Hematologic correlates of left atrial spontaneous echo contrast and thromboembolism in nonvalvular atrial fibrillation

Objective. This meta-analysis aimed at exploring the predictive value of CHA2DS2-VASc score for the left atrial thrombus (LAT) or left atrial spontaneous echo contrast (LASEC) in patients with nonvalvular atrial fibrillation (NVAF). Methods. PubMed, Embase, Web of Science, ScienceDirect, Cochrane Library, and Chinese core journals of the CNKI and Wanfang databases were searched to identify all the relevant papers that were published up to January 2020. The data were extracted for pooled odds ratios (ORs) with 95% confidence intervals (CIs), heterogeneity, subgroup, publication bias, and sensitivity analysis. Results. Overall, 15 studies containing 6223 patients with NVAF were enrolled. All studies were evaluated for LAT, and 12 studies were evaluated for LASEC. The pooled analysis using a random-effects model showed that a high CHA2DS2-VASc score was related with LAT/LASEC (pooled OR=1.59, 95% CI: 1.35–1.88, P<0.001) with high heterogeneity (I2=76.9%, P<0.001) and LAT (pooled OR=1.83, 95% CI: 1.44–2.33, P<0.001) with high heterogeneity (I2=79.4%, P<0.001). The subgroup analysis demonstrated that the sample size may be the main source of heterogeneity. Although the Begg’s funnel plot based on 15 studies for LAT/LASEC (P=0.029) and 12 studies for LAT (P=0.046) indicated the presence of publication bias among the included studies, the trim-and-fill method verified the stability of the pooled outcomes. In addition, sensitivity analysis indicated that all effects were stable. Conclusion. The results of this meta-analysis showed that the CHA2DS2-VASc score is related with LAT and LASEC in patients with NVAF. However, more studies are warranted to address this issue.

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Integrated Backscatter Assessment of Left Atrial Spontaneous Echo Contrast in Chronic Nonvalvular Atrial Fibrillation: Relation with Clinical and Echocardiographic Parameters

Journal of the American Society of Echocardiography ◽

10.1067/mje.2000.104739 ◽

2000 ◽

Vol 13 (7) ◽

pp. 666-673 ◽

Cited By ~ 7

Author(s):

Takahide Ito ◽

Michihiro Suwa ◽

Ayaka Kobashi ◽

Hatsumi Yagi ◽

Tomomi Nakamura ◽

...

Keyword(s):

Atrial Fibrillation ◽

Left Atrial ◽

Nonvalvular Atrial Fibrillation ◽

Integrated Backscatter ◽

Spontaneous Echo Contrast ◽

Echocardiographic Parameters

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Dabigatran exhibits low intensity of left atrial spontaneous echo contrast in patients with nonvalvular atrial fibrillation as compared with warfarin

Heart and Vessels ◽

10.1007/s00380-016-0871-5 ◽

2016 ◽

Vol 32 (3) ◽

pp. 326-332 ◽

Cited By ~ 3

Author(s):

Tetsuya Watanabe ◽

Yukinori Shinoda ◽

Kuniyasu Ikeoka ◽

Hirooki Inui ◽

Hidetada Fukuoka ◽

...

Keyword(s):

Atrial Fibrillation ◽

Left Atrial ◽

Nonvalvular Atrial Fibrillation ◽

Spontaneous Echo Contrast ◽

Low Intensity

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Predictors of spontaneous echo contrast and left atrial appendage thrombosis in nonvalvular atrial fibrillation

Russian Journal of Cardiology ◽

10.15829/1560-4071-2020-3765 ◽

2020 ◽

Vol 25 (7) ◽

pp. 3765

Author(s):

N. Yu. Khorkova ◽

T. P. Gizatulina ◽

A. V. Belokurova ◽

E. A. Gorbatenko

Keyword(s):

Atrial Fibrillation ◽

Left Atrial ◽

Left Atrial Appendage ◽

Left Ventricular ◽

Atrial Appendage ◽

Nonvalvular Atrial Fibrillation ◽

Spontaneous Echo Contrast ◽

Obese Class ◽

Group 2 ◽

Group 1

Aim. To identify predictors of spontaneous echo contrast (SEC) and/or left atrial appendage (LAA) thrombosis in patients with nonvalvular atrial fibrillation (AF) who are referred for elective cardioversion or catheter ablation (CA).Material and methods. A retrospective analysis of data from 638 patients with nonvalvular AF who were hospitalized from 2014 to 2017 for cardioversion or CA was performed. All patients underwent diagnostic tests, including transthoracic and transesophageal echocardiography (TEE).Results. According to the TEE results, two groups of patients were formed: group 1 — 95 patients (14,9%) with signs of SEC and/or thrombosis in LAA; group 2 — 543 patients (85,1%) without SEC or thrombosis in LAA. Patients with the phenomenon of SEC and/or LAA thrombosis were older, had a higher risk on the CHA2DS2-VASc score. These patients were more likely to have coronary heart disease (CAD), hypertension, stage IIA chronic heart failure, obese class >II, persistent or permanent AF Patients in both groups did not differ in anticoagulant therapy. Patients in group 1 had a larger size of the left and right atria, right ventricle, left ventricular (LV) end-systolic and end-diastolic diameters, higher LV mass index, lower values of LV ejection fraction and blood flow velocity in LAA. Logistic regression revealed following independent predictors of SEC and/or LAA thrombosis: CAD (odds ratio (OR) 2,289; 95% confidence interval (CI) 1,313-3,990; p=0,003), persistent or permanent AF (OR 2,071; 95% CI 1,222-3,510; p=0,007), LA diameter >43 mm (OR 3,569; 95% CI 2,0822-6,117; p<0,001), concentric or eccentric LV hypertrophy (OR 2,230; 95% CI 1,302-3,819; p=0,003).Conclusion. As the result, all patients referring for CA or cardioversion, regardless of the CHA2DS2-VASc score, should underwent LAA. According to this study, the presence of CAD, persistent or permanent AF, LA diameter >43 mm, concentric or eccentric LV hypertrophy are independent predictors of SEC and/or LAA thrombosis.

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