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Updated: Sep 27, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
07:41

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

Atrial fibrillation: relation between clinical risk factors and transoesophageal echocardiographic risk factors for

S Illien1, S Maroto-Järvinen, G von der Recke

  • 1Department of Medicine-Cardiology, University of Bonn, Bonn, Germany.

Heart (British Cardiac Society)
|January 16, 2003
PubMed

Insights

Clinical risk factors for thromboembolism correlate with transesophageal echocardiography (TOE) findings of a thrombogenic milieu in atrial fibrillation patients. TOE can identify high-risk individuals, even those without obvious clinical risk factors.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Atrial fibrillation (AF) poses a significant risk for thromboembolic events.
  • Identifying patients at high risk for stroke is crucial for effective anticoagulation management.
  • Transesophageal echocardiography (TOE) offers detailed cardiac imaging, potentially revealing markers of thrombogenicity.

Purpose of the Study:

  • To investigate the association between established clinical risk factors for thromboembolism and specific echocardiographic markers indicative of a thrombogenic milieu in patients with non-rheumatic atrial fibrillation.
  • To determine if TOE can identify a thrombogenic state in patients lacking clear clinical risk factors.

Main Methods:

  • A prospective study involving 301 consecutive patients with non-rheumatic atrial fibrillation undergoing TOE.
  • Assessment of clinical risk factors including hypertension, diabetes, prior thromboembolism, age over 65, and heart failure.
  • Evaluation of TOE parameters: spontaneous echo contrast, thrombus presence, and left atrial appendage blood flow velocity.

Main Results:

  • 255 patients (84.7%) had at least one clinical risk factor.
  • 158 patients (52.5%) exhibited TOE markers of a thrombogenic milieu (reduced flow, dense spontaneous echo contrast, or both).
  • Reduced left ventricular ejection fraction and age > 65 were independent predictors of a thrombogenic milieu. The likelihood of a thrombogenic milieu increased with the number of clinical risk factors.

Conclusions:

  • A strong correlation exists between clinical risk factors and TOE-identified markers of a thrombogenic milieu in AF patients.
  • TOE is valuable in detecting a thrombogenic state, particularly in patients who do not present with apparent clinical risk factors, aiding in risk stratification.
Abstract

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