Document Detail

Left atrial spontaneous echo contrast is highly associated with previous stroke in patients with atrial fibrillation or mitral stenosis.
MedLine Citation:
PMID:  8322375     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Spontaneous echo contrast is a dynamic smokelike signal that is detected by transesophageal echocardiography in patients with stasis of blood in the left atrium. We designed this study to determine if spontaneous echo contrast is associated with an increased risk of previous stroke or peripheral embolism. METHODS: Forty-two patients with spontaneous echo contrast were identified (34 had atrial fibrillation or mitral stenosis; 8 had neither). Control subjects comprised 40 patients randomly selected from patients with atrial fibrillation or mitral stenosis who did not have spontaneous echo contrast at transesophageal echocardiography. The frequency of vascular risk factors, echocardiographic features, and stroke or peripheral embolism within 1 year of echocardiography were compared in the two groups. RESULTS: The frequency of traditional risk factors for stroke were the same in both groups, yet 9 of 42 patients with spontaneous contrast had stroke or peripheral embolism compared with only 1 of 40 control subjects (P < .02; relative risk, 10.6; 95% confidence interval, 1.3 to 88.4). In patients with nonvalvular atrial fibrillation, 6 of 12 patients with spontaneous contrast had a stroke or peripheral embolism compared with 1 of 28 patients without spontaneous contrast (P < .001; relative risk, 27.0; 95% confidence interval, 2.7 to 267.8). CONCLUSIONS: Spontaneous echo contrast is highly associated with previous stroke or peripheral embolism in patients with atrial fibrillation or mitral stenosis. Transesophageal echocardiography may enable stratification of cardioembolic risk in patients with nonvalvular atrial fibrillation.
M I Chimowitz; M A DeGeorgia; R M Poole; A Hepner; W M Armstrong
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  24     ISSN:  0039-2499     ISO Abbreviation:  Stroke     Publication Date:  1993 Jul 
Date Detail:
Created Date:  1993-08-03     Completed Date:  1993-08-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1015-9     Citation Subset:  IM    
Department of Neurology, University of Michigan Medical Center, Ann Arbor 48109.
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MeSH Terms
Atrial Fibrillation / complications*
Cerebrovascular Disorders / complications*,  radiography
Heart Atria / radiography*
Middle Aged
Mitral Valve Stenosis / complications*
Risk Factors
Comment In:
Stroke. 1994 Jun;25(6):1295-6   [PMID:  8202999 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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