| Contrast-enhanced tissue Doppler imaging of the left atrial appendage is a new quantitative measure of spontaneous echocardiographic contrast in atrial fibrillation. | |
| | |
MedLine Citation:
|
PMID: 17137842 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
AIMS: Although left atrial appendage spontaneous echo contrast (LAASEC) is a marker of increased thromboembolic risk in atrial fibrillation, it has previously only been evaluated qualitatively. We sought to determine if an intravenous contrast echocardiographic agent combined with tissue Doppler imaging (TDI) of the LAA could accurately quantify LAA-SEC in patients with atrial fibrillation. METHODS AND RESULTS: We prospectively identified 55 patients with persistent atrial arrhythmias (mean age 63+/-13 years) undergoing a transesophageal echocardiography (TEE), with LAA-SEC prior to direct current cardioversion. In addition to off-line calculation of backscatter index and shear rate, quantification of the velocity in a color TDI region of interest was performed in the LAA cavity following a 0.5-mL intravenous bolus of Optison. LAA-SEC was qualitatively graded by a blindedreader as mild (n = 29) or severe (n = 26), and was compared off-line to TEE-derived quantitative variables. Compared to patients with mild LAA-SEC, those with severe LAA-SEC had significantly decreased LAA emptying velocity, LAA TDI mean velocities and shear rate. Over the whole group, the mean maximal velocity of the LAA using TDI correlated with LAA emptying velocity (r = 0.59; P < 0.0001), shear rate (r = 0.55; P < 0.0001) and LAA area (r = 0.34; P = 0.014). Severe LAA-SEC was found with 72% sensitivity and 82% specificity if TDI mean velocity was <6.13 cm/s. On logistic regression analysis, LAA-TDI was the only predictor of qualitative LAA-SEC grade. CONCLUSION: Contrast-enhanced TDI is an original new tool that provides a quantification of the mean velocity of LAA-SEC that might improve our decision making in patients with atrial fibrillation. |
| | |
Authors:
|
Erwan Donal; John A Sallach; R Daniel Murray; Jeanne K Drinko; Susan E Jasper; James D Thomas; Allan L Klein |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology Volume: 9 ISSN: 1532-2114 ISO Abbreviation: Eur J Echocardiogr Publication Date: 2008 Jan |
Date Detail:
|
Created Date: 2008-02-12 Completed Date: 2008-06-03 Revised Date: 2008-07-29 |
Medline Journal Info:
|
Nlm Unique ID: 100890618 Medline TA: Eur J Echocardiogr Country: England |
Other Details:
|
Languages: eng Pagination: 5-11 Citation Subset: IM |
Affiliation:
|
CHU Rennes, Rennes, France. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Albumins
/
administration & dosage Atrial Appendage / ultrasonography* Atrial Fibrillation / ultrasonography* Contrast Media / administration & dosage Echocardiography, Transesophageal* Female Fluorocarbons / administration & dosage Humans Image Processing, Computer-Assisted Injections, Intravenous Male Middle Aged Prospective Studies ROC Curve Regression Analysis |
| Chemical | |
Reg. No./Substance:
|
0/Albumins; 0/Contrast Media; 0/FS 069; 0/Fluorocarbons |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Anti-IgA antibodies in common variable immunodeficiency (CVID): diagnostic workup and therapeutic st...
Next Document: Fatty acid composition and lipid peroxidation of soft-shelled turtle, Pelodiscus sinensis, fed diffe...