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Femoral signal intensity: a new method for prediction of embolic risk
Ertugrul Ercan1, Nezihi Baris, Istemihan Tengiz
1Department of Cardiology, Central Hospital, Bayrakli-Izmir 35000, Turkey.
Insights
Patients with mitral stenosis and left atrial spontaneous echo contrast face high thromboembolism risk. Femoral artery signal intensity changes can help predict this risk, aiding clinical decisions.
Area of Science:
- Cardiology
- Vascular Ultrasound
- Thromboembolism Research
Background:
- Mitral stenosis patients with left atrial spontaneous echo contrast (LA SEC) exhibit elevated thromboembolic risk.
- Predicting this risk is crucial for effective patient management.
Purpose of the Study:
- To evaluate femoral artery signal intensity alteration as a predictor of thromboembolic risk in mitral stenosis patients.
- To compare signal intensity changes in patients with and without LA SEC.
Main Methods:
- Utilized ultrasound (USG) with a linear probe to assess femoral artery signal intensity.
- Compared signal intensity alteration (%) at 180 seconds post-cuff inflation (300 mmHg) across three groups: severe mitral stenosis with LA SEC, mild mitral stenosis without LA SEC, and healthy controls.
Main Results:
- Femoral artery signal intensity alteration (%) was significantly higher in the severe mitral stenosis with LA SEC group compared to the other two groups (P < 0.001).
- This finding correlated with higher echocardiographic, clinical, and laboratory indicators of thromboembolic risk in Group 1.
Conclusions:
- Increased femoral artery signal intensity alteration is detectable in mitral stenosis patients with LA SEC.
- This ultrasound-derived metric shows potential as a non-invasive marker for predicting thromboembolic risk.
Abstract:
Mitral stenotic patients with left atrial spontaneous echo contrast (LA SEC) are associated with high risk of thromboembolism. The aim of this study was to predict thromboembolic risk in mitral stenotic patients. Femoral artery signal intensity alteration (%) was compared among the groups. Group 1 had severe mitral stenosis with LA SEC and group 2 slight mitral stenosis without LA SEC. Group 3 patients had normal transthoracic echocardiography. Femoral artery longitudinal view was studied with a linear USG probe (7.5 MHz, HP 2500). The femoral cuff was inflated to 300 mmHg, 7-12 cm below the inguinal ligament. Cuff inflation resulted in femoral arterial blood stasis. Intraluminal signal intensity increased in seconds. The femoral signal intensity alteration (%) at 180 seconds was compared to baseline. After femoral cuff inflation, femoral signal intensity alteration (%) was significantly higher in group 1 than groups 2 and 3 (P < 0.001). Group 1 patients had higher thromboembolic risk on the basis of their echocardiographic, clinical, and laboratory parameters. Increased signal intensity alteration (%) can be detected in the femoral artery in mitral stenotic patients with LA SEC.
