Left atrial appendage smoke-like echo in dilated cardiomyopathy: its clinical significance and relation to left atrial appendage function.
To elucidate the clinical significance and pathogenesis of left atrial appendage smoke-like echo in dilated cardiomyopathy (DCM), clinical history and transesophageal echocardiographic assessment of left atrial appendage (LAA) anatomy and function were studied in 18 DCM patients with smoke-like echo (SE), 34 patients with DCM but no smoke-like echo and in 14 age-matched normal subjects. Patients with SE had a larger left atrial appendage area, a lower peak LAA systolic flow velocity (PLAAV), a greater incidence of atrial fibrillation, with both left atrial appendage thrombi and a history of arterial embolic episodes, than did patients without SE. Patients in sinus rhythm with SE had a minimal LAA area (5.0 +/- 3.0 cm2) larger than that in the no SE group (3.0 +/- 1.6 cm2) (p < 0.05), and LAA ejection fraction (18 +/- 10%) and PLAAV (24 +/- 9 cm/sec) less than that in the no SE group (40 +/- 11% and 39 +/- 16 cm/sec, respectively) (P < 0.05). Patients with atrial fibrillation (AF) and SE had PLAAV (15 +/- 6 cm/sec) less than that in AF patients without SE (30 +/- 12 cm/sec) (p < 0.05). It is concluded that smoke-like echo in LAA is an indicator of DCM patients with an increased thromboembolic risk usually associated with dilated and poorly contractile LAA.
Chou
H T
HT
Department of Medicine, China Medical College Hospital, Taichung, Taiwan.
Wang
T F
TF
D000328:Adult; D000368:Aged; D016279:Atrial Function, Left; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003328:Coronary Thrombosis / Q000209:etiology; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged