Document Detail

Aortic spontaneous echocardiographic contrast and hemostatic markers in patients with nonrheumatic atrial fibrillation.
MedLine Citation:
PMID:  11834664     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To determine the relationship between spontaneous echocardiographic contrast (SEC) in the descending thoracic aorta and plasma levels of hemostatic markers in patients with nonrheumatic atrial fibrillation (AF). DESIGN AND SETTINGS: A cross-sectional study at a university hospital. PATIENTS AND MEASUREMENTS: In 91 consecutive patients (mean +/- SE age, 70 +/- 1 years; 68 men) with nonrheumatic AF who underwent transesophageal echocardiography, plasma levels of markers for platelet activity (platelet factor 4 [PF4] and beta-thromboglobulin [beta-TG]), thrombotic status (thrombin-antithrombin III complex [TAT]), and fibrinolytic status (D-dimer and plasmin-alpha(2)-plasmin inhibitor complex [PIC]) were determined. RESULTS: Forty-three patients who had aortic SEC (AoSEC) were older (72 years vs 68 years; p < 0.05) and had a higher prevalence of chronic AF (88% vs 52%; p < 0.05) than 48 patients without AoSEC. TAT, PIC, and D-dimer levels were significantly higher in patients with AoSEC than in those without AoSEC, whereas PF4 and beta-TG levels were not different between the two groups. Although the prevalence of cerebral embolism did not differ between the two groups (23% vs 29%), the prevalence of peripheral embolism was higher in patients with AoSEC than in those without AoSEC (10% vs 0%; p < 0.05). Multivariate analysis revealed mitral regurgitation (odds ratio, 7.53; p < 0.02), SEC in the left atrium (odds ratio, 2.14; p < 0.02), and aortic atherosclerosis (odds ratio, 1.87; p < 0.04) emerged as independent predictors of AoSEC. CONCLUSIONS: Patients with nonrheumatic AF who have AoSEC appear to have enhanced coagulation activity but not platelet activity. Intensive anticoagulation treatment might be required for these patients.
Keiko Nakagawa; Tadakazu Hirai; Noriko Shinokawa; Shutaro Takashima; Takashi Nozawa; Hidetsugu Asanoi; Hiroshi Inoue
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chest     Volume:  121     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-02-08     Completed Date:  2002-03-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  500-5     Citation Subset:  AIM; IM    
Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan.
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MeSH Terms
Antithrombin III / analysis
Aorta, Thoracic / ultrasonography*
Aortic Diseases / ultrasonography
Arteriosclerosis / ultrasonography
Atrial Fibrillation / blood*,  ultrasonography*
Cross-Sectional Studies
Echocardiography, Transesophageal
Fibrin Fibrinogen Degradation Products / analysis
Intracranial Embolism / diagnosis
Magnetic Resonance Imaging
Peptide Hydrolases / analysis
Platelet Factor 4 / analysis
Tomography, X-Ray Computed
beta-Thromboglobulin / analysis
Reg. No./Substance:
0/Fibrin Fibrinogen Degradation Products; 0/antithrombin III-protease complex; 0/beta-Thromboglobulin; 0/fibrin fragment D; 37270-94-3/Platelet Factor 4; 9000-94-6/Antithrombin III; EC 3.4.-/Peptide Hydrolases

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