Comprehensive left atrial appendage optimization of thrombus using surface echocardiography: the CLOTS multicenter pilot trial
| Autor: | Elizabeth A. Lieber, John A. Sallach, Craig R. Asher, Allen G. Borowski, Sharon L. Mulvagh, Jianbo Li, Marcus F. Stoddard, Allan L. Klein, Erwan Donal, Jeanne K. Drinko, Neil J. Weissmann, William A. Zoghbi, Senthil Thambidorai, Carolyn Apperson-Hansen, Sarinya Puwanant, Joseph F. Malouf, Wael A. Jaber, Sukaina J. Jaffer, Susan E. Jasper |
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| Přispěvatelé: | Cleveland Clinic, Baylor College of Medicine (BCM), Baylor University, Mayo Clinic |
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Male
Pilot Projects 030204 cardiovascular system & hematology 0302 clinical medicine Doppler tissue imaging MESH: Ohio [INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing Left atrial MESH: Aged Pilot trial Atrial fibrillation Structure and function MESH: Reproducibility of Results MESH: Atrial Fibrillation Echocardiography Cardiology cardiovascular system Female [SDV.IB]Life Sciences [q-bio]/Bioengineering MESH: Image Enhancement Cardiology and Cardiovascular Medicine [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing Algorithms Thrombus medicine.medical_specialty Spontaneous echo contrast Left atrial appendage MESH: Algorithms Sensitivity and Specificity 03 medical and health sciences [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system Internal medicine Image Interpretation Computer-Assisted medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases MESH: Thrombosis Aged Ohio MESH: Humans business.industry Reproducibility of Results Mean age Thrombosis medicine.disease Image Enhancement MESH: Pilot Projects MESH: Sensitivity and Specificity MESH: Male body regions MESH: Echocardiography business MESH: Female MESH: Image Interpretation Computer-Assisted 030217 neurology & neurosurgery |
| Zdroj: | Journal of The American Society of Echocardiography Journal of The American Society of Echocardiography, Elsevier, 2009, 22 (10), pp.1165-72. ⟨10.1016/j.echo.2009.05.028⟩ |
| ISSN: | 0894-7317 |
| DOI: | 10.1016/j.echo.2009.05.028⟩ |
| Popis: | International audience; BACKGROUND: The aim of this study was to determine the ability to identify thrombus within the left atrial appendage (LAA) in the setting of atrial fibrillation (AF) using transthoracic echocardiography (TTE). In AF, the structure and function of the LAA has historically been evaluated using transesophageal echocardiography (TEE). The role of TTE remains undefined. METHODS: The Comprehensive Left Atrial Appendage Optimization of Thrombus (CLOTS) multicenter study enrolled 118 patients (85 men; mean age, 67 +/- 13 years) with AF of >2 days in duration undergoing clinically indicated TEE. On TEE, the LAA was evaluated for mild spontaneous echo contrast (SEC), severe SEC, sludge, or thrombus. Doppler Tissue imaging (DTI) peak S-wave and E-wave velocities of the LAA walls (anterior, posterior, and apical) were acquired on TTE. Transthoracic echocardiographic harmonic imaging (with and without intravenous contrast) was examined to determine its ability to identify LAA SEC, sludge, or thrombus. RESULTS: Among the 118 patients, TEE identified 6 (5%) with LAA sludge and 2 (2%) with LAA thrombi. Both LAA thrombi were identified on TTE using harmonic imaging with contrast. Anterior, posterior, and apical LAA wall DTI velocities on TTE varied significantly among the 3 groups examined (no SEC, mild SEC, severe SEC, sludge or thrombus). An apical E velocity < or = 9.7 cm/s on TTE best identified the group of patients with severe SEC, sludge, or thrombus. An anterior S velocity < or = 5.2 cm/s on TTE best identified the group of patients with sludge or thrombus. CONCLUSIONS: The CLOTS multicenter pilot trial determined that TTE is useful in the detection of thrombus using harmonic imaging combined with intravenous contrast (Optison; GE Healthcare, Milwaukee, WI). Additionally, LAA wall DTI velocities on TTE are useful in determining the severity of LAA SEC and detecting sludge or thrombus. |
| Databáze: | OpenAIRE |
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