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    Accessory left atrial diverticulae: contractile properties depicted with 64-slice cine-cardiac CT.

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    Authors
    Killeen, Ronan P
    Ryan, Ronan
    MacErlane, Aoife
    Martos, Ramon
    Keane, David
    Dodd, Jonathan D
    Affiliation
    Departments of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4,, Ireland.
    Issue Date
    2012-02-01T10:35:00Z
    MeSH
    Adult
    Atrial Appendage/physiopathology/*radiography
    Atrial Fibrillation/*etiology/physiopathology/radiography
    *Atrial Function, Left
    Diastole
    Diverticulum/complications/physiopathology/*radiography
    Female
    Heart Diseases/complications/physiopathology/*radiography
    Humans
    Male
    Middle Aged
    *Myocardial Contraction
    Predictive Value of Tests
    Regression Analysis
    Retrospective Studies
    Systole
    *Tomography, X-Ray Computed
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    Citation
    Int J Cardiovasc Imaging. 2010 Feb;26(2):241-8. Epub 2009 Sep 19.
    Journal
    The international journal of cardiovascular imaging
    URI
    http://hdl.handle.net/10147/207689
    DOI
    10.1007/s10554-009-9511-9
    PubMed ID
    19768571
    Abstract
    To assess the contractility of accessory left atrial appendages (LAAs) using multiphasic cardiac CT. We retrospectively analyzed the presence, location, size and contractile properties of accessory LAAs using multiphasic cardiac 64-slice CT in 102 consecutive patients (63 males, 39 females, mean age 57). Multiplanar reformats were used to create image planes in axial oblique, sagittal oblique and coronal oblique planes. For all appendages with an orifice diameter >or= 10 mm, axial and sagittal diameters and appendage volumes were recorded in atrial diastole and systole. Regression analysis was performed to assess which imaging appearances best predicted accessory appendage contractility. Twenty-three (23%) patients demonstrated an accessory LAA, all identified along the anterior LA wall. Dimensions for axial oblique (AOD) and sagittal oblique (SOD) diameters and sagittal oblique length (SOL) were 6.3-19, 3.4-20 and 5-21 mm, respectively. All appendages (>or=10 mm) demonstrated significant contraction during atrial systole (greatest diameter reduction was AOD [3.8 mm, 27%]). Significant correlations were noted between AOD-contraction and AOD (R = 0.57, P < 0.05) and SOD-contraction and AOD, SOD and SOL (R = 0.6, P < 0.05). Mean diverticulum volume in atrial diastole was 468.4 +/- 493 mm(3) and in systole was 171.2 +/- 122 mm(3), indicating a mean change in volume of 297.2 +/- 390 mm(3), P < 0.0001. Stepwise multiple regression analysis revealed SOL to be the strongest independent predictor of appendage contractility (R(2) = 0.86, P < 0.0001) followed by SOD (R(2) = 0.91, P < 0.0001). Accessory LAAs show significant contractile properties on cardiac CT. Those accessory LAAs with a large sagittal height or depth should be evaluated for contractile properties, and if present should be examined for ectopic activity during electrophysiological studies.
    Language
    eng
    ISSN
    1875-8312 (Electronic)
    1569-5794 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1007/s10554-009-9511-9
    Scopus Count
    Collections
    St. Vincent's University Hospital

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