Prevalence and predictors of left atrial thrombus in patients with rheumatic atrial fibrillation undergoing cardiac surgery: a cross-sectional study
Abstract Background Unlike non-rheumatic atrial fibrillation (AF), where left atrial thrombus (LAT) is predominantly confined to the left atrial appendage (LAA), a significant proportion of LAT in rheumatic AF occurs within the left atrial cavity (LAC). However, LAC thrombosis in rheumatic AF has no...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-025-04473-6 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832595012738613248 |
|---|---|
| author | Jie Cui Yixiao Zhang Yulin Wang Fangyu Liu Hao Lai Qiang Ji Chunsheng Wang |
| author_facet | Jie Cui Yixiao Zhang Yulin Wang Fangyu Liu Hao Lai Qiang Ji Chunsheng Wang |
| author_sort | Jie Cui |
| collection | DOAJ |
| description | Abstract Background Unlike non-rheumatic atrial fibrillation (AF), where left atrial thrombus (LAT) is predominantly confined to the left atrial appendage (LAA), a significant proportion of LAT in rheumatic AF occurs within the left atrial cavity (LAC). However, LAC thrombosis in rheumatic AF has not been extensively studied. This study aimed to evaluate the prevalence of LAT and its subtypes and identify potential predictors of LAT. Methods This retrospective study included adult patients with rheumatic AF who underwent open-heart surgery for mitral valvular abnormalities between January 2019 and December 2020. LAT was identified through intraoperative inspection and categorized as either LAC thrombus or LAA thrombus. The prevalence of LAT and its subtypes was calculated, and logistic regression analysis was performed to identify predictors of LAT. Results A total of 530 patients (mean age: 59.7 ± 9.5 years; male: 29.8%) with a predominance of mitral stenosis (59.6%) were included. LAT was identified in 82 patients (15.5%), including 44 (8.3%) with LAA thrombus and 38 (7.2%) with LAC thrombus. In the multivariable logistic regression model, coronary artery disease (OR: 6.35, 95% CI: 2.79–14.46, p < 0.001), larger left atrial diameter (OR: 1.31 per 10 mm increase, 95% CI: 1.02–1.68, p = 0.03), and moderate-to-severe mitral stenosis (OR: 1.77, 95% CI: 1.00–3.13, p = 0.05) were independently associated with an increased risk of LAT, whereas moderate-to-severe mitral regurgitation was independently associated with a decreased risk of LAT (OR: 0.21, 95% CI: 0.11–0.43, p < 0.001). Conclusion In patients with rheumatic AF undergoing open-heart mitral valve surgery, LAT can be located in either the LAA or LAC. The presence of LAT was independently associated with coronary artery disease, left atrial enlargement, and mitral valvular abnormalities. Timely screening and management of LAT are crucial to mitigate potentially fatal thromboembolic events. |
| format | Article |
| id | doaj-art-eebfe25ba5d849ea92e2a10ecab3b289 |
| institution | Kabale University |
| issn | 1471-2261 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj-art-eebfe25ba5d849ea92e2a10ecab3b2892025-01-19T12:09:28ZengBMCBMC Cardiovascular Disorders1471-22612025-01-0125111010.1186/s12872-025-04473-6Prevalence and predictors of left atrial thrombus in patients with rheumatic atrial fibrillation undergoing cardiac surgery: a cross-sectional studyJie Cui0Yixiao Zhang1Yulin Wang2Fangyu Liu3Hao Lai4Qiang Ji5Chunsheng Wang6Department of Cardiovascular Diseases, Zhongshan Hospital Fudan UniversityDepartment of Cardiovascular Surgery, Zhongshan Hospital Fudan UniversityShanghai Institute of Cardiovascular Diseases, Zhongshan Hospital Fudan UniversityDepartment of Cardiovascular Surgery, Zhongshan Hospital Fudan UniversityShanghai Institute of Cardiovascular Diseases, Zhongshan Hospital Fudan UniversityShanghai Institute of Cardiovascular Diseases, Zhongshan Hospital Fudan UniversityShanghai Institute of Cardiovascular Diseases, Zhongshan Hospital Fudan UniversityAbstract Background Unlike non-rheumatic atrial fibrillation (AF), where left atrial thrombus (LAT) is predominantly confined to the left atrial appendage (LAA), a significant proportion of LAT in rheumatic AF occurs within the left atrial cavity (LAC). However, LAC thrombosis in rheumatic AF has not been extensively studied. This study aimed to evaluate the prevalence of LAT and its subtypes and identify potential predictors of LAT. Methods This retrospective study included adult patients with rheumatic AF who underwent open-heart surgery for mitral valvular abnormalities between January 2019 and December 2020. LAT was identified through intraoperative inspection and categorized as either LAC thrombus or LAA thrombus. The prevalence of LAT and its subtypes was calculated, and logistic regression analysis was performed to identify predictors of LAT. Results A total of 530 patients (mean age: 59.7 ± 9.5 years; male: 29.8%) with a predominance of mitral stenosis (59.6%) were included. LAT was identified in 82 patients (15.5%), including 44 (8.3%) with LAA thrombus and 38 (7.2%) with LAC thrombus. In the multivariable logistic regression model, coronary artery disease (OR: 6.35, 95% CI: 2.79–14.46, p < 0.001), larger left atrial diameter (OR: 1.31 per 10 mm increase, 95% CI: 1.02–1.68, p = 0.03), and moderate-to-severe mitral stenosis (OR: 1.77, 95% CI: 1.00–3.13, p = 0.05) were independently associated with an increased risk of LAT, whereas moderate-to-severe mitral regurgitation was independently associated with a decreased risk of LAT (OR: 0.21, 95% CI: 0.11–0.43, p < 0.001). Conclusion In patients with rheumatic AF undergoing open-heart mitral valve surgery, LAT can be located in either the LAA or LAC. The presence of LAT was independently associated with coronary artery disease, left atrial enlargement, and mitral valvular abnormalities. Timely screening and management of LAT are crucial to mitigate potentially fatal thromboembolic events.https://doi.org/10.1186/s12872-025-04473-6Atrial fibrillationRheumatic heart diseaseLeft atrial appendage thrombusLeft atrial cavity thrombus |
| spellingShingle | Jie Cui Yixiao Zhang Yulin Wang Fangyu Liu Hao Lai Qiang Ji Chunsheng Wang Prevalence and predictors of left atrial thrombus in patients with rheumatic atrial fibrillation undergoing cardiac surgery: a cross-sectional study BMC Cardiovascular Disorders Atrial fibrillation Rheumatic heart disease Left atrial appendage thrombus Left atrial cavity thrombus |
| title | Prevalence and predictors of left atrial thrombus in patients with rheumatic atrial fibrillation undergoing cardiac surgery: a cross-sectional study |
| title_full | Prevalence and predictors of left atrial thrombus in patients with rheumatic atrial fibrillation undergoing cardiac surgery: a cross-sectional study |
| title_fullStr | Prevalence and predictors of left atrial thrombus in patients with rheumatic atrial fibrillation undergoing cardiac surgery: a cross-sectional study |
| title_full_unstemmed | Prevalence and predictors of left atrial thrombus in patients with rheumatic atrial fibrillation undergoing cardiac surgery: a cross-sectional study |
| title_short | Prevalence and predictors of left atrial thrombus in patients with rheumatic atrial fibrillation undergoing cardiac surgery: a cross-sectional study |
| title_sort | prevalence and predictors of left atrial thrombus in patients with rheumatic atrial fibrillation undergoing cardiac surgery a cross sectional study |
| topic | Atrial fibrillation Rheumatic heart disease Left atrial appendage thrombus Left atrial cavity thrombus |
| url | https://doi.org/10.1186/s12872-025-04473-6 |
| work_keys_str_mv | AT jiecui prevalenceandpredictorsofleftatrialthrombusinpatientswithrheumaticatrialfibrillationundergoingcardiacsurgeryacrosssectionalstudy AT yixiaozhang prevalenceandpredictorsofleftatrialthrombusinpatientswithrheumaticatrialfibrillationundergoingcardiacsurgeryacrosssectionalstudy AT yulinwang prevalenceandpredictorsofleftatrialthrombusinpatientswithrheumaticatrialfibrillationundergoingcardiacsurgeryacrosssectionalstudy AT fangyuliu prevalenceandpredictorsofleftatrialthrombusinpatientswithrheumaticatrialfibrillationundergoingcardiacsurgeryacrosssectionalstudy AT haolai prevalenceandpredictorsofleftatrialthrombusinpatientswithrheumaticatrialfibrillationundergoingcardiacsurgeryacrosssectionalstudy AT qiangji prevalenceandpredictorsofleftatrialthrombusinpatientswithrheumaticatrialfibrillationundergoingcardiacsurgeryacrosssectionalstudy AT chunshengwang prevalenceandpredictorsofleftatrialthrombusinpatientswithrheumaticatrialfibrillationundergoingcardiacsurgeryacrosssectionalstudy |