リケラボ論文検索は、全国の大学リポジトリにある学位論文・教授論文を一括検索できる論文検索サービスです。

リケラボ 全国の大学リポジトリにある学位論文・教授論文を一括検索するならリケラボ論文検索大学・研究所にある論文を検索できる

リケラボ 全国の大学リポジトリにある学位論文・教授論文を一括検索するならリケラボ論文検索大学・研究所にある論文を検索できる

大学・研究所にある論文を検索できる 「A novel method to demonstrate thrombus formation of the left atrial appendage in patients with persistent atrial fibrillation by cardiac computed tomography」の論文概要。リケラボ論文検索は、全国の大学リポジトリにある学位論文・教授論文を一括検索できる論文検索サービスです。
リケラボ

コピーが完了しました

URLをコピーしました

論文の公開元へ論文の公開元へ
書き出し

A novel method to demonstrate thrombus formation of the left atrial appendage in patients with persistent atrial fibrillation by cardiac computed tomography

田中 基英 近畿大学

2023.01.12

概要

Background: Transesophageal echocardiography (TEE) is currently the gold stan dard t ech niqu e for diagnosing left atrial appen dage (LAA) t hrom bi. Cardiac com puted tom ography (CT) has been expect ed t o becom e an alternative m eth od to TEE; however, a reliable quantitative evalu ation m ethod has n ot been established.

Methods and results: We enrolled 177 patien ts w it h persistent atrial fibrillation w h o u nderw en t bot h cardiac CT an d TEE before cath eter ablation. The patients w ere classified in to two groups according to the TEE results: th e t hrom bus group (13 patients) and non-t hrom bu s group (164 patients). Th e Houn sfield u nit (HU) den sity at the proxim al LAA (LAAp) and distal LAA (LAAd) w as m easured on cardiac CT im ages. The LAAd/LAAp HU ratio and st an dard deviation of HU density (HU-SD) at t he LAAd w ere evalu ated. We created an algorithm by decision tree analysis t o predict LAA th rom bus form ation usin g t he HU ratio and HU-SD. Definite absence of LAA throm bu s (Cat egory-I) w as diagnosed for 139 patien ts by com bining the first and second branch ing of th e decision tree (Category-Ia: HU ratio of 0.26, Category-Ib: HU ratio of<0.26, HD-SD of 26.94). Definit e presen ce of LAA throm bus (Cat egory-Ⅱ) was diagnosed for 3 patien ts using th e third bran ching of the decision tree (Category-Ⅱ: HU ratio of<0.26 and HU-SD of<13.85). Highly possibility of LAA th rom bu s (Category-III), bu t not definite, was diagnosed for the rem aining 35 patien ts; therefore, these patien ts requ ired diagn ostic TEE. The diagnostic accu racy of this algorithm w as 0.95.

Conclusion: We have proposed a reliable algorithm to diagnose LAA throm bus form ation u sing the HU ratio and HU-SD.

論文の公開元へ

関連論文

関連論文をもっと見る

参考文献

[1] H.S. Jørgensen, H. Nakayam a, J. Reith, H.O. Raaschou, T.S. Olsen, Acute stroke with atrial fibrillation. The Copenhagen Stroke Study, Stroke 27 (10) (1996) 1765–1769.

[2] M.F. Stoddard, P.R. Dawkins, C.R. Prince, N.M. Am m ash, Left atrial appendage throm bus is not uncomm on in patients with acute atrial fibrillation and a recent embolic event: a transesophageal echocardiographic study, J. Am . Coll. Cardiol. 25 (2) (1995) 452–459.

[3] J.L. Blackshear, J.A. Odell, Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation, Ann. Thorac. Surg. 61 (2) (1996) 755– 759.

[4] J.R. Belcher, W. Som erville, Systemic embolism and left auricular thrombosis in relation to m itral valvotom y, Br. Med. J. 22 (1955) 1000–1003.

[5] M. Zabalgoitia, J.L. Halperin, L.A. Pearce, J.L. Blackshear, R.W. Asinger, R.G. Hart, Transesophageal echocardiographic correlates of clinical risk of throm boembolism in nonvalvular atrial fibrillation. Stroke Prevention in Atrial Fibrillation III Investigators, J. Am . Coll. Cardiol. 31 (7) (1998) 1622– 1626.

[6] Y. Agmon, B.K. Khandheria, F. Gentile, J.B. Seward, Echocardiographic assessm ent of the left atrial appendage, J. Am . Coll. Cardiol. 34 (7) (1999) 1867–1877.

[7] C. Pollick, D. Taylor, Assessment of left atrial appendage function by transesophageal echocardiography. Implications for the developm ent of throm bus, Circulation 84 (1) (1991) 223–231.

[8] E. Donal, H. Yam ada, C. Leclercq, D. Herpin, The left atrial appendage, a small, blind-ended structure, Chest 128 (3) (2005) 1853–1862.

[9] C.T. January, L.S. Wann, J.S. Alpert, et al., Am erican College of Cardiology/ Am erican Heart Association Task Force on Practice Guidelines. 2014 AHA/ACC/ HRS guideline for the management of patients with atrial fibrillation: a report of the Am erican College of Cardiology/Am erican Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society, J. Am . Coll. Cardiol. 64 (21) (2014) e1–e76.

[10] H. Calkins, G. Hindricks, R. Cappato, et al., Docum ent Reviewers: 2017 HRS/ EHRA/ECAS/APHRS/SOLAECE expert consensus statem ent on catheter and surgical ablation of atrial fibrillation, Europace. 20 (2018) e1–e160.

[11] J.K. Min, K.T. Spencer, K.T. Furlong, J.M. DeCara, L. Sugeng, R.P. Ward, R.M. Lang, Clinical features of complications from transesophageal echocardiography: a single-center case series of 10,000 consecutive exam inations, J. Am. Soc. Echocardiogr. 18 (9) (2005) 925–929.

[12] W.G. Daniel, R. Erbel, W. Kasper, C.A. Visser, R. Engberding, G.R. Sutherland, E. Grube, P. Hanrath, B. Maisch, K. Dennig, Safety of transesophageal echocardiography. A multicenter survey of 10,419 examinations, Circulation 83 (3) (1991) 817–821.

[13] J.B. Seward, B.K. Khandheria, J.K. Oh, W.K. Freeman, A.J. Tajik, Critical appraisal of transesophageal echocardiography: limitations, pitfalls, and com plications, J. Am. Soc. Echocardiogr. 5 (3) (1992) 288–305.

[14] J.N. Kirkpatrick, C. Mitchell, C. Taub, S. Kort, J. Hung, M. Swaminathan, ASE statem ent on protection of patients and echocardiography service providers during the 2019 novel coronavirus outbreak: endorsed by the Am erican College of Cardiology, J. Am . Soc. Echocardiogr. 33 (6) (2020) 648–653.

[15] R. Yasuoka, T. Kurita, Y. Kotake, Y. Akaiwa, N. Hashiguchi, K. Motoki, H. Yam amoto, K. Kobuke, Y. Iwanaga, Y. Hirano, S. Miyazaki, A novel m ethod to estim ate blood flow velocity in the left atrial appendage using en hanced computed tom ography: role of Hounsfield unit density ratio at two distinct points within the left atrial appendage, Heart Vessels 32 (7) (2017) 893–901.

[16] S. Puwanant, B.C. Varr, K. Shrestha, S.K. Hussain, W.H.W. Tang, R.S. Gabriel, O. M. Wazni, M. Bhargava, W.I. Saliba, J.D. Thomas, B.D. Lindsay, A.L. Klein, Role of the CHADS2 score in the evaluation of throm boem bolic risk in patients with atrial fibrillation undergoing transesophageal echocardiography before pulmonary vein isolation, J. Am. Coll. Cardiol. 54 (22) (2009) 2032–2039.

[17] D. Scherr, D. Dalal, K. Chilukuri, et al., Incidence and predictors of left atrial throm bus prior to catheter ablation of atrial fibrillation, J. Cardiovasc. Electrophysiol. 20 (2009) 379–384.

[18] T.W. Wallace, B.D. Atwater, J.P. Daubert, et al., Prevalence and clinical characteristics associated with left atrial appendage thrombus in fully anticoagulated patients undergoing catheter-directed atrial fibrillation ablation, J. Cardiovasc. Electrophysiol. 21 (2010) 849–852.

[19] D. Frenkel, S.A. D’Am ato, M. Al-Kazaz, S.M. Markowitz, et al., Prevalence of left atrial thrombus detection by transesophageal echocardiography: a comparison of continuous non-vitamin K antagonist oral anticoagulant versus warfarin therapy in patients undergoing catheter ablation for atrial fibrillation, JACC Clin. Electrophysiol. 2 (2016) 295–303.

[20] B.F. Gage, A.D. Waterm an, W. Shannon, M. Boechler, M.W. Rich, M.J. Radford, Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation, JAMA 285 (22) (2001) 2864, https:// doi.org/10.1001/jam a.285.22.2864 .

[21] G.Y.H. Lip, R. Nieuwlaat, R. Pisters, D.A. Lane, H.J.G.M. Crijns, Refining clinical risk stratification for predicting stroke and thromboem bolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation, Chest 137 (2) (2010) 263–272.

[22] H. Shimizu, Y.o. Murakam i, S.-I. Inoue, Y. Ohta, K.o. Nakamura, H. Katoh, T. Sakne, N. Takahashi, S. Ohata, T. Sugamori, Y. Ishibashi, T. Shimada, High plasm a brain natriuretic polypeptide level as a m arker of risk for throm boembolism in patients with nonvalvular atrial fibrillation, Stroke 33 (4) (2002) 1005–1010.

