Kardiologiia · 2015
[Detection of Signs of Thrombus Formation in Patients With Typical Atrial flutter].
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Sychev O S, Borodaĭ A A, Borodaĭ E S
Аннотация
AIM: to assess rate of detection of markers of thrombi formation and to determine whether transthoracic echocardiography data or clinical characteristics predict severe left atrial appendage [LAA] dysfunction (low LAA velocity, severe spontaneous echo contrast [SEC], LAA thrombus) in patients with typical atrial flutter (AFI).
MATERIAL AND METHODS: Consecutive 406 patients (299 with atrial fibrillation [AFib] and 107 with AFI) underwent transesophageal echocardiography before cardioversion. Mean age was 59.3 years, mean CHA2DS2-VASc score--1.86, mean LAA velocity--37.02 cm/s.
RESULTS: Compared with patients with AF those with AFI had lower rate of detection of markers of thrombi formation (p < 0.05). Among patients with AFI 1.8% had SEC grade 4+, 7.4%--LAA velocity ≤ 25 cm/s. LAA thrombus was found in 2.8 and 8.1% of patients with AFI and AFib, respectively. Prevalence of thrombi in left ventricular (LV) cavity was significantly higher in patients with AFI (3.13 vs. 0.3% in patients with AFib, p = 0.02). In patients with AFI systolic LV dysfunction was the main and ost significant predictor of severe LAA dysfunction and presence LV thrombus.
CONCLUSION: AFI associated high risk of embolic events is primarily determined by its adverse effect on LV function.
MATERIAL AND METHODS: Consecutive 406 patients (299 with atrial fibrillation [AFib] and 107 with AFI) underwent transesophageal echocardiography before cardioversion. Mean age was 59.3 years, mean CHA2DS2-VASc score--1.86, mean LAA velocity--37.02 cm/s.
RESULTS: Compared with patients with AF those with AFI had lower rate of detection of markers of thrombi formation (p < 0.05). Among patients with AFI 1.8% had SEC grade 4+, 7.4%--LAA velocity ≤ 25 cm/s. LAA thrombus was found in 2.8 and 8.1% of patients with AFI and AFib, respectively. Prevalence of thrombi in left ventricular (LV) cavity was significantly higher in patients with AFI (3.13 vs. 0.3% in patients with AFib, p = 0.02). In patients with AFI systolic LV dysfunction was the main and ost significant predictor of severe LAA dysfunction and presence LV thrombus.
CONCLUSION: AFI associated high risk of embolic events is primarily determined by its adverse effect on LV function.