Document Detail

Right atrial spontaneous echo contrast indicates a high incidence of perfusion defects in pulmonary scintigraphy in patients with atrial fibrillation.
MedLine Citation:
PMID:  19165566     Owner:  NLM     Status:  MEDLINE    
This study investigated the relationship between right atrial SEC (RA-SEC) and silent pulmonary embolism (PE) in patients with nonvalvular atrial fibrillation (NVAF). Spontaneous echo contrast (SEC) within the cardiac chambers is associated with an increased risk of thromboembolism. However, most studies have examined the relationship between left atrial SEC and systemic thromboembolic disease. Transesophageal echocardiography (TEE) was performed in 210 patients with NVAF to assess a risk of thromboembolism. Right atrial SEC was detected in 37 patients, and 35 of these patients with RA-SEC and 29 patients without RA-SEC were enrolled in this study. However, patients with a history of symptomatic PE or deep vein thrombosis were excluded. Spontaneous echo contrast was diagnosed by TEE as the presence of smoke-like echoes that swirled in a circular pattern. PE was diagnosed by pulmonary scintigraphy. Thrombotic and thrombolytic parameters, including serum concentrations of plasmin-alpha-plasmin inhibitor complex (PIC), thrombin-antithrombin complex (TAT), D-dimer, and fibrinogen were measured in all patients. Left ventricular dimension, cardiac function, and hematologic parameters were similar in the two groups. Nevertheless, the incidence of perfusion defects in pulmonary scintigraphy was significantly higher in the group with RA-SEC (40%) than in the group without RA-SEC (7%; chi-square, P=0.006). The increased incidence of perfusion defects in pulmonary scintigraphy in patients with RA-SEC indicates that right atrial SEC may be a predictable factor at a high risk of PE.
Yoshinori Yasuoka; Johji Naito; Keiji Hirooka; Wakatomi Chin; Kunio Miyatake; Hideo Kusuoka; Yukihiro Koretsune
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-01-23
Journal Detail:
Title:  Heart and vessels     Volume:  24     ISSN:  1615-2573     ISO Abbreviation:  Heart Vessels     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-23     Completed Date:  2009-06-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511258     Medline TA:  Heart Vessels     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  32-6     Citation Subset:  IM    
Cardiovascular Division, Osaka Minami Medical Center, 2-1 Kidohigashi-machi, Kawachinagano, Osaka 586-8521, Japan.
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MeSH Terms
Atrial Fibrillation / ultrasonography*
Contrast Media / adverse effects*
Echocardiography, Transesophageal / adverse effects,  methods*
Follow-Up Studies
Heart Atria
Japan / epidemiology
Middle Aged
Pulmonary Embolism / epidemiology,  etiology*,  radionuclide imaging
Risk Factors
Reg. No./Substance:
0/Contrast Media

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