Document Detail

Atrial fibrillation with left atrial spontaneous contrast detected by transesophageal echocardiography is a potent risk factor for stroke.
MedLine Citation:
PMID:  8752187     Owner:  NLM     Status:  MEDLINE    
Nonrheumatic atrial fibrillation (AF) frequently coexists with other risk factors for cerebral ischemia. This study was originally designed to determine which combinations of clinical and echocardiographic abnormalities were most closely associated with the risk of cerebral ischemic events. Patients with cerebral ischemic events (n = 214) and community-based control subjects (n = 201) underwent transesophageal echocardiography and carotid artery imaging. Adjusted odds ratios (ORs) were determined using multiple logistic regression analysis. Independent risk factors for cerebral ischemia included diabetes, carotid stenosis, aortic sclerosis, left ventricular dysfunction, left ventricular hypertrophy, left atrial (LA) spontaneous contrast, and proximal aortic atheroma. Nonrheumatic AF in combination with LA spontaneous contrast and LA enlargement showed a strong association with cerebral ischemic events (OR 33.7 [95% confidence interval 4.53 to 251]). In subjects with sinus rhythm or nonrheumatic AF, LA enlargement was not associated with an increased risk of cerebral ischemic events in the absence of LA spontaneous contrast. However, only 2 patients and 1 control subject had nonrheumatic AF without LA spontaneous contrast or LA enlargement. Therefore, study of a larger number of subjects is required to address the issue of whether nonrheumatic AF itself carries increased risk. The combination of nonrheumatic AF with LA spontaneous contrast is a potent risk factor for cerebral ischemia. Ascertaining the risk factor in nonrheumatic AF requires adequate examination for underlying cardiac, aortic, and carotid vascular disease. Transesophageal echocardiography may contribute to this assessment.
E F Jones; P Calafiore; J J McNeil; A M Tonkin; G A Donnan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  78     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1996 Aug 
Date Detail:
Created Date:  1996-10-01     Completed Date:  1996-10-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  425-9     Citation Subset:  AIM; IM    
Alfred Hospital, Melbourne, Australia.
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MeSH Terms
Aortic Diseases / complications
Arteriosclerosis / complications
Atrial Fibrillation / complications*,  ultrasonography
Atrial Function, Left
Brain Ischemia / etiology
Cardiomegaly / complications
Carotid Arteries / ultrasonography
Carotid Stenosis / complications
Cerebrovascular Disorders / etiology*
Constriction, Pathologic / complications
Contrast Media*
Diabetes Complications
Echocardiography, Transesophageal*
Heart Atria / ultrasonography
Hypertrophy, Left Ventricular / complications
Logistic Models
Middle Aged
Odds Ratio
Risk Factors
Ventricular Dysfunction, Left / complications
Reg. No./Substance:
0/Contrast Media

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