Clinical Study of Left Atrial Appendage Blood Flow Velocity Combined with Serum D-D and TBIL in Predicting Left Atrial Appendage Thrombosis in Patients with Non-Valvular Atrial Fibrillation
Objective:To evaluate the predictive value of left atrial appendage(LAA)blood flow velocity combined with serum D-dimer(D-D)and total bilirubin(TBIL)in LAA thrombosis in patients with non-valvular atrial fibrillation(NVAF).Methods:340 patients with NVAF who were admitted to The Second Hospital of Shanxi Medical University from July 2020 to October 2022 were selected and divided into thrombus group(52 cases)and non thrombus group(288 cases)according to the presence or absence of LAA thrombosis.The baseline data,LAA blood flow velocity,D-D and TBIL levels were compared between two groups.The factors affecting LAA thrombosis in NVAF patients were analyzed by multivariate logistic regression model,the value of LAA blood flow velocity combined with serum D-D and TBIL in predicting LAA thrombosis in NVAF patients were analyzed by receiver operating characteristic(ROC)curve.Results:The proportion of persistent atrial fibrillation,age,B-type natriuretic peptide(BNP),D-D and TBIL levels in thrombus group were higher than those in non thrombus group(P＜0.05).The LAA filling speed and LAA emptying speed in thrombus group were lower than those in non thrombus group(P＜0.05).Multivariate logistic regression analysis showed that,persistent atrial fibrillation,older age,increased BNP level,increased D-D level,and increased TBIL level were risk factors for LAA thrombosis in NVAF patients(P＜0.05),high LAA filling speed and high LAA emptying speed were protective factors(P＜0.05).ROC curve analysis showed that the AUC(95％CI)of LAA filling speed,LAA emptying speed,D-D,TBIL and the combination of the four in predicting LAA thrombosis in NVAF patients was 0.826(0.764-0.888),0.735(0.668-0.802),0.833(0.763-0.903),0.837(0.777-0.897),0.928(0.887-0.970),and the AUC of the combination of the four was significantly higher than that of the single prediction.Conclusions:The decrease of LAA filling speed,the decrease of LAA emptying speed,the increase of D-D level and the increase of TBIL level are the influencing factors of LAA thrombosis in NVAF patients.LAA blood flow velocity combined with D-D and TBIL can improve the predictive value of LAA thrombosis in NVAF patients.
NETL
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万方数据
