Prevalence and clinical impact of left atrial thrombus and dense spontaneous echo contrast in patients with atrial fibrillation and low CHADS2 score
Prevalence and clinical impact of left atrial thrombus and dense spontaneous echo contrast in patients with atrial fibrillation and low CHADS2 score
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DOI：
10.1093/ejechocard/jen256
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发表时间：
2009-05-01
影响因子：
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通讯作者：
Seidl, Karlheinz
中科院分区：
文献类型：
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作者：
Kleemann, Thomas;Becker, Torsten;Seidl, Karlheinz
评价接受心脏复律的低CHADS（2）评分房颤（AF）患者中左心房（LA）血栓和致密自发性超声造影（SEC）的患病率和临床影响。前瞻性单中心登记研究ANTIK中共有295例CHADS（2）评分为0或1的非瓣膜性AF患者，在心脏复律前接受经食管超声心动图检查，被纳入研究。中位随访时间为5年。3%的患者存在LA血栓，8%的患者存在致密SEC。血栓或致密型SEC的独立预测因子为射血分数（EF）< 40% and LA diameter >≥ 50 mm。在抗凝患者中，血栓和致密型SEC与5年随访期间卒中或死亡风险增加无关（OR 1.55，95% CI 0.50-4.83）。尽管CHADS（2）评分较低（0/1），但3%的患者有LA血栓，8%的患者有致密型SEC。血栓和致密SEC的独立预测因子为EF < 40% and LA dimension >= 50 mm。因此，超声心动图可能是CHADS（2）评分低的患者进一步风险分层的有用工具。
To evaluate the prevalence and clinical impact of left atrial (LA) thrombus and dense spontaneous echo contrast (SEC) in patients with atrial fibrillation (AF) and low CHADS(2) score undergoing cardioversion.A total of 295 consecutive patients with non-valvular AF and a CHADS(2) score of 0 or 1 from the prospective single-centre registry ANTIK, who underwent transoesophageal echocardiography before cardioversion, were included in the study. Median follow-up was 5 years. LA thrombus was present in 3% and dense SEC in 8% of patients. Independent predictors for the presence of thrombus or dense SEC were ejection fraction (EF) < 40% and LA diameter >= 50 mm. In anticoagulated patients, thrombus and dense SEC were not independently associated with an increased risk for stroke or death during the 5 year follow-up (OR 1.55, 95% CI 0.50-4.83).Despite a low CHADS(2) score of 0/1, 3% of patients have LA thrombus and 8% of patients have dense SEC. Independent predictors for the presence of thrombus and dense SEC were EF < 40% and LA dimension >= 50 mm. Thus, echocardiography might be a useful tool for further risk stratification in patients with low CHADS(2) score.