Significance of left atrial spontaneous echo contrast in rheumatic mitral valve disease as a predictor of systemic arterial embolization

A transesophageal echocardiographic study

Juey Jen Hwang, Peiliang Kuan, Jin Jer Chen, Yu Lin Ko, Jun Jack Cheng, Jiunn Lee Lin, Yung Zu Tseng, Wen Pin Lien

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

The association between left atrial spontaneous echo contrast (SEC) and a history of systemic arterial embolization was evaluated in 359 consecutive patients with rheumatic mitral valve disease during a 3-year period. All patients underwent transesophageal echocardiographic (TEE) and cardiac catheterization studies. Of these, 207 patients had predominant mitral stenosis, 55 had significant mitral regurgitation, and the remaining 97 with xenograft mitral valve replