Aortic atherosclerotic plaque and long-term prognosis in patients with atrial fibrillation: A transesophageal echocardiography study

摘要

Background: Both left atrial spontaneous echo contrast (LASEC) and aortic atherosclerotic plaque (AoP) ??4.0 mm in thickness are predictors of cardiovascular events after stroke. The aim of this study was to investigate impact of AoP ??4.0 mm or LASEC on cardiovascular events in patients with atrial fibrillation (AF). Methods and Results: One hundred and eight consecutive patients with AF were enrolled and studied. Patients were grouped according to the presence or absence of AoP ??4.0 mm in the proximal aortic arch on transesophageal echocardiography (TEE). Cardiovascular events included death, myocardial infarction, ischemic stroke, systemic embolism and congestive heart failure. During a follow-up period (median, 3.9 years), cardiovascular event-free survival rate was significantly lower in patients with AoP ??4.0 mm than in patients without AoP ??4.0 mm (log-rank, P=0.01). In contrast, patients with LASEC showed a trend toward lower cardiovascular event-free survival than those without LASEC (log-rank, P=0.10). Univariate TEE predictors of cardiovascular events were AoP ??4.0 mm, LASEC and left atrial appendage flow velocity. On multivariate Cox regression analysis, AoP ??4.0 mm was the only TEE predictor of cardiovascular events during follow-up (P=0.02, hazard ratio, 2.6; 95% confidence interval: 1.1-6.0). Conclusions: In the present unselected patients with AF, AoP predicted long-term cardiovascular events.