Left atrial appendage volume >8.75 mL predicted atrial fibrillation with 76.6% sensitivity and 48.6% specificity, and was an independent predictor of AF (95% CI 1.01-1.30; P=0.038).
Case-Control
LAA and LA volumes, as well as LAA orifice dimensions measured by CTA, are significantly greater in patients with AF and independently predict its presence.
p-value: p=0.038
Background: As an integral part of the left atrium (LA), the left atrial appendage (LAA) plays an important role in atrial fibrillation (AF). However, the relationship between LAA remodeling and AF has not been clearly defined. This retrospective case-control study aimed to assess the morphological and functional features of the LA and the LAA in AF patients using images obtained by computed tomography angiography (CTA). Methods: -test was used to analyze the normally distributed data, and the Wilcoxon rank-sum test was used for abnormally distributed data. The best critical value of predictors of AF was calculated using receiver operating characteristic (ROC) curve analysis. The correlation of the LAA volume change with the major and minor axes, area, and perimeter of the LAA orifice, and the LAA depth were analyzed using the Pearson correlation coefficient. Results: The LAA orifice's minor axis, LAA volume, and LA volume were significantly greater (P=0.004, P=0.010, and P<0.001, respectively) in patients with AF than in those without AF. The LAA volume 95% confidence interval (CI): 1.01 to 1.30; P=0.038 and LA volume (95% CI: 1.03 to 1.07; P<0.001) were significantly independent predictors of AF. An LAA volume of 8.75 mL had the highest predictive value for AF area under the curve (AUC), 0.612, with a sensitivity of 76.6% and a specificity of 48.6%. In contrast, an LA volume of 97.15 mL had the highest predictive value for AF (AUC, 0.771), with a sensitivity of 90.6% and a specificity of 53.6%. The change of LAA volume was positively weakly correlated with the area and perimeter of the LAA orifice (r=0.1703 and r=0.1378, respectively). The LAA emptying fraction was negatively correlated with the major axis and the area of the LAA orifice. The major and minor axes, area, and perimeter of the LAA orifice, and LAA depth were significantly greater in female than in male patients (P=0.003, P=0.003, P=0.001, P=0.019, and P<0.001, respectively). Conclusions: The AF patients had a longer minor axis of the LAA orifice than that of the control group, resulting in a more circular LAA orifice. The LAA orifice area and perimeter were positively correlated with LAA volume change. The LAA orifice major and minor axes, area, and perimeter, and the LAA depth of the female patients were significantly greater than those of their male counterparts in AF patients.
Tian et al. (Fri,) conducted a case-control in Atrial fibrillation. Left atrial appendage (LAA) and left atrial (LA) volume vs. Patients without atrial fibrillation was evaluated on Atrial fibrillation (95% CI 1.01-1.30, p=0.038). Left atrial appendage volume >8.75 mL predicted atrial fibrillation with 76.6% sensitivity and 48.6% specificity, and was an independent predictor of AF (95% CI 1.01-1.30; P=0.038).