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[Occurrence of dynamic atrial spontaneous contrast in patients with mitral disease]
J Azevedo1, M A Garcia-Fernandez, D SanRoman
1Laboratório de Ecocardiografia, Hospital General Gregorio Marañon, Madrid, Espanha.
Objective:
The aim of this study was to analyze, through transesophageal echocardiography, different factors related to left atrial spontaneous echocardiographic formation.
Design:
Transthoracic and transesophageal comparative study of left atrial thrombotic phenomena.
Setting:
Ambulatory and in hospital patients referred to Gregorio Marañon General Hospital Echocardiographic Laboratory.
Patients:
120 consecutive patients with mitral valve disease or prosthesis were included in this transesophageal echocardiographic prospective study. All patients were divided in two groups, according with left atrial spontaneous contrast. In each patient we measured total left atrial area, rhythm abnormalities, mitral valve area, left atrial cavity thrombus and maximal mitral regurgitation area.
Measurements And Results:
Transthoracic echocardiography did not detect any patient with left atrial spontaneous contrast, compared to 57.5% diagnosed through the transesophageal technique. Transesophageal echocardiography diagnosed left atrial thrombosis in 19% (n = 23) of patients compared to 1% (n = 2) through the transthoracic technique. In the group with left atrial contrast, 59% of patients had mitral regurgitation less than 600 mm2, 64% were in atrial fibrillation and left atrial total area was 28 +/- 10.8 mm2.
Conclusions:
Transesophageal echocardiography is the technique of choice to diagnose, with greater security, left atrial cavity thrombosis, and establish the relationship of echocardiographic variables and left atrial thrombotic phenomena. Among these echocardiographic factors, left atrial dynamic spontaneous echocontrast is fundamental.