1
|
Hwang SH, Roh SY, Shim J, Choi JI, Kim YH, Oh YW. Atrial Fibrillation: Relationship between Left Atrial Pressure and Left Atrial Appendage Emptying Determined with Velocity-encoded Cardiac MR Imaging. Radiology 2017; 284:381-389. [DOI: 10.1148/radiol.2017161654] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Sung Ho Hwang
- From the Department of Radiology (S.H.H., Y.W.O.) and Division of Cardiology, Department of Internal Medicine (S.Y.R., J.S., J.I.C., Y.H.K.), Korea University Anam Hospital, Anam-dong 5-ga, Seongbuk-gu, Seoul 136-705, Republic of Korea
| | - Seung Young Roh
- From the Department of Radiology (S.H.H., Y.W.O.) and Division of Cardiology, Department of Internal Medicine (S.Y.R., J.S., J.I.C., Y.H.K.), Korea University Anam Hospital, Anam-dong 5-ga, Seongbuk-gu, Seoul 136-705, Republic of Korea
| | - Jaemin Shim
- From the Department of Radiology (S.H.H., Y.W.O.) and Division of Cardiology, Department of Internal Medicine (S.Y.R., J.S., J.I.C., Y.H.K.), Korea University Anam Hospital, Anam-dong 5-ga, Seongbuk-gu, Seoul 136-705, Republic of Korea
| | - Jong-il Choi
- From the Department of Radiology (S.H.H., Y.W.O.) and Division of Cardiology, Department of Internal Medicine (S.Y.R., J.S., J.I.C., Y.H.K.), Korea University Anam Hospital, Anam-dong 5-ga, Seongbuk-gu, Seoul 136-705, Republic of Korea
| | - Young-Hoon Kim
- From the Department of Radiology (S.H.H., Y.W.O.) and Division of Cardiology, Department of Internal Medicine (S.Y.R., J.S., J.I.C., Y.H.K.), Korea University Anam Hospital, Anam-dong 5-ga, Seongbuk-gu, Seoul 136-705, Republic of Korea
| | - Yu-Whan Oh
- From the Department of Radiology (S.H.H., Y.W.O.) and Division of Cardiology, Department of Internal Medicine (S.Y.R., J.S., J.I.C., Y.H.K.), Korea University Anam Hospital, Anam-dong 5-ga, Seongbuk-gu, Seoul 136-705, Republic of Korea
| |
Collapse
|
2
|
Abstract
Atrial fibrillation (AF) remains the most common arrhythmia encountered in clinical practice. One of its more common deleterious effects is the development of thromboembolism leading to stroke. The left atrial appendage (LAA) has been shown to the site of the majority of thrombus formation leading to stroke. Anticoagulation with warfarin has been the treatment of choice for prevention of embolic events. Newer anticoagulants have been developed but they still have the potential side effect of causing major bleeding. Occlusion of the LAA has emerged as an alternative therapeutic approach to medical therapy. The aim of this article is to discuss in detail the role of the LAA in thromboembolism in AF, role of device and surgical therapies, and the current clinical data supporting their use. This is particularly timely in that there is now an approved LAA closure device approved in the US for stroke prevention in patients with nonvalvular AF.
Collapse
|
4
|
Abstract
The "elimination" of the left atrial appendage (LAA) seems to be an attractive alternative to oral anticoagulation in the treatment of atrial fibrillation, especially in patients with contraindications to oral anticoagulation therapy. The LAA, however, plays an important role in the maintenance and regulation of the cardiac function, in arterial hypertension, atrial fibrillation, coronary heart disease, valvular heart disease, and heart failure. Data, mainly from animal studies, indicate that elimination of the LAA may impede thirst in patients with hypovolemia, may impair hemodynamic response to volume or pressure overload, may decrease cardiac output, and may promote heart failure. It may have adverse effects in humans as well. Further studies on the hemodynamic and neurohumoral consequences of left atrial appendage elimination are required to advance our understanding of LAA physiology and pathophysiology.
Collapse
Affiliation(s)
- Claudia Stöllberger
- Medizinische Abteilung, Krankenanstalt Rudolfstiftung, Steingasse 31/18, A-1030 Vienna, Austria.
| | | | | |
Collapse
|