Left atrial appendage anatomical and functional parameters have been proposed to improve stroke risk stratification in atrial fibrillation, but current evidence remains conflicting.
Does left atrial appendage morphology and function predict the risk of ischaemic stroke in patients with atrial fibrillation?
LAA morphological and functional parameters show potential for improving thromboembolic risk stratification in AF beyond the CHA2DS2-VASc score, though current evidence remains conflicting.
AF is the most common cardiac arrhythmia and has been identified as an independent risk factor for stroke. The European Society of Cardiology guidelines recommend a thromboembolic event risk assessment based on the CHA2DS2-VASc score. However, stroke also occurs in some patients with a low CHA2DS2-VASc score. Therefore, it is necessary to find new factors to improve thromboembolic risk stratification in AF patients. Over 90% of embolic strokes are caused by thrombi originating from the left atrial appendage (LAA). Thus, certain anatomical or functional parameters of the LAA could potentially be used to predict cardioembolic stroke. Studies have suggested that some of these factors, such as LAA morphology, number of LAA lobes, LAA dimensions, LAA volume, distance from the LAA ostium to the first bend of LAA, LAA orifice diameter, extent of LAA trabeculations, LAA takeoff, LAA flow velocity and LAA strain rate, are independently associated with a higher risk of stroke in a population of patients with AF and improve the performance of the CHA2DS2-VASc score. However, the results are conflicting and, so far, no new parameter has been added to the CHA2DS2-VASc score.
Dudzińska-Szczerba et al. (Wed,) conducted a review in Atrial Fibrillation. Left atrial appendage morphology and function assessment was evaluated on Ischaemic stroke. Left atrial appendage anatomical and functional parameters have been proposed to improve stroke risk stratification in atrial fibrillation, but current evidence remains conflicting.