Aortic Atherosclerotic Plaque and Long-Term Prognosis in Patients With Atrial Fibrillation - A Transesophageal Echocardiography Study

作者：Okura Hiroyuki^*; Kataoka Toru; Yoshiyama Minoru; Yoshikawa Junichi; Yoshida Kiyoshi

来源：Circulation Journal, 2013, 77(1): 68-72.

DOI：10.1253/circj.CJ-12-0583

• Arrhythmia
• Diastole
• Echocardiography
• Prognosis

Background: Both left atrial spontaneous echo contrast (LASEC) and aortic atherosclerotic plaque (AoP) %26gt;= 4.0 mm in thickness are predictors of cardiovascular events after stroke. The aim of this study was to investigate impact of AoP %26gt;= 4.0 mm or LASEC on cardiovascular events in patients with atrial fibrillation (AF). %26lt;br%26gt;Methods and Results: One hundred and eight consecutive patients with AF were enrolled and studied. Patients were grouped according to the presence or absence of AoP %26gt;= 4.0 mm in the proximal aortic arch on transesophageal echocardiography (TEE). Cardiovascular events included death, myocardial infarction, ischemic stroke, systemic embolism and congestive heart failure. During a follow-up period (median, 3.9 years), cardiovascular event-free survival rate was significantly lower in patients with AoP %26gt;= 4.0 mm than in patients without AoP %26gt;= 4.0 mm (log-rank, P=0.01). In contrast, patients with LASEC showed a trend toward lower cardiovascular event-free survival than those without LASEC (log-rank, P=0.10). Univariate TEE predictors of cardiovascular events were AoP %26gt;= 4.0 mm, LASEC and left atrial appendage flow velocity. On multivariate Cox regression analysis, AoP %26gt;= 4.0 mm was the only TEE predictor of cardiovascular events during follow-up (P=0.02, hazard ratio, 2.6; 95% confidence interval: 1.1-6.0). %26lt;br%26gt;Conclusions: In the present unselected patients with AF, AoP predicted long-term cardiovascular events. (Circ J 2013; 77: 68-72)

• 出版日期2013-1