CLINICAL IMPLICATIONS AND FACTORS RELATED TO LEFT ATRIAL SPONTANEOUS ECHO CONTRAST IN CHRONIC NONVALVULAR ATRIAL-FIBRILLATION

被引:41
作者
HWANG, JJ
KO, FN
LI, YH
MA, HM
WU, GJ
CHANG, H
WANG, SM
SCHIE, JT
TSENG, YZ
KUAN, P
TENG, CM
LIEN, WP
机构
[1] NATL TAIWAN UNIV HOSP,DEPT INTERNAL MED,TAIPEI 100,TAIWAN
[2] NATL TAIWAN UNIV HOSP,DEPT EMERGENCY MED,TAIPEI,TAIWAN
[3] NATL TAIWAN UNIV,COLL MED,INST PHARMACOL,TAIPEI,TAIWAN
关键词
NONVALVULAR ATRIAL FIBRILLATION; SPONTANEOUS ECHO CONTRAST; ECHOCARDIOGRAPHY; PLATELET AGGREGABILITY;
D O I
10.1159/000176648
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The mechanisms leading to formation of spontaneous echo contrast (SEC), a smoke-like echo on echocardiography, are still controversial. To further explore the clinical implications and factors related to SEC formation, the correlation among echocardiographic variables, hematologic parameters or platelet aggregability, and the occurrence of SEC was studied in 119 patients with chronic nonvalvular atrial fibrillation. There were 75 men and 44 women with a mean age of 65 +/- 10 years (range 38-88). Left atrial SEC was detected in 39 patients (33%) by transesophageal echocardiography. Patients with history of systemic embolism were more frequently found to have left atrial SEC and left atrial thrombus by univariate analysis. Multivariate analysis showed that left atrial SEC (p < 0.001) was the only independent predictor of history of systemic embolism. Age, sex, left atrial or left ventricular dimension, left ventricular ejection fraction, antiplatelet or anticoagulant therapy and the percentage of lone atrial fibrillation were not significantly different between patients with and without left atrial SEC. Among the hematologic parameters, higher hematocrit was found in patients with left atrial SEC, while white blood cell and platelet counts were comparable in both groups. Platelet aggregability with different concentrations of inducers, adenosine diphosphate and collagen, was evaluated by the turbidimetric method in 15 patients with left atrial SEC and in 42 patients without left atrial SEC who were not receiving antiplatelet or anticoagulant therapy. No significant difference was found in platelet aggregability using four inducer concentrations between two groups of patients. It is therefore concluded that SEC formation is related to the hematocrit level in patients with nonvalvular atrial fibrillation, and the results also support the hypothesis that left atrial SEC comes from erythrocyte aggregation.
引用
收藏
页码:69 / 75
页数:7
相关论文
共 22 条
[1]   HEMATOLOGIC CORRELATES OF LEFT ATRIAL SPONTANEOUS ECHO CONTRAST AND THROMBOEMBOLISM IN NONVALVULAR ATRIAL-FIBRILLATION [J].
BLACK, IW ;
CHESTERMAN, CN ;
HOPKINS, AP ;
LEE, LCL ;
CHONG, BH ;
WALSH, WF .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1993, 21 (02) :451-457
[2]   LEFT ATRIAL SPONTANEOUS ECHO CONTRAST - A CLINICAL AND ECHOCARDIOGRAPHIC ANALYSIS [J].
BLACK, IW ;
HOPKINS, AP ;
LEE, LCL ;
WALSH, WF ;
JACOBSON, BM .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1991, 18 (02) :398-404
[3]   PREVALENCE AND CLINICAL IMPLICATIONS OF ATRIAL SPONTANEOUS CONTRAST IN PATIENTS UNDERGOING TRANSESOPHAGEAL ECHOCARDIOGRAPHY [J].
CASTELLO, R ;
PEARSON, AC ;
LABOVITZ, AJ .
AMERICAN JOURNAL OF CARDIOLOGY, 1990, 65 (16) :1149-1153
[4]   DETECTION OF SPONTANEOUS ECHOCARDIOGRAPHIC CONTRAST WITHIN THE LEFT ATRIUM BY TRANSESOPHAGEAL ECHOCARDIOGRAPHY - SPONTANEOUS ECHOCARDIOGRAPHIC CONTRAST [J].
ERBEL, R ;
STERN, H ;
EHRENTHAL, W ;
SCHREINER, G ;
TREESE, N ;
KRAMER, G ;
THELEN, M ;
SCHWEIZER, P ;
MEYER, J .
CLINICAL CARDIOLOGY, 1986, 9 (06) :245-252
[5]   TWO-DIMENSIONAL ECHOCARDIOGRAPHIC IDENTIFICATION OF BLOOD STASIS IN THE LEFT ATRIUM [J].
GARCIAFERNANDEZ, MA ;
MORENO, M ;
BANUELOS, F .
AMERICAN HEART JOURNAL, 1985, 109 (03) :600-601
[6]   REPORT OF THE AMERICAN-SOCIETY-OF-ECHOCARDIOGRAPHY COMMITTEE-ON-NOMENCLATURE-AND-STANDARDS-IN-2-DIMENSIONAL-ECHOCARDIOGRAPHY [J].
HENRY, WL ;
DEMARIA, A ;
GRAMIAK, R ;
KING, DL ;
KISSLO, JA ;
POPP, RL ;
SAHN, DJ ;
SCHILLER, NB ;
TAJIK, A ;
TEICHHOLZ, LE ;
WEYMAN, AE .
CIRCULATION, 1980, 62 (02) :212-217
[7]   REAPPRAISAL BY TRANSESOPHAGEAL ECHOCARDIOGRAPHY OF THE SIGNIFICANCE OF LEFT ATRIAL THROMBI IN THE PREDICTION OF SYSTEMIC ARTERIAL EMBOLIZATION IN RHEUMATIC MITRAL-VALVE DISEASE [J].
HWANG, JJ ;
KUAN, PL ;
LIN, SC ;
CHEN, WJ ;
LEI, MH ;
KO, YL ;
CHENG, JJ ;
LIN, JL ;
CHEN, JJ ;
LIEN, WP .
AMERICAN JOURNAL OF CARDIOLOGY, 1992, 70 (07) :769-773
[8]  
HWANG JJ, 1993, AM J CARDIOL, V72, P677
[9]  
HWANG JJ, IN PRESS AM HEART J
[10]   CIRCADIAN VARIATION IN PLATELET-FUNCTION IN HEALTHY-VOLUNTEERS [J].
JAFRI, SM ;
VANROLLINS, M ;
OZAWA, T ;
MAMMEN, EF ;
GOLDBERG, AD ;
GOLDSTEIN, S .
AMERICAN JOURNAL OF CARDIOLOGY, 1992, 69 (09) :951-954