| Objective: The morphological characteristics of left atrial appendage in patients with non-valvular atrial fibrillation were analyzed by enhanced CT scans and CARTO-3.0 system to explore the differences of morphological characteristics of left atrial appendage caused by age,sex,duration of atrial fibrillation,heart failure,CHA2DS2-VASc score and so on.Method:One hundred and sixty-two AF patients undergoing radiofrequency ablation from May 2014 to October 2018 in the Second Hospital of Hebei Medical University were collected.All patients underwent Cardiac contrast-enhanced CT examination before operation.Three-dimensional reconstruction of pulmonary vein and left atrium was carried out by processing technique,and the image was introduced into CARTO-3.0 system for morphological observation and parameter measurement of left atrial appendage.The patients were divided into groups according to their age,sex,history of atrial fibrillation,history of heart failure and CHA2DS2-VASc score.The differences of the LAA morphology,the LAA opening shape,the caliber of LAA,the length and the number of lobes of LAA were analyzed between groups to explore the related factors that cause the change of the LAA morphological characteristics.Results:1.Analysis of morphological characteristics of LAA in patients with different types of AF:Compared with paroxysmal AF patients,persistent AF patients had larger LAA orifice diameter(the maximum diameter:27.53±5.50 mm vs 24.54±5.50 mm,the minimum diameter:20.88±4.22 mm vs 16.75±4.08 mm,Rao 30ocau20o diameter:23.59±4.42 mm vs 20.56±4.74 mm,P<0.05);but there was no significant difference in LAA orifice diameter in patients with long-term persistent AF compared with those in patients with persistent AF less than one year(the maximum diameter:27.69±5.68 mm vs 27.11±5.11 mm,the minimum diameter:21.17±4.62 mm vs 20.11±2.85 mm,Rao30ocau20odiameter: 23.69± 4.41 mm vs 23.33±4.56 mm,P>0.05).There was no significant difference in the LAA morphology,the LAA opening shape,the length of LAA and the number of LAA lobes between paroxysmal AF patients and persistent AF patients and between less than one year persistent AF patients and long-term persistent AF patients.2.Analysis of morphological characteristics of LAA in patients with different stroke risk:According to CHA2DS2-VASc score the petients were divided into two groups : the low risk group whoes CHA2DS2-VASc score?1 and the middle-high risk group whoes CHA2DS2-VASc score?2.The study found that patients in middle-high risk group had larger LAA diameter than patients in low risk group(the maximum diameter:26.77±5.71 mm vs 24.00±5.21 mm,the minimum diameter:19.20±4.49 mm vs 17.09±4.50 mm,Rao30ocau20odiameter: 22.64±4.81 mm vs 20.32±4.56 mm,P<0.05).There was statistical difference in the shape distribution of LAA orifice in patients with different stroke risk: Compared with low-risk patients,middle-high risk patients had more oval LAA orifice(56/103,54.4% vs 27/59,45.8%)but less water drop(15/103,14.6% vs 11/59,18.6%)and Foot-like(7/103,6.8% vs 7/59,11.9%).3.The number of LAA lobes in different gender patients with AF is different,the proportion of multi-lobe LAA in male patients is higher than that in female patients(23/98,23.37% vs 5/64,7.81%).4.The LAA opening size and shape,the LAA shape and the number of LAA lobes in the patients with AF were not significantly affected by age and heart failure.5.There was a positive correlation between the LAA opening diameter and the left atrium anteroposterior diameter(measured by TTE): the maximum diameter of LAA and anteroposterior diameter of left atrium: r=0.283,P<0.05;the minimum diameter of LAA and anteroposterior diameter of left atrium: r=0.467,P<0.05;the Rao30ocau20odiameter of LAA and anteroposterior diameter of left atrium: r=0.282,P<0.05.Conclusion:The LAA opening diameter in patients with persistent AF is larger than that in patients with paroxysmal AF.AF patients with higher CHA2DS2-VASc score have larger LAA diameter. |
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