| Objective:To explore the relationship between left atrial appendage morphological（LAA-M）and left atrial appendage thrombus（LAAT）in low risk of stroke patients with nonvalvular atrial fibrillation to guide the atrial fibrillation（AF）anticoagulation through 64 row cardiac spiral computed tomography.Methods:The study consecutive recruited 154 low risk of stroke patients with atrial fibrillation（Male,CHA2DS2-VASc score≤1 minute;Female,CHA2DS2-VASc score≤2 minute）in the first affiliated hospital of Guangxi medical university between January 2014 and October 2017,and all these patients had set up GE 64 row cardiac spiral CT examination,Patients were divided into three groups according to the results of transesophageal echocardiography（TEE）:thrombosis[32 cases,age（53.0±11.6 years）],clouds[36 cases,age（56.4±8.8 years）]and no thrombosis groups[86 cases,age（53.2±8.1 years）],and measured left atrial appendage morphological structure through CT three-dimensional reconstruction system.Comparing the difference betweenthrombosis,clouds and no thrombosis groups of their general clinical data,blood biochemical indicators,LAA-M,left atrial appendage orifice morphology（LAA-OM）,left atrial appendage orifice long axis（LAA-OL）,left atrial appendage orifice short axis（LAA-OS）,left atrial appendage orifice perimeter（LAA-OC）,left atrial appendage orifice area（LAA-OA）,eft atrial appendage height（LAA-H）,left atrial appendage volume（LAA-V）,left atrial appendage lobes and the relationship between and left superior pulmonary vein（LSPV）position.Results:There were no difference between these three groups in general clinical date including:Gender,age,BMI,smoking,high blood pressure,diabetes,brain natriuretic peptide（BNP）,creatine kinase-MB（CK-MB）,cardiac troponin I（cTnI）,LAA-OM,LAA-H,left atrial appendage lobes and LAA relationship with LSPV position（P>0.05）.Compared with no thrombus group,the incidence of persistent AF in thrombosis and cloud group was higher than no thrombus group,and LAA-OL,LAA-OS,LAA-OC,LAA-OA,LAA-V were significantly increased（P<0.05）.The prevalence of cauliflower LAA in thrombus group was obviously higher than cloud group and no thrombosis group（P<0.05）.Multivariate logistic regression analysis identified cauliflower shape and increase of LAA-OL,LAA-OC are an independent risk factor of LAAT.Conclusion:The CHA2DS2-VASc score was low risk of NVAF patients with stroke（male≤1 minute and female≤2 minutes）,persistent AF,cauliflower shape and increase of LAA-OL,LAA-OS,LAA-OC,LAA-OA,LAA-V are predictors of LAAT,cauliflower shape and increase of LAA-OL,LAA-OC are an independent risk factor of LAAT,this part of patients with NVAF anticoagulation may get more benefit. |
