[A study on the relationship between spontaneous contrast echoes in left atrium and cerebral embolism in patients with chronic atrial fibrillation by using transesophageal echocardiography].
We assessed the relationship between the presence of spontaneous eotrast echoes (SCEs) in left atrium (LA) and the incidence of cerebral embolism. Transesophageal echocardiography (TEE) was performed in 56 patients (36 male, age 69.6 +/- 8.9 yrs.) with non-valvular chronic atrial fibrillation (NVAF), In 37 patients (66.1%), SCEs were detected by TEE, However, SCEs could not be detected in any patients by transthoracic echocardiography (TTE). In 9 patients (16.1%), left atrial thrombi were detected by TEE, but they could not be detected by TTE. According to the degree of SCEs, the patients were divided into three groups as follows; Group (-) (n = 19): SCEs were not detectable, Group (mild) (n = 17): SCEs were detectable in part of LA, Group (marked) (n = 20): SCEs were detectable in whole LA. LA thrombi were detected in 1 (5%) of the Group (-) patients, 2 (12%) of the Group (mild) patients and 6 (30%) of the Group (marked) patients (p = NS). 17 patients had a history of cerebral embolism. In Group (-), only one patient (5%) had a history of cerebral embolism. But 4 patients (24%) of Group (mild) and 12 patients (60%) of Group (marked) had histories of cerebral embolism. The incidence of cerebral embolism was significantly higher in Group (marked) than Group (-) (P less than 0.01) and Group (mild) (P less than 0.05). We conclude that, in patients with NVAF, the presence of SCEs by TEE may be a useful variable in identifying increased risk of cerebral embolism.
Hirabayashi
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Department of Cardiovascular Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000473:pathology; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012306:Risk; D013318:Stroke Volume; D014859:Warfarin / Q000627:therapeutic use
D014859:Warfarin