Left atrial appendage morphology and the risk of stroke
In patients with non-valvular atrial fibrillation (AF) the risk of stroke is five times higher than in patients with sinus rhythm. Moreover, stroke is likely to be more severe in the AF patient population. Left atrial appendage (LAA) is the most common source of emboli in AF-related stroke. LAA thro...
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doaj-39402e97263c4f3aa2f5be78459c92d22021-05-24T12:06:06ZengMedia Med PublicisRomanian Journal of Cardiology1220-658X2734-63822021-03-013114651https://doi.org/10.47803/rjc.2021.31.1.46Left atrial appendage morphology and the risk of strokeEmese Zsarnóczay0Lili Száraz1Anikó Ilona Nagy2https://orcid.org/0000-0002-0519-5172Béla Merkely3https://orcid.org/0000-0001-6514-0723Pál Maurovich-Horvat4https://orcid.org/0000-0003-0885-736XJudit Simon5https://orcid.org/0000-0001-8063-3462MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, HungaryMTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, HungaryMTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, HungaryMTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, HungaryMTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, HungaryMTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, HungaryIn patients with non-valvular atrial fibrillation (AF) the risk of stroke is five times higher than in patients with sinus rhythm. Moreover, stroke is likely to be more severe in the AF patient population. Left atrial appendage (LAA) is the most common source of emboli in AF-related stroke. LAA thrombus is present in 15% of AF patients. Therefore, numerous studies aimed to evaluate the role of LAA structure and function in stroke formation. Higher LAA volume and bigger LAA orifice have been reported to be associated with increased risks of stroke. Moreover, not only the size, but also the shape of the LAA influences thrombus formation. The presence of an obvious bend in the proximal part of the dominant LAA lobe, described as chicken wing LAA morphology has been reported to be protective against stroke. However, other studies are not consistent with this finding and there is no consensus about LAA morphology categories. LAA has reservoir, contractile, electric and endocrine functions, that can provide essential information about the risk of clot formation and embolic events. Decreased LAA flow velocity, reflecting lower LAA contractility has been described to be associated with higher stroke risk. All in all, even if the LAA plays an important role in stroke formation, there are controversial literature data, therefore further studies are needed to evaluate the underlying mechanisms.https://www.romanianjournalcardiology.ro/wp-content/uploads/2021/03/RRC_art-7-1.pdfatrial fibrilationstrokethrombusleft atrial appendagemorphology |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Emese Zsarnóczay Lili Száraz Anikó Ilona Nagy Béla Merkely Pál Maurovich-Horvat Judit Simon |
spellingShingle |
Emese Zsarnóczay Lili Száraz Anikó Ilona Nagy Béla Merkely Pál Maurovich-Horvat Judit Simon Left atrial appendage morphology and the risk of stroke Romanian Journal of Cardiology atrial fibrilation stroke thrombus left atrial appendage morphology |
author_facet |
Emese Zsarnóczay Lili Száraz Anikó Ilona Nagy Béla Merkely Pál Maurovich-Horvat Judit Simon |
author_sort |
Emese Zsarnóczay |
title |
Left atrial appendage morphology and the risk of stroke |
title_short |
Left atrial appendage morphology and the risk of stroke |
title_full |
Left atrial appendage morphology and the risk of stroke |
title_fullStr |
Left atrial appendage morphology and the risk of stroke |
title_full_unstemmed |
Left atrial appendage morphology and the risk of stroke |
title_sort |
left atrial appendage morphology and the risk of stroke |
publisher |
Media Med Publicis |
series |
Romanian Journal of Cardiology |
issn |
1220-658X 2734-6382 |
publishDate |
2021-03-01 |
description |
In patients with non-valvular atrial fibrillation (AF) the risk of stroke is five times higher than in patients with sinus rhythm. Moreover, stroke is likely to be more severe in the AF patient population. Left atrial appendage (LAA) is the most common source of emboli in AF-related stroke. LAA thrombus is present in 15% of AF patients. Therefore, numerous studies aimed to evaluate the role of LAA structure and function in stroke formation. Higher LAA volume and bigger LAA orifice have been reported to be associated with increased risks of stroke. Moreover, not only the size, but also the shape of the LAA influences thrombus formation. The presence of an obvious bend in the proximal part of the dominant LAA lobe, described as chicken wing LAA morphology has been reported to be protective against stroke. However, other studies are not consistent with this finding and there is no consensus about LAA morphology categories. LAA has reservoir, contractile, electric and endocrine functions, that can provide essential information about the risk of clot formation and embolic events. Decreased LAA flow velocity, reflecting lower LAA contractility has been described to be associated with higher stroke risk. All in all, even if the LAA plays an important role in stroke formation, there are controversial literature data, therefore further studies are needed to evaluate the underlying mechanisms. |
topic |
atrial fibrilation stroke thrombus left atrial appendage morphology |
url |
https://www.romanianjournalcardiology.ro/wp-content/uploads/2021/03/RRC_art-7-1.pdf |
work_keys_str_mv |
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