title: Effect of batroxobin on spontaneous echo contrast and hemorheology in left atrial appendage in atrial fibrillation assessed by transesophageal echocardiograpy.
abstract: Controversy exists regarding the effect of defibrination on spontaneous echo contrast and flow dynamics in left atrial appendage (LAA) in atrial fibrillation. We aimed to investigate the effect of batroxobin, which decreases plasma fibrinogen level, on the echo intensity of spontaneous echo contrast in LAA. In 36 patients with atrial fibrillation (duration 7 +/- 4 years), transesophageal echocardiography was performed at baseline and 24 hours after batroxobin administration (0.2 U/kg). At the orifice of the LAA, integrated backscatter of echo contrast and peak velocity of LAA emptying flow were measured. Plasma fibrinogen and whole blood viscosity were also measured. Fibrinogen and viscosity were significantly lower after batroxobin administration (96 +/-38 mg/dl and 4.35 +/- 0.56 cp) than those at baseline (320 +/- 61 mg/dl and 4.71 +/- 0.61 cp, both p <0.001). A significant positive correlation between changes in plasma fibrinogen and whole blood viscosity (r = 0.49, p = 0.002) was shown. The integrated backscatter significantly decreased from 14 +/- 3 to 12 +/- 3 decibels after batroxobin (p <0.001), and the changes in integrated backscatter and plasma fibrinogen was significantly correlated. Therefore, batroxobin administration improved blood rheology and decreased blood cell aggregation, which are effective in preventing left atrial thrombus formation.
authors.affiliation: Second Department of Internal Medicine, Kagawa Medical University, Kita, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Sakamoto
authors.forename: K
authors.initials: K
authors.lastname: Mizushige
authors.forename: Y
authors.initials: Y
authors.lastname: Takagi
authors.forename: T
authors.initials: T
authors.lastname: Ueda
authors.forename: K
authors.initials: K
authors.lastname: Ohmori
authors.forename: H
authors.initials: H
authors.lastname: Matsuo
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001281:Atrial Fibrillation / Q000097:blood* / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D012103:Batroxobin / Q000494:pharmacology*; D001783:Blood Flow Velocity / Q000187:drug effects; D001809:Blood Viscosity / Q000187:drug effects*; D016009:Chi-Square Distribution; D017548:Echocardiography, Transesophageal; D005260:Female; D005343:Fibrinolytic Agents / Q000494:pharmacology*; D018056:Hemorheology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D012044:Regression Analysis
chemical_list: D005343:Fibrinolytic Agents; D012103:Batroxobin