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Dilated cardiomyopathy, spontaneous echo contrast in the aorta and embolic events

Güliz Kozdağ1, Gökhan Ertaş, Tayfun Sahin

  • 1Dept. of Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.

Acta Cardiologica
|March 24, 2010
PubMed

Insights

Spontaneous echocardiographic contrast (SEC) in the aorta (Ao-SEC) is common in dilated cardiomyopathy (DCM). While Ao-SEC correlates with cardiac function and atherosclerosis, left atrial SEC, not Ao-SEC, is linked to thromboembolism.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Echocardiography

Background:

  • Spontaneous echocardiographic contrast (SEC) is frequently observed in patients with dilated cardiomyopathy (DCM).
  • The clinical significance and correlates of aortic SEC (Ao-SEC) in DCM patients require further investigation.

Purpose of the Study:

  • To determine the frequency of Ao-SEC in DCM patients.
  • To identify clinical factors associated with Ao-SEC.
  • To assess the relationship between Ao-SEC and thromboembolism.

Main Methods:

  • Ninety-two consecutive DCM patients were evaluated.
  • Transthoracic and transesophageal echocardiography were performed.
  • Clinical data and echocardiographic findings, including SEC in different cardiac chambers and aortic plaque presence, were analyzed.

Main Results:

  • Ao-SEC was detected in 58% of DCM patients.
  • Ao-SEC was associated with lower cardiac index, SEC in the left atrium and ventricle, larger aortic root dimensions, and complex aortic atherosclerotic plaques.
  • Left atrial SEC, not Ao-SEC, was the significant determinant of thromboembolism.

Conclusions:

  • Ao-SEC is a prevalent finding in DCM and correlates with cardiac dysfunction and atherosclerosis.
  • Thromboembolism in DCM patients is more strongly associated with left atrial SEC than with Ao-SEC.
  • Despite its association with embolic events in follow-up, Ao-SEC is not the primary predictor of thromboembolism in this cohort.
Abstract

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