Clinical and Echocardiographic Predictors of Left Atrial Thrombus Formation

Abstract

Aim: To investigate the relation between left atrial appendix function derived from quantitativetissue Doppler analysis and left atrial thrombus (LAT) existence. Methods: Fifty-six patients who had undergone transesophageal echocardiography (TEE) withdifferent diagnosis (31 female, 25 male with a mean age of 58 ± 18 years) were included in thestudy. Demographic, clinical and echocardiographic variables of the patients with and withoutLAT on their TEE were compared.Results: Atrial fibrillation was significantly more frequent in patients with LAT. The differencebetween mean ejection fractions was almost reached significance. However, left atrial andventricular tissue Doppler variables were similar between the two groups. Combined data oflower ejection fraction and atrial fibrillation predicted LAT with 85 % specificity. Conclusion: There is no statistical significance relation between left atrial appendix andventricular functions derived from quantitative tissue Doppler analysis and left atrial thrombus(LAT) existence

Keywords

• left atrial thrombus,prediction,tissue Doppler

Sol Atrial Apendikste Trombüs Oluşumunun Klinik ve Ekokardiyografik Belirteçleri

Abstract

Amaç: Doku Doppler ile kantitatif olarak belirlenen sol atriyal appendiks (SAA) fonksiyonlarıile sol atrial trombüs (SAT) varlığı arasındaki ilişkiyi araştırmak.Yöntem: Çeşitli sebeplerle transözofajiyal ekokardiyografi (TÖE) uygulanan 56 olgu (31 kadın,25 erkek; Ortalama yaş 58 ± 18 yıl ) çalışmaya alındı. TÖE yapılan olgularda sol atriyalappendiksinde trombüs saptanan olgular ile diğer olguların demografik, klinik veekokardiyografik verileri karşılaştırıldı.Bulgular: Trombüsü olan grupta atrial fibrilasyon istatistiksel olarak daha sıktı. Ejeksiyonfraksiyonu iki grup arasında sınırda anlamlı olarak farklıydı. Hastaların sol atrial ve ventrikülerdoku Doppler değişkenleri arasında anlamlı fark saptanmadı. Düşük ejeksiyon fraksiyonu veatrial fibrilasyon varlığı %85 özgüllük ile SAA’de trombüs varlığını öngördürüyordu.Sonuç: Sol atrial trombüs varlığı ile atriyal doku Doppler parametreleri arasında istatistikselolarak anlamlı bir ilişki mevcut değildir

Keywords

• sol atriyal trombüs,belirteç,doku Doppler

References

1. Kavlak ES, Kucukoglu H, Yigit Z, et al: Clinical and echocardiographic risk factors for embolization in the presence of left atrial thrombus. Echocardiography. 24:515-21, 2007.
2. Yamaji K, Fujimoto S, Yutani C, Hashimoto T, Nakamura S: Is the site of thrombus formation in the left atrial appendage associated with the risk of cerebral embolism? Cardiology. 97: 104-10, 2002.
3. Sanada J, Komaki S, Sannou K et al: Significance of atrial fibrillation, left atrial thrombus and severity of stenosis for risk of systemic embolism in patients with mitral stenosis. J Cardiol. 33: 1-5, 1999.
4. Goswami KC, Yadav R, Bahl VK: Predictors of left atrial appendage clot: a transesophageal echocardiographic study of left atrial appendage function in patients with severe mitral stenosis. Indian Heart J. 56: 628-35, 2004.
5. Yahia AM, Shaukat A, Kirmani JF, Latorre JG, Qureshi AI: Prevalence and Prediction of Left Atrial Thrombus in Patients with a Recent Cerebral Ischemic Event, Who Are in Sinus Rhythm: A Single-Center Experience. J Neuroimaging. 14, 2009.
6. Rader VJ, Khumri TM, Idupulapati M, Stoner CN, Magalski A, Main ML: Clinical predictors of left atrial thrombus and spontaneous echocardiographic contrast in patients with atrial fibrillation. J Am Soc Echocardiogr. 20: 1181-5, 2007.
7. Habara S, Dote K, Kato M, et al: Prediction of left atrial appendage thrombi in non-valvular atrial fibrillation. Eur Heart J. 28: 2217-22, 2007.
8. Ellis K, Ziada KM, Vivekananthan D, et al: Transthoracic echocardiographic predictors of left atrial appendage thrombus. Am J Cardiol. 97: 421-5, 2006.

9. Cavalcante JL, Al-Mallah M, Arida M, Garcia-Sayan E, Chattahi J, Ananthasubramaniam K: The relationship between spontaneous echocontrast, transesophageal echocardiographic parameters, and blood hemoglobin levels. J Am Soc Echocardiogr. 21: 868-72, 2008.
10. Cayli M, Acartürk E, Demir M, Kanadaşi M: Systolic tissue velocity is a useful echocardiographic parameter in assessment of left atrial appendage function in patients with mitral stenosis. Echocardiography. 24: 816-22, 2007.
11. Wilensky RL, Jung SC: Thrombo-embolism in patients with decreased left ventricular function: incidence, risk, and treatment. J Cardiovasc Risk 2: 91-96, 1995.