Clinical and echocardiographic risk factors for embolization in the presence of left atrial thrombus

Echocardiography

Volumn 24, Issue 5, 2007, Pages 515-521

  Kavlak, Ela Sahinbas ^a,c   Kucukoglu, Hayriye ^b   Yigit, Zerrin ^a   Okcun, Baris ^a   Baran, Turker ^a   Ozkan, Alev Arat ^a   Kucukoglu, Serdar ^a  

^a ISTANBUL UNIVERSITY   (Turkey)

^b Bakirkoy State Teaching and Research Hospital for Psychiatry and Neurology   (Turkey)

^c NONE   (Turkey)

Author keywords

Embolism cerebral; Left atrial appendage function; Left atrium; Thrombus; Transesophageal echocardiography

Indexed keywords

ECHO CONTRAST MEDIUM;

ADULT; ARTICLE; ARTIFICIAL EMBOLISM; BRAIN EMBOLISM; CARDIOVERSION; CEREBROVASCULAR ACCIDENT; CONTROLLED STUDY; ECHOCARDIOGRAPHY; FEMALE; HEART ATRIUM APPENDAGE; HEART ATRIUM THROMBOSIS; HEART EJECTION FRACTION; HEART LEFT ATRIUM; HEART SIZE; HUMAN; MAJOR CLINICAL STUDY; MALE; PRIORITY JOURNAL; RISK FACTOR; SINUS RHYTHM; TRANSESOPHAGEAL ECHOCARDIOGRAPHY; TRANSTHORACIC ECHOCARDIOGRAPHY;

ADULT; AGED; ATRIAL FIBRILLATION; ATRIAL FUNCTION; BLOOD FLOW VELOCITY; BRAIN ISCHEMIA; CASE-CONTROL STUDIES; CEREBROVASCULAR ACCIDENT; ECHOCARDIOGRAPHY; FEMALE; HEART ATRIA; HUMANS; INTRACRANIAL EMBOLISM; LOGISTIC MODELS; MALE; MIDDLE AGED; MITRAL VALVE STENOSIS; PREDICTIVE VALUE OF TESTS; RESEARCH DESIGN; RETROSPECTIVE STUDIES; RISK FACTORS; STROKE VOLUME; THROMBOSIS; TURKEY;

EID: 34247357052     PISSN: 07422822     EISSN: 15408175     Source Type: Journal    
DOI: 10.1111/j.1540-8175.2007.00420.x     Document Type: Article

References (32)

