.05). After adjusting for potential risk factors, LAD ≥ 43 mm was found to be an independent risk factor for thromboembolism (p = 0.013) and stroke (p = 0.024). The area under the receiver operating characteristic curve of LAD for predicting thromboembolism reached 0.696 at 1 year, 0.635 at 2 years, and 0.660 at 3 years. Conclusions: A larger LAD was related to a higher risk of thromboembolism in patients with LVNC. The LAD may be a useful predictor for thrombotic risk stratification among such patients. MDPI 2022-11-30 /pmc/articles/PMC9788599/ /pubmed/36547423 http://dx.doi.org/10.3390/jcdd9120426 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Xu, Wei
Yang, Yanmin
Zhu, Jun
Tan, Jiangshan
Wang, Jingyang
Wang, Lulu
Left Atrial Diameter and the Risk of Thromboembolism in Patients with Left Ventricular Noncompaction
title Left Atrial Diameter and the Risk of Thromboembolism in Patients with Left Ventricular Noncompaction
title_full Left Atrial Diameter and the Risk of Thromboembolism in Patients with Left Ventricular Noncompaction
title_fullStr Left Atrial Diameter and the Risk of Thromboembolism in Patients with Left Ventricular Noncompaction
title_full_unstemmed Left Atrial Diameter and the Risk of Thromboembolism in Patients with Left Ventricular Noncompaction
title_short Left Atrial Diameter and the Risk of Thromboembolism in Patients with Left Ventricular Noncompaction
title_sort left atrial diameter and the risk of thromboembolism in patients with left ventricular noncompaction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9788599/
https://www.ncbi.nlm.nih.gov/pubmed/36547423
http://dx.doi.org/10.3390/jcdd9120426
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