ISSN 1016-5169 | E-ISSN 1308-4488
Archives of the Turkish Society of Cardiology
The influence of left ventricular diameter on left atrial appendage size and thrombus formation in patients with dilated cardiomyopathy [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2010; 38(2): 90-94

The influence of left ventricular diameter on left atrial appendage size and thrombus formation in patients with dilated cardiomyopathy

Aurora Bakalli1, Lulzim Kamberi1, Ejup Pllana1, Bedri Zahiti1, Gani Dragusha1, Ahmet Brovina2
1Department of Cardiology, University Clinical Center of Kosova, Prishtine, Kosove
2Department of Hematology, University Clinical Center of Kosova, Prishtine, Kosove


OBJECTIVES
Patients with dilated cardiomyopathy are considered a high risk group for left ventricular (LV) thrombus formation. However, the left atrial appendage (LAA) might be an additional site for thrombus formation in this patient group. We evaluated the association between LV size and left atrium/LAA size and determined the incidence of spontaneous echo contrast (SEC)/thrombus in the LV, left atrium, and LAA in patients with and without enlarged LV dimensions.

STUDY DESIGN
In a prospective design, we examined 45 patients with transthoracic and transesophageal echocardiography. Nineteen patients had an enlarged LV dimension (group 1: LV end-diastolic diameter ≥58 mm), and 26 patients had a normal LV size (group 2). Nonvalvular atrial fibrillation (AF) was present in 13 patients (68.4%) in group 1 and in 14 patients (53.9%) in group 2. Echocardiographic parameters included LV dimension and ejection fraction, left atrial diameter, LAA maximal area, and detection of SEC/thrombus in the LV, left atrium, and LAA.

RESULTS
The two groups were similar with regard to demographic and clinical features. Patients in group 1 had a significantly increased LV end-diastolic diameter (63.5±3.8 mm vs. 50.9±0.9 mm; p<0.001) and decreased ejection fraction (45.3±11.7% vs. 56.0±10.2%; p=0.002). Left atrial diameter did not differ significantly, but maximal LAA area was significantly greater in group 1 (4.9±2.3 cm2 vs. 3.3±0.8 cm2; p=0.002). Among the frequencies of SEC and thrombus in the LV, left atrium, and LAA, only the frequency of thrombus in the LAA was significantly higher in group 1 (36.8% vs. 7.7%; p=0.05). Compared to patients with a normal LV size and AF, the coexistence of AF with dilated LV was significantly associated with a greater LV end-diastolic diameter (p<0.001) and LAA maximal area (p=0.02).

CONCLUSION
Patients with a dilated LV have a larger LAA and seem to be at a higher risk for LAA thrombus formation.

Keywords: Atrial appendage/ultrasonography, atrial fibrillation/complications; cardiomyopathy, dilated/complications; echocardiography, transesophageal; thrombosis/diagnosis.

How to cite this article
Aurora Bakalli, Lulzim Kamberi, Ejup Pllana, Bedri Zahiti, Gani Dragusha, Ahmet Brovina. The influence of left ventricular diameter on left atrial appendage size and thrombus formation in patients with dilated cardiomyopathy. Turk Kardiyol Dern Ars. 2010; 38(2): 90-94

Corresponding Author: Aurora Bakalli, Kosovo
Manuscript Language: English


Journal Metrics

Journal Citation Indicator: 0.18
CiteScore: 1.1
Source Normalized Impact
per Paper:
0.22
SCImago Journal Rank: 0.348

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