1. Kumagai K, Fukunami M, Kitabake A, et al : Increased cardiovascular clotting in patients with chronic atrial fibrillation. J Am Coll Cardiol 1990 16 : 377 380.
2. Vigna C, de Rito V, Criconia GM, et al : Left atrial thrombus and spontaneous echo contrast in nonanticoagulated mitral stenosis. A transesophageal echocardiographic study. Chest 1993 103 : 348 352.
3. Chiang CW, Lo SK, Ko YS, et al : Predictors of systemic embolism in patients with mitral stenosis. A prospective study. Ann Intern Med 1998 128 : 885 889.
4. Atrial Fibrillation Investigators : Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation: analysis of pooled data from five randomized controlled trials. Arch Intern Med 1994 154 : 1449 1457.
5. Klein AL, Grimm RA, Black IW, et al : Cardioversion guided by transesophageal echocardiography: The ACUTE Pilot Study. A randomized, controlled trial. Assessment of Cardioversion Using Transesophageal Echocardiography. Ann Intern Med 1997 126 : 200 209.
6. Özkan M, Kaymaz C, Kirma C, et al : Predictors of left atrial thrombus and spontaneous echo contrast in rheumatic valve disease before and after mitral valve replacement. Am J Cardiol 1998 82 : 1066 1070.
7. Stollberger C, Chnupa P, Kronik G, et al : Transesophageal echocardiography to assess embolic risk in patients with atrial fibrillation: ELAT study group; Embolism in left atrial thrombi. Ann Intern Med 1998 128 : 630 638.
8. Özer N, TokgözoPlu L, Övünç K, et al : Left atrial appendage function in patients with cardioembolic stroke in sinus rhythm and atrial fibrillation. J Am Soc Echocardiogr 2000 13 (7 661 665.
9. Dubrava J, Garay R : The role of transesophageal echocardiography in detection of cardiogenic and aortic sources of embolism in stroke and transient ischaemic attacks. Vnitr Lek 2006 52 (2 144 151.
10. Fatkin D, Feneley M : Stratification of thromboembolic risk of atrial fibrillation by transthoracic echocardiography and transesophageal echocardiography: The relative role of left atrial appendage function, mitral valve disease, and spontaneous echocardiographic contrast. Prog Cardiovasc Dis 1996 39 (1 57 68.
11. Perez Y, Duval AM, Carville C, et al : Is left atrial appendage flow a predictor for outcome of cardioversion of nonvalvular atrial fibrillation? A transthoracic and transesophageal echocardiographic study. Am Heart J 1997 134 : 745 751.
12. Agmon Y, Khandheria BK, Gentile F, et al : Echocardiographic assessment of the left atrial appendage. J Am Coll Cardiol 1999 34 : 1867 1877.
13. Hwang JJ, Chen JJ, Lin SC, et al : Diagnostic accuracy of transesophageal echocardiography for detecting left atrial thrombi in patients with rheumatic heart disease having undergone mitral valve operations. Am J Cardiol 1993 72 : 677 681.
14. Pollick C, Taylor D : Assessment of left atrial appendage function by transesophageal echocardiography: implications for the development of thrombus. Circulation 1991 84 : 223 231.
15. Suetsugu M, Matsuzaki M, Toma Y, et al : Detection of mural thrombi and analysis of blood flow velocities in the left atrial appendage using transesophageal two-dimensional echocardiography and pulsed Doppler flowmetry. J Cardiol 1988 18 : 385 394.
16. Verhost PMJ, Kamp O, Visser CA, et al : Left atrial appendage flow velocity assessment using transesophageal echocardiography in nonrheumatic atrial fibrillation and systemic embolism. Am J Cardiol 1993 71 : 192 196.
17. Torrecilla EG, Garcia-Fernandez MA, David EP, et al : Predictors of left atrial spontaneous echo contrast and thrombi in patients with mitral stenosis and atrial fibrillation. Am J Cardiol 2000 86 : 529 534.
18. Mügge A, Kühn H, Nikutta P, et al. : Assessment of left atrial appendage function by biplane transesophageal echocardiography in patients with nonrheumatic atrial fibrillation: identification of a subgroup of patients at increased embolic risk. J Am Coll Cardiol 1994 23 : 599 607.
19. Blackshear JL, Safford RE, Pearce LA, (on behalf of The Stroke Prevention in Atrial Fibrillation Investigators) : F-amplitude, left atrial appendage velocity, and thromboembolic risk in nonrheumatic atrial fibrillation. Clin Cardiol 1996 19 : 309 313.
20. Pozzoli M, Febo O, Torbicki A, et al. Left atrial appendage dysfunction: A cause of thrombosis - Evidence by transesophageal echocardiography - Doppler studies. J Am Soc Echocardiogr 1991 4 : 435 441.
21. Omran H, Rang B, Schmidt H, et al : Incidence of left atrial thrombi in patients in sinus rhythm and with a recent neurologic deficit. Am Heart J 2000 140 (4 658 662.
22. Bilge M, Güler N, Eryonucu B, et al : Functions of left atrial appendix in hypertensive patients with sinus rhythm. J Am Soc Echocardiogr 2000 14 : 670 675.
23. Kamalesh M, Copeland TB, Sawada S : Severely reduced left atrial appendage function: A cause of embolic stroke in patients in sinus rhythm? J Am Soc Echocardiogr 1998 11 : 9.
24. Kasliwal RR, Mittal S, Kanojia A, et al : A study of spontaneous echo contrast in patients with rheumatic mitral stenosis and normal sinus rhythm: An Indian perspective. Br Heart J 1995 74 : 296 299.
25. Zabalgoitia M, Halperin JL, Pearce LA, et al (SPAF III investigators) : Transesophageal echocardiographic correlates of clinical risk of thromboembolism in nonvalvular atrial fibrillation. J Am Coll Cardiol 1998 31 : 1622 1626.
26. Uslu N, Nurkalem Z, Orhan AL, et al : Transthoracic echocardiographic predictors of the left atrial appendage contraction velocity in stroke patients with sinus rhythm. Tohoku J Exp Med 2006 208 (4 291 298 (ISSN: 0040-8727).
27. Bernhardt P, Schmidt H, Hammerstingl C, et al : Atrial thrombi - A prospective follow-up study over 3 years with transesophageal echocardiography and cranial magnetic resonance imaging. Echocardiography 2006 23 (5 388 394.
28. Okamoto M, Fujii Y, Makita Y, et al : Left atrial appendage function in patients with systemic embolism in spite of in sinus rhythm. J Am Soc Echocardiogr 2006 19 (2 211 214.
29. Bernhardt P, Schmidt H, Sommer T, et al : Atrial fibrillation - Patients at high risk for cerebral embolism. Clin Res Cardiol 2006 95 (3 148 153.
30. Agmon Y, Khandheria BK, Gentile F, et al : Clinical and echocardiographic characteristics of patients with left atrial thrombus and sinus rhythm: Experience in 20 643 consecutive transesophageal echocardiographic examinations. Circulation 2002 105 (1 27 31.
31. Mikell FL, Asinger RW, Elsperger J, et al : Regional stasis of blood in the dysfunctional left ventricle: echocardiographic detection and differentiation from early thrombosis. Circulation 1982 66 : 755 763.
32. Kupper AJ, Verheugt FW, Peels CH, et al : Left ventricular thrombus incidence and behaviour studied by serial 2-dimensional echocardiography in acute myocardial infarction: left ventricular wall motion, systemic embolism and oral anticoagulation. J Am Coll Cardiol 1989 13 : 1514 1520.