Abstract
In patients with atrial fibrillation（AF）, left atrial appendage filling defect（LAAFD）is sometimes seen only at the early phase of dual phase enhanced cardiac computed tomography（ECCT）. In the present study, we compared differences in clinical characteristics between AF patients with（LAAFD+ group, n = 16）or without（LAAFD- group, n = 48）LAAFD. Left atrial volume（LAV）, left ventricular systolic/diastolic function by transthoracic echocardiography, spontaneous echo contrast（SEC）, left atrial appendage（LAA）flow and Pulse Doppler velocity of tissue Doppler imaging（PWV-TDI）by transesophageal echocardiography, and the ratio of Hounsfield unit of LAA and ascending aorta（LAA/AA HU ratio）both at early and delayed phases of ECCT were evaluated. In the LAAFD+ group, proportion of persistent AF, plasma BNP value, LAV were higher, and LAA flow and PWV-TDI were lower than for the LAAFD- group. In multivariate logistic regression analysis, LAA flow and PWV-TDI at LAA orifice were significant predictors of LAAFD. The LAA/AA HU ratio at the early phase of ECCT was significantly lower in patients with dense SEC than in patients without SEC. The presence of LAAFD was influenced by LAA function and was frequently coexistent with dense SEC. Therefore, the presence of LAAFD might be an indirect risk of stroke.
