Related Experiment Video

Updated: Feb 18, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
07:41

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

4.4K

The Refinement of Risk Stratification for Atrial Thrombus or Spontaneous Echo Contrast in Nonvalvular Atrial

Wenna Ning1, Yang Li1, Chunyan Ma2

  • 1Department of Cardiology, The First Hospital Affiliated to China Medical University.

International Heart Journal
|November 21, 2017
PubMed

Insights

Serum uric acid (SUA) and left atrial diameter (LAD) improve risk prediction for left atrial thrombus/spontaneous echo contrast in nonvalvular atrial fibrillation (NVAF) patients. Elevated SUA or LAD in moderate-risk NVAF patients indicates a higher risk of thromboembolism.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Medical Diagnostics

Background:

  • Nonvalvular atrial fibrillation (NVAF) patients with left atrial thrombus or spontaneous echo contrast (LAT/SEC) face increased thromboembolic risk.
  • Current risk stratification scores like CHADS₂ and CHA₂DS₂-VASc may not fully capture this risk in all NVAF patients.
  • Identifying additional predictive factors for LAT/SEC is crucial for refining anticoagulant therapy decisions.

Purpose of the Study:

  • To evaluate the added predictive value of serum uric acid (SUA) and left atrial diameter (LAD) to CHADS₂ and CHA₂DS₂-VASc scores for LAT/SEC in NVAF patients.
  • To explore the influence of SUA and LAD levels on LAT/SEC occurrence, particularly within the moderate-risk group.
  • To propose a concept of a borderline high-risk group to guide clinical anticoagulant management in NVAF.

Main Methods:

  • A cohort of 284 NVAF patients without prior anticoagulant history was analyzed.
  • Patients were categorized into LAT/SEC positive or negative groups based on transesophageal echocardiography (TEE).
  • The predictive performance of CHADS₂, CHA₂DS₂-VASc, and their combinations with SUA and LAD was assessed.

Main Results:

  • 61 patients (21.48%) exhibited LAT/SEC.
  • Serum uric acid (SUA) and left atrial diameter (LAD) were identified as independent risk factors for LAT/SEC.
  • Incorporating LAD and SUA significantly enhanced the predictive power of CHADS₂ and CHA₂DS₂-VASc for LAT/SEC.
  • In the moderate-risk group, LAT/SEC incidence increased significantly when SUA or LAD exceeded established cut-off values.

Conclusions:

  • Serum uric acid (SUA) and left atrial diameter (LAD) serve as valuable additional predictors for LAT/SEC in NVAF patients, augmenting CHADS₂ and CHA₂DS₂-VASc scores.
  • Elevated SUA or LAD levels in moderate-risk NVAF patients are associated with increased LAT/SEC and a higher risk of thromboembolic events.
  • These findings support the identification of a borderline high-risk group, aiding in tailored anticoagulant therapy decisions for NVAF management.

Keywords:
Borderline high risk groupLeft atrial thrombusPredictive value

More Related Videos

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

2.2K
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

84.6K

Related Concept Videos

Imaging Studies for Cardiovascular System II:Types of Echocardiography01:20

Imaging Studies for Cardiovascular System II:Types of Echocardiography

Echocardiography plays a role in assessing cardiac health and detecting heart conditions, with various types providing critical insights for diagnosis and treatment.
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
684
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
388
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
641
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
309