Article

PDF
Access to the PDF text
Advertising


Free Article !

Archives of cardiovascular diseases
Volume 106, n° 4
page 266 (avril 2013)
Doi : 10.1016/j.acvd.2013.03.055
Abstracts

Transesophageal markers of thromboembolism in non-valvular atrial fibrillation patients with a CHADS2 score=0
 

S. Ederhy, S. Ederhy, S. Lang, L. Boyer Chatenet, N. Haddour, C. Meuleman, G. Fleury, A. Saroumadi, F. Boccara, E. Di Angelantonio, A. Cohen
 Hôpital Saint-Antoine, Paris, France 

Background .– Transesophageal echocardiography (TEE) parameters (left atrial appendage, LAA thrombus or spontaneous echocardiographic contrast (SEC), aortic atheroma (AAA) are powerful markers of thromboembolism (TE) in non-valvular atrial fibrillation (NVAF) patients. However, the prevalence and potential impact of these abnormalities have not been evaluated in patients at very low risk of TE. We evaluated TEE-detected LASEC, thrombus and AAA in AF patients referred for cardioversion and analyzed the subgroup of patients with a CHADS2 score=0.

Patients .– Among 763 consecutive patients hospitalized for NVAF, prior to cardioversion, TEE was systematically performed within 24h after admission; 205 patients had a CHADS2 score=0. The following parameters were described: presence and severity of LASEC, LA thrombus, aortic atheroma (AAA).

Results .– Mean age was 54.5±13.5years. AF was paroxysmal in 101 patients (49.3%), persistent in 82 (40.0%) and permanent in 22 (10.7%). Transthoracic echocardiography showed LVEF<40% in 12 (5.9%) and median of mean LA area was 18 (15–23) cm2. LA thrombus was found in one patient (0.5%), LASEC in 60 (29.3%), classified as mild in 43 (21.0%), moderate in 14 (6.8%) and severe in three (1.5%). AAA was present in six patients (2.9%). The Table 1 compares some baseline characteristics in patients with (LAASEC/thrombus or aortic atheroma4mm) or without TEE abnormalities, defined as an endpoint.

In the multivariate analysis, age (OR, 1.04, 95% CI 1.01–1.07), non paroxysmal AF (OR, 3.23, 95% CI 1.54–6.78) and LA area (OR, 1.08, 95% CI 1.02–1.16) were predictors of TEE-detected LASEC/thrombus or aortic atheroma.

Conclusions .– TEE prior to cardioversion in NVAF found TEE-detected risk markers of thromboembolism (LASEC/thrombus or aortic atheroma) in one third of patients with a CHADS2 score=0.


Top of the page

© 2013  Published by Elsevier Masson SAS.
EM-CONSULTE.COM is registrered at the CNIL, déclaration n° 1286925.
As per the Law relating to information storage and personal integrity, you have the right to oppose (art 26 of that law), access (art 34 of that law) and rectify (art 36 of that law) your personal data. You may thus request that your data, should it be inaccurate, incomplete, unclear, outdated, not be used or stored, be corrected, clarified, updated or deleted.
Personal information regarding our website's visitors, including their identity, is confidential.
The owners of this website hereby guarantee to respect the legal confidentiality conditions, applicable in France, and not to disclose this data to third parties.
Close
Article Outline
You can move this window by clicking on the headline
@@#110903@@