title: Morphological features of the left atrial appendage in consecutive coronary computed tomography angiography patients with and without atrial fibrillation.
abstract: The majority of intracardiac thrombi form in the left atrial appendage (LAA). Enlargement of this structure, together with certain morphological features, may indicate a predisposition to the formation of thrombi and subsequent cardioembolic stroke. Thus far, studies on LAA morphology have largely focused on those patients with atrial fibrillation (AF). Taking a different approach, we investigated the variation in LAA morphology in a consecutive patient population with and without AF. We evaluated 808 consecutive patients (529 females; mean age 52.5±9.9 years) who underwent coronary artery computed tomography angiography (CCTA), the majority of whom (749) had no history of AF. We assessed the length, lobe number, and morphological classification of their LAAs. Demographic data and medical histories were collated from medical records and then correlated with LAA morphology. The proportions of each of the four morphological classes of LAA for the overall vs. non-AF population were: WindSock, 62.3/61.5%; Cactus, 18.6/18.8%; ChickenWing, 10.0/10.0%; and CauliFlower, 9.2/9.6%. Age (p<0.001; r = 0.156) and female gender (p<0.001) were both found to be associated with an increased body surface area (BSA)-related LAA length. Male patients were more likely to manifest multi-lobed (p = 0.003) LAAs, and overweight patients with a greater number of multi-lobed LAA morphological classes (p = 0.010). No associations with morphological LAA features could be found for patients with diabetes, hypertension, or dyslipidemia. Nor did the size of the left atrium exhibit any correlation with BSA-related LAA length. In the overall and non-AF populations, aging and female gender were associated with longer BSA-indexed LAAs.
authors.affiliation: Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.|Unit of Radiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Miika
authors.identifier: http://orcid.org/0000-0001-5280-1772
authors.initials: M
authors.lastname: Korhonen
authors.affiliation: Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.|Unit of Radiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Johannes
authors.initials: J
authors.lastname: Parkkonen
authors.affiliation: Heart Center, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Marja
authors.initials: M
authors.lastname: Hedman
authors.affiliation: Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.|Unit of Radiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Muuronen
authors.affiliation: Neuro Center, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Juha
authors.initials: J
authors.lastname: Onatsu
authors.affiliation: Department of Cardiology, Keski-Suomi Central Hospital, Jyväskylä, Finland.
authors.forename: Pirjo
authors.initials: P
authors.lastname: Mustonen
authors.affiliation: Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.|Unit of Radiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Ritva
authors.initials: R
authors.lastname: Vanninen
authors.affiliation: Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.|Unit of Radiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Mikko
authors.initials: M
authors.lastname: Taina
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000503:physiopathology; D000072226:Computed Tomography Angiography / Q000379:methods*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged