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Clinical and echocardiographic risk factors for embolization in the presence of left atrial thrombus

Ela Sahinbas Kavlak1, Hayriye Kucukoglu, Zerrin Yigit

  • 1Department of Cardiology, Institute of Cardiology, Istanbul University, Istanbul, Turkey. esahinbas@yahoo.com

Echocardiography (Mount Kisco, N.Y.)
|April 26, 2007
PubMed

Insights

In patients with left atrial thrombi (LAT), preserved heart function and spontaneous echo-contrast in the left atrial appendage increase the risk of cerebral embolization. These factors differ from those causing thrombus formation.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Imaging

Background:

  • Left atrial thrombi (LAT) are a significant risk factor for embolic events, particularly ischemic stroke.
  • Understanding the predictors of embolization in LAT patients is crucial for risk stratification and treatment.
  • Transesophageal echocardiography (TEE) is a key imaging modality for diagnosing LAT and assessing cardiac function.

Purpose of the Study:

  • To identify clinical and echocardiographic factors associated with embolization in patients diagnosed with left atrial thrombi (LAT).
  • To differentiate factors contributing to thrombus formation versus factors promoting embolization in LAT patients.

Main Methods:

  • Retrospective analysis of clinical and echocardiographic data from 192 patients with LAT.
  • Patients were evaluated using transthoracic and transesophageal echocardiography.
  • Group comparison based on the presence or absence of prior ischemic stroke.

Main Results:

  • Patients with a history of ischemic stroke had smaller left atrial diameter, more left atrial appendage spontaneous echo-contrast, and higher appendage ejection fraction and emptying velocity.
  • Sinus rhythm was more prevalent, and mitral stenosis was less common in the stroke group.
  • Spontaneous echo-contrast in the left atrial appendage was associated with increased embolization risk.

Conclusions:

  • Cerebral embolization risk is elevated in LAT patients with preserved left atrial appendage ejection fraction and emptying velocity.
  • Spontaneous echo-contrast within the left atrial appendage is a significant predictor of embolization.
  • The factors influencing embolization may differ from those initiating thrombus formation in LAT.
Abstract

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