[23] K. Kirchhof, T. Welzel, C. Mecke, S. Zoubaa, K. Sartor, Differentiation of white, m ixed, and red thrombi: value of CT in estim ation of the prognosis of throm bolysis phantom study, Radiology 228 (1) (2003) 126–130.

[24] C. Teunissen, J. Habets, B.K. Velthuis, M.J. Cramer, P. Loh, Double-contrast, single-phase com puted tom ography angiography for ruling out left atrial appendage thrombus prior to atrial fibrillation ablation, Int. J. Cardiovasc. Im aging 33 (1) (2017) 121–128.

[25] M. Dorenkamp, C. Sohns, D. Vollm ann, L. Lüthje, J. Seegers, R. Wachter, M. Puls, W. Staab, J. Lotz, M. Zabel, Detection of left atrial thrombus during routine diagnostic work-up prior to pulmonary vein isolation for atrial fibrillation: role of transesophageal echocardiography and m ultidetector computed tomography, Int. J. Cardiol. 163 (1) (2013) 26–33.

[26] R.B. Tang, J.Z. Dong, Z.Q. Zhang, Z.A. Li, X.P. Liu, J.P. Kang, R.H. Yu, D.Y. Long, C.S. Ma, Com parison of contrast enhanced 64-slice computed tomography and transesophageal echocardiography in detection of left atrial throm bus in patients with atrial fibrillation, J. Interv. Card. Electrophysiol. 22 (3) (2008) 199–203.

[27] S. Achenbach, D. Sacher, D. Ropers, et al., Electron beam computed tomography for the detection of left atrial thrombi in patients with atrial fibrillation, Heart 90 (2004) 1477–1478.

[28] YY Kim, AL Klein, SS Halliburton, et al., Left atrial appendage filling defects identified by multidetector com puted tomography in patients undergoing radiofrequency pulm onary vein antral isolation: a com parison with transesophageal echocardiography, Am. Heart J. 154 (2007) 1199–1205.

[29] W.A. Jaber, R.D. White, S.A. Kuzmiak, J.M. Boyle, A. Natale, C. AppersonHansen, J.D. Thomas, C.R. Asher, Com parison of ability to identify left atrial throm bus by three-dim ensional tom ography versus transesophageal echocardiography in patients with atrial fibrillation, Am . J. Cardiol. 93 (4) (2004) 486–489.

[30] R. Hom si, B. Nath, J.A. Luetkens, J.O. Schwab, H.H. Schild, C.P. Naehle, Can contrast-enhanced multi-detector computed tom ography replace transesophageal echocardiography for the detection of throm bogenic m ilieu and throm bi in the left atrial appendage: a prospective study with 124 patients, Rofo. 188 (2016) 45–52.

[31] S.T. Sawit, A. Garcia-Alvarez, B. Suri, J. Gaztanaga, L. Fernandez-Friera, J.G. Mirelis, M. D’Anca, V. Fuster, J. Sanz, M.J. Garcia, Usefulness of cardiac com puted tom ographic delayed contrast en hancement of the left atrial appendage before pulmonary vein ablation, Am . J. Cardiol. 109 (5) (2012) 677–684.

[32] J. Hur, Y.J. Kim, H.-J. Lee, J.-W. Ha, J.H. Heo, E.-Y. Choi, C.-Y. Shim , T.H. Kim, J.E. Nam , K.O. Choe, B.W. Choi, Left atrial appendage throm bi in stroke patients: detection with two-phase cardiac CT angiography versus transesophageal echocardiography, Radiology 251 (3) (2009) 683–690.

[33] S.C. Kim , E.J. Chun, S.I. Choi, S.-J. Lee, H.-J. Chang, M.-K. Han, H.-J. Bae, J.H. Park, Differentiation between spontaneous echocardiographic contrast and left atrial appendage thrombus in patients with suspected em bolic stroke using two-phase m ultidetector com puted tomography, Am . J. Cardiol. 106 (8) (2010) 1174–1181.

[34] J. Romero, S.A. Husain, I. Kelesidis, J. Sanz, H.M. Medina, M.J. Garcia, Detection of left atrial appendage throm bus by cardiac com puted tomography in patients with atrial fibrillation: a meta-analysis, Circ. Cardiovasc. Im ag. 6 (2) (2013) 185–194.

[35] H. Zou, Y. Zhang, J. Tong, Z. Liu, Multidetector com puted tomography for detecting left atrial/left atrial appendage thrombus: a m eta-analysis, Intern. Med. J. 45 (10) (2015) 1044–1053.

[36] T. Watson, E. Shantsila, G.YH. Lip, Mechanism s of thrombogenesis in atrial fibrillation: Virchow’s triad revisited, Lancet 373 (9658) (2009) 155–166.

参考文献をもっと見る

全国の大学の
卒論・修論・学位論文
を
一発検索！

この論文の関連論文を見る