CARDIOVASCULAR JOURNAL OF AFRICA • Volume 34, No 4, September/October 2023 AFRICA 233 conducted for intergroup univariate analysis. The correlations of CHA2DS2-VASc score with CTA-based LAA classification and RT-3D-TEE measurement parameters were explored using Spearman’s analysis. Receiver operating characteristic (ROC) curves were plotted to explore the predictive values of CTA and RT-3D-TEE for LAA thrombus, and the area under the ROC curve (AUC), 95% confidence interval (CI), sensitivity and specificity were calculated; p < 0.05 suggested that the difference was statistically significant. Results There were significant differences in the age, disease course, incidence of hypertension, diabetes mellitus, coronary heart disease, heart failure, stroke/transient ischaemic attack/ thromboembolism, vascular disease, B-type natriuretic peptide and serum uric acid levels and CHA2DS2-VASc score (p < 0.05), but the differences in gender, BMI, type of atrial fibrillation and plasma fibrinogen level were not significant between the two groups (p > 0.05) (Table 1). Group A had 16 cases of windsock LAA, 36 of chickenwing LAA, 11 of cactus LAA and 49 of cauliflower LAA. The numbers of cases of windsock LAA, chicken-wing LAA, cactus LAA and cauliflower LAA in group B were four, 29, two and 17, respectively. There were significant differences in LAA classification between the two groups (χ2 = 8.946, p = 0.030) (Fig. 1). The LVEF, LAD, maximum and minimum diameter of the LAA orifice and LAA length showed significant differences (p < 0.05), while no significant differences in LVEDd, LVESd, LAAV and E were observed between the two groups (p > 0.05) (Table 2). The CHA2DS2-VASc score was positively correlated with cauliflower LAA (p < 0.001) but not with windsock, chicken-wing and cactus LAA (p > 0.05) (Table 3). The CHA2DS2-VASc score had a negative correlation with LVEF (p < 0.001), and it was positively correlated with LAD, maximum and minimum diameter of the LAA orifice and LAA length (p < 0.001) (Table 4). Fig. 2 shows ROC curves of the CTA results, RT-3DTEE measurement parameters and CHA2DS2-VASc score in predicting LAA thrombosis in atrial fibrillation patients. The predictive values of the CTA results, RT-3D-TEE measurement parameters and CHA2DS2-VASc score for LAA thrombosis in atrial fibrillation patients, analysed by ROC curves, are listed in Table 5. All the curves had large AUC and high sensitivity and specificity, suggesting that CTA results, RT-3DTEE measurement parameters and CHA2DS2-VASc score were significant for predicting LAA thrombosis in atrial fibrillation patients. Table 1. General data of patients Variables Group A (n = 112) Group B (n = 52) t/χ2 p-value Age (years) 67.28 ± 8.16 61.44 ± 7.67 4.345 0.000 Gender, n (%) Male 70 (62.50) 31 (59.62) 0.125 0.724 Female 42 (37.50) 21 (40.38) BMI (kg/m2) 24.86 ± 1.21 24.78 ± 1.15 0.400 0.690 Disease course (month) 32.62 ± 9.24 13.84 ± 5.67 13.510 0.000 Type of atrial fibrillation, n (%) Paroxysmal 54 (48.21) 22 (42.31) 0.498 0.480 Persistent 58 (51.79) 30 (57.69) Hypertension, n (%) Yes 82 (73.21) 14 (26.92) 31.353 0.000 No 30 (26.79) 38 (73.08) Diabetes mellitus, n (%) Yes 29 (25.89) 5 (9.62) 5.726 0.017 No 83 (74.11) 47 (90.38) Coronary heart disease, n (%) Yes 37 (33.04) 7 (13.46) 6.931 0.008 No 75 (66.96) 45 (86.54) Heart failure, n (%) Yes 46 (41.07) 2 (3.85) 23.771 0.000 No 66 (58.93) 50 (96.15) Stroke/transient ischaemic attack/thromboembolism, n (%) Yes 28 (25.00) 0 (0.00) 15.676 0.000 No 84 (75.00) 52 (100.00) Vascular disease, n (%) Yes 91 (81.25) 3 (5.77) 82.701 0.000 No 21 (18.75) 49 (94.23) B-type natriuretic peptide (pg/ml) 329.45 ± 132.77 138.49 ± 59.16 9.912 0.000 Plasma fibrinogen (g/l) 2.81 ± 0.36 2.71 ± 0.51 1.442 0.151 Serum uric acid (μmol/l) 414.17 ± 45.73 362.08 ± 56.27 6.298 0.000 CHA2DS2-VASc score 4.16 ± 1.28 0.67 ± 0.47 19.048 0.000 BMI, body mass index. Table 2. RT-3D-TEE measurement parameters of patients Variables Group A (n = 112) Group B (n = 52) t p-value LVEF (%) 62.01 ± 6.03 64.19 ± 5.98 2.160 0.032 LVEDd (mm) 45.02 ± 3.87 46.31 ± 5.40 1.743 0.083 LVESd (mm) 30.27 ± 3.26 31.18 ± 5.02 1.390 0.166 LAD (mm) 44.12 ± 5.44 41.65 ± 6.53 2.536 0.012 LAAV (m/s) 46.52 ± 16.98 44.37 ± 17.49 0.747 0.456 Maximum diameter of LAA orifice (mm) 21.47 ± 4.46 19.35 ± 4.72 2.781 0.006 Minimum diameter of LAA orifice (mm) 16.14 ± 4.43 14.31 ± 4.75 2.406 0.017 LAA length (mm) 32.04 ± 5.39 28.45 ± 4.76 4.114 0.000 E (cm/s) 0.98 ± 0.19 1.01 ± 0.18 0.956 0.340 LVEF, left ventricular ejection fraction; LVEDd, left ventricular end-diastolic diameter; LVESd, left ventricular end-systolic diameter; LAD, left atrial diameter; LAAV, LAA flow velocity; LAA, left atrial appendage; E, early diastolic peak velocity of mitral valve. Table 3. Correlations of CHA2DS2-VASc score with CTA results LAA classification rs p-value Windsock 0.017 0.186 Chicken-wing 0.064 0.214 Cactus 0.082 0.092 Cauliflower 0.424 < 0.001 Table 4. Correlations of CHA2DS2-VASc score with RT-3D-TEE measurement parameters RT-3D-TEE measurement parameter rs p-value LVEF –0.341 < 0.001 LAD 0.220 < 0.001 Maximum diameter of LAA orifice 0.324 < 0.001 Minimum diameter of LAA orifice 0.305 < 0.001 LAA length 0.373 < 0.001 LVEF, left ventricular ejection fraction; LAD, left atrial diameter; LAA, left atrial appendage.
RkJQdWJsaXNoZXIy NDIzNzc=