Kardiologiia · 2015
[Detection of Signs of Thrombus Formation in Patients With Typical Atrial Flutter].
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Sychov O S, Borodai A A, Borodai 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 (AFl).
MATERIAL AND METHODS: Consecutive 406 patients (299 with atrial fibrillation [AFib] and 107 with AFl) 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 AFl had lower rate of detection of markers of thrombi formation (p<0.05). Among patients with AFl 1.8% had SEC grade 4+, 7.4% - LAA velocity less or equal 25 cm/s. LAA thrombus was found in 2.8 and 8.1% of patients with AFl and AFib, respectively. Prevalence of thrombi in left ventricular (LV) cavity was significantly higher inpatients with AFl (3.13 vs. 0.3% in patients with AFib, p=0.02). In patients with AFl systolic LV dysfunction was the main and ost significant predictor of severe LAA dysfunction and presence LV thrombus.
CONCLUSION: AFl 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 AFl) 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 AFl had lower rate of detection of markers of thrombi formation (p<0.05). Among patients with AFl 1.8% had SEC grade 4+, 7.4% - LAA velocity less or equal 25 cm/s. LAA thrombus was found in 2.8 and 8.1% of patients with AFl and AFib, respectively. Prevalence of thrombi in left ventricular (LV) cavity was significantly higher inpatients with AFl (3.13 vs. 0.3% in patients with AFib, p=0.02). In patients with AFl systolic LV dysfunction was the main and ost significant predictor of severe LAA dysfunction and presence LV thrombus.
CONCLUSION: AFl associated high risk of embolic events is primarily determined by its adverse effect on LV function.