Arrhythmias & electrophysiology
Relationship Between Fibrosis, Endocardial Endothelial Damage, and Thrombosis of Left Atrial Appendage in Atrial Fibrillation
Authors' conclusion
These histological findings may be essential in considering the pathophysiology of LAAT and stroke within the atrial cardiomyopathy context.
Study context
- Population
- Patients with atrial fibrillation (AF) scheduled for left atrial appendage (LAA) excision during surgery
- Participants
- 96 patients
- Exposure
- Patients with LAAT and/or ischemic stroke history vs those without
- Outcome
- LAA fibrosis degree and endocardial endothelial damage (CD31 expression)
Main finding
As reported in the abstract
| Group | Value | CD31 expression |
|---|---|---|
| LAAT and/or stroke | 18.4% (SD 9.9%) | 0.27 [IQR: 0.05-0.57] |
| No LAAT or stroke | 10.4% (SD 7.0%) | 1.02 [IQR: 0.49-1.65] |
Value
LAAT and/or stroke18.4% (SD 9.9%)
No LAAT or stroke10.4% (SD 7.0%)
CD31 expression
LAAT and/or stroke0.27 [IQR: 0.05-0.57]
No LAAT or stroke1.02 [IQR: 0.49-1.65]
- LAAT and/or stroke vs No LAAT or stroke: P < 0.0001 — fibrosis degree
- LAAT and/or stroke vs No LAAT or stroke: P < 0.0001 — CD31 expression
- Endothelial damage (E4) associated with LAAT and/or stroke history independent of AF type (multivariate logistic regression), OR
- 3.47
- Nonparoxysmal AF: fibrosis (F4) independently associated with LAAT and/or stroke, OR
- 3.66
- Nonparoxysmal AF: endothelial damage (E4), OR
- 4.62
- Nonparoxysmal AF: non-chicken-wing LAA morphology, OR
- 3.79
- Fibrosis degree correlated with endothelial damage, R = −0.38
- P = 0.0001
Observational data: associations, not effects.
Original publication
Relationship Between Fibrosis, Endocardial Endothelial Damage, and Thrombosis of Left Atrial Appendage in Atrial Fibrillation. JACC Clin Electrophysiol. Published 22 March 2023. doi:10.
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