Morphological features of the left atrial appendage on multislices computed tomography in patients with non-valvular atrial fibrilation

Abstract

Objective: To study morphological characteristics of left atrial appendage on computed tomography in patients with non-valvular atrial fibrillation. [1]
 Methods: A cross-sectional descriptive study was conducted in 66 patients with non-valvular atrial fibrilation who underwent multislices computed tomography at Hanoi Heart Hospital from August 2020 to October 2022. Data of medical history, clinical examination, ECG, echocardiography were collected. We assessed the length, lobe number, and morphological classification of their LAAs on multislices computed tomography. 
 Result: From 8/2020 to 10/2022, 66 patients were included in the study, the mean age was 58,4 ± 10,8 with male/femail ratio of 3/1. The proportion of left atrium morphology including chicken wing, wind sock, cauliflower and cactus is 56,6%; 19,7%; 12,1% and 10,6%, respectively. Most of the left atrium in the study group had 2 lobé (51,5%), 3 lobes (21,2%), 1 lobe (18,2%) and 4 lobes (9,1%). There was no diference in left atrial appendage morphology according to CHA2DS2-VASc score, and risk factors for atrial fibrillation (gender, heart failure, hypertension, diabetes, stroke). Patients with left atrial dilatation (LAVi > 34ml/m2) had a larger mouth diameter and area than the group without left atrial dilatation (p< 0,001 and 0,008). 
 Conclusion: The left atrial appendage has 4 main morphologies: chicken wing, wind sock, cauliflower and cactus, in which the chicken wing shape is the most common. Most of the left atrial appendage have 2 lobes and 3 lobes. There was no difference in left atrial appendage morphology by age group, atrial fibrillation risk factors.