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

Abstract

Background

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.

Methods

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_ES) > 77.7 ml/m² was used as the reference standard for the LAE diagnosis.

Results

227 patients were enrolled in the group, 101 (44.5%) of whom had LAE. LAV_ES and LAV_MD (r = 0.983), LAVI_ES and LAVI_MD (r = 0.984), LAA_ES and LAVI_ES (r = 0.817), LAA_MD and LAVI_ES (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.

Conclusions

The axial LAA measured by CTA can be served as a parameter for the rapid and accurate diagnosis of LAE in patients with PAF.