Dilated left atrium and pulmonary veins in patients with calcified coronary artery: a potential contributor to the genesis of atrial fibrillation.
BACKGROUND
Coronary artery disease (CAD) is an important etiology of atrial fibrillation (AF). Coronary artery calcification is a marker of coronary atherosclerosis and coronary events. The purpose of this study was to investigate whether larger left atrium (LA) and pulmonary veins (PVs) were seen by multidetector computed tomography (MDCT) scans in those patients with higher coronary calcium scores.


RESULTS
A total of 166 patients undergoing MDCT for general check-up (n = 128, 77%) or suspected CAD (n = 38, 23%) were enrolled and divided into a control (calcium score = 0, n = 60), medium calcium score (calcium score = 100 approximately 400, n = 47), and high calcium score (calcium score >400, n = 59) groups. Diameters and areas of the LA, left atrial appendage (LAA), and PVs were measured by MDCT. The high calcium score group had significantly larger PVs diameters, LAA orifice area (1.9 +/- 1.4 cm(2), 0.9 +/- 0.5 cm(2), 0.8 +/- 0.4 cm(2), P < 0.005), LA anterior-posterior distance (32.2 +/- 6.8 mm, 30.4 +/- 6.5 mm, 27.3 +/- 6.0 mm, P < 0.05), and transverse distance (52.6 +/- 7.3 mm, 50.2 +/- 9 mm, 49.5 +/- 4.6 mm, P < 0.05) than the medium calcium score and control groups. Six (3.6%) patients with paroxysmal AF had higher calcium scores and larger diameters of LA, LAA, and PVs than those (96.4%) without paroxysmal AF. Two patients in the high calcium score group had calcified PVs localized to the right upper and left upper PVs. The incidence of calcified PVs was 1.2% for the total patients and 3.3% for the high calcium score patients.


CONCLUSIONS
In the presence of high calcium scores in this patient population, the LA, LAA, and PVs were enlarged.
Pan
Nan-Hung
NH
Division of Cardiovascular Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
Tsao
Hsuan-Ming
HM
Chang
Nen-Chung
NC
Lee
Chih-Ming
CM
Chen
Yi-Jen
YJ
Chen
Shih-Ann
SA
D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology* / Q000473:pathology; D002114:Calcinosis / Q000150:complications / Q000473:pathology*; D002118:Calcium / Q000378:metabolism; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000473:pathology*; D003324:Coronary Artery Disease / Q000150:complications / Q000473:pathology*; D005260:Female; D006325:Heart Atria; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000473:pathology*; D014057:Tomography, X-Ray Computed
D002118:Calcium