Dilated left atrium and pulmonary veins in patients with calcified coronary artery: a potential contributor to the genesis of atrial fibrillation.

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題名:Dilated left atrium and pulmonary veins in patients with calcified coronary artery: a potential contributor to the genesis of atrial fibrillation.

作者:張念中

Chen Shih-Ann 貢獻者:醫學系內科學科

上傳時間:2009-08-11T05:50:00Z

摘要:Coronary artery disease (CAD) is an important etiology of atrial fibrillation (AF). Coronary artery

calcification is a marker of coronary atherosclerosis and coronary events. The purpose of this study was to investigate whether larger left atrium (LA) and

pulmonary veins (PVs) were seen by multidetector

computed tomography (MDCT) scans in those patients with higher coronary calcium scores. METHODS AND RESULTS: A total of 166 patients undergoing MDCT for general check-up (n = 128, 77%) or suspected CAD (n = 38, 23%) were enrolled and divided into a control (calcium score = 0, n = 60), medium calcium score (calcium score = 100

approximately 400, n = 47), and high calcium score

(calcium score >400, n = 59) groups. Diameters and areas of the LA, left atrial appendage (LAA), and PVs were measured by MDCT. The high calcium score group had significantly larger PVs diameters, LAA orifice area (1.9 +/- 1.4 cm(2), 0.9 +/- 0.5 cm(2), 0.8 +/- 0.4

cm(2), P < 0.005), LA anterior-posterior distance (32.2 +/- 6.8 mm, 30.4 +/- 6.5 mm, 27.3 +/- 6.0 mm, P < 0.05), and transverse distance (52.6 +/- 7.3 mm, 50.2 +/- 9 mm, 49.5 +/- 4.6 mm, P < 0.05) than the medium calcium score and control groups. Six (3.6%) patients with paroxysmal AF had higher calcium scores and larger diameters of LA, LAA, and PVs than those (96.4%) without paroxysmal AF. Two patients in the high calcium score group had

calcified PVs localized to the right upper and left upper PVs. The incidence of calcified PVs was 1.2% for the total patients and 3.3% for the high calcium score

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patients. CONCLUSION: In the presence of high calcium scores in this patient population, the LA, LAA, and PVs were enlarged.

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