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[Relationship between left atrial spontaneous contrast echo and coagulofibrinolytic findings]
1Department of Clinical Laboratory, Sapporo Medical University Hospital.
Rinsho Byori. the Japanese Journal of Clinical Pathology
|March 1, 1995
Summary
Transesophageal echocardiography (TEE) can detect spontaneous echo contrast (SCE), indicating a high risk for cerebral embolism. Higher SCE grades correlate with increased coagulation and fibrinolysis markers, suggesting an association between SCE and blood clotting activation.
Area of Science:
- Cardiology
- Hematology
- Medical Imaging
Background:
- Transesophageal echocardiography (TEE) identifies left atrial thrombi (LAT) and spontaneous echo contrast (SCE).
- Patients with LAT or SCE face a significant risk of cerebral embolism.
- The clinical significance of SCE in relation to hemostasis requires further investigation.
Purpose of the Study:
- To investigate the relationship between spontaneous echo contrast (SCE) detected by TEE and markers of coagulation and fibrinolysis.
- To determine if SCE grade correlates with specific hemostatic factors.
Main Methods:
- Eighty-three patients underwent TEE with simultaneous blood sampling.
- Plasma levels of thrombin-antithrombin (TAT), plasmin-alpha 2-plasmin inhibitor complex (PIC), D-dimer, fibrinogen, and thrombomodulin (TM) were measured.
- Patients were categorized into four groups based on SCE grade (echo density and left atrial area).
Main Results:
- Plasma TAT and D-dimer levels were significantly higher in patients with high-grade SCE compared to those with lower grades.
- Plasma thrombomodulin (TM) levels were lower in patients with high-grade SCE.
- These findings suggest a correlation between high-grade SCE and heightened coagulation and fibrinolysis activity.
Conclusions:
- High-grade spontaneous echo contrast detected by transesophageal echocardiography is associated with activation of coagulation and fibrinolysis.
- TEE-detected SCE may serve as a non-invasive indicator of prothrombotic states.
- Further research is warranted to explore the predictive value of SCE in embolic events.