The value of computed tomography angiography for evaluation of left atrial enlargement in patients with persistent atrial fibrillation

• Published in: BMC cardiovascular disorders Vol. 24; no. 1; pp. 502 - 11
• Main Authors: Lin, Fang-Fang, Chen, Qian, Wu, Qiu-Yan, Li, Shi-Jie, Zhu, Yao-Bin, Tang, Yi, Xue, Yun-Jing, Luo, Jie-Wei, Li, Zuo-An, Chen, Hong-Yi
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 19.09.2024; BioMed Central; BMC
• Subjects: Ablation; Aged; Angiography; Atrial fibrillation; Atrial Fibrillation - diagnosis; Atrial Fibrillation - diagnostic imaging; Atrial Fibrillation - physiopathology; Atrial Function, Left; Atrial Remodeling; Body mass index; Cardiac arrhythmia; Cardiomegaly - diagnostic imaging; Catheters; Computed tomography; Computed Tomography Angiography; CT imaging; Diagnosis; Enlargement; Female; Fibrillation; Heart; Heart Atria - diagnostic imaging; Heart Atria - physiopathology; Heart atrium; Heart enlargement; Heart rate; Humans; Left atrial area; Left atrial enlargement; Male; Medical examination; Medical imaging; Middle Aged; Multidetector Computed Tomography; Normal distribution; Predictive Value of Tests; Pulmonary Veins - diagnostic imaging; Pulmonary Veins - physiopathology; Radiation; Reproducibility of Results; Retrospective Studies; Software; Statistical analysis; Tomography; Veins & arteries; Vertebrae; Work stations; China; Computed tomography angiography; Left atrial area; Left atrial enlargement; Atrial fibrillation
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-024-04187-1

The post-processing technology of CTA offers significant advantages in evaluating left atrial enlargement (LAE) in patients with persistent atrial fibrillation (PAF). This study aims to identify parameters for rapidly and accurately diagnosing LAE in patients with PAF using CT cross-sections. Left atrial pulmonary venous (PV) CT was performed to 300 PAF patients with dual-source CT, and left atrial volume (LAV), left atrial anteroposterior diameter (LAD1), left atrial transverse diameter (LAD2), and left atrial area (LAA) were measured in the ventricular end systolic (ES) and middle diastolic (MD). LA index (LAI) = LA parameter/body surface area (BSA). Left atrial volume index (LAVI ) > 77.7 ml/m was used as the reference standard for the LAE diagnosis. 227 patients were enrolled in the group, 101 (44.5%) of whom had LAE. LAV and LAV (r = 0.983), LAVI and LAVI (r = 0.984), LAA and LAVI (r = 0.817), LAA and LAVI (r = 0.814) had strong positive correlations. The area under curve (AUC) showed that all measured parameters were suitable for diagnosing LAE, and the diagnostic efficacy was compared as follows: LAA/LAAI> LAD> the relative value index of LAD, LAD2> LAD1. LAA and LAAI demonstrated comparable diagnostic efficacy, with LAA being more readily available than LAAI. The axial LAA measured by CTA can be served as a parameter for the rapid and accurate diagnosis of LAE in patients with PAF.