Does Ratio of Width to Length of Left Atrial Appendage Determine the Occurrence of Cerebrovascular Stroke Event in Both Genders?
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Objective : To see the Left atrial appendage size (width and length) in ischemic cerebrovascular accident (CVA) patients.
Design and method: Transesophageal echocardiography (TEE) was done in ischemic CVA patients after initial stabilization. We compared width length ratio(WLR) calculated from the average of width and length of LAA observed in earlier study by John P et al as controls. We chose this autopsy study as controls, as it is not possible to have TEE data in normal subjects.
Results : Study group includes 143 patients (F:M::37:106) and control group was 400 subjects (F:M::200:200) from the previous study. The mean ± std of width and length of LAA in females and males in study group were 1.99±0.67, 2.397±0.58 and 2.19±0.73, 2.49±0.66 respectively. In females, WLR is more (0.83 ± 0.37) in study group than in control group (0.66±0.26) which is statistically significant (z=4.06, P < 0.000001). So also for males (study group: control group :: 0.88 ±0.39 : 0.71±0.28) which is also statistically significant (z=7.03, P < 0.000001). So, broad and short LAA could determine the formation and dislodgement of thrombus resulting in embolic stroke in both sexes.
In conclusion, higher the width length ratio of left atrial appendage greater chances of embolic stoke.