Aortic Atherosclerotic Plaque and Long-Term Prognosis in Patients With Atrial Fibrillation

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  • – A Transesophageal Echocardiography Study –

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Background: Both left atrial spontaneous echo contrast (LASEC) and aortic atherosclerotic plaque (AoP) ≥4.0mm in thickness are predictors of cardiovascular events after stroke. The aim of this study was to investigate impact of AoP ≥4.0mm 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 ≥4.0mm 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 ≥4.0mm than in patients without AoP ≥4.0mm (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 ≥4.0mm, LASEC and left atrial appendage flow velocity. On multivariate Cox regression analysis, AoP ≥4.0mm 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.  (Circ J 2013; 77: 68–72)<br>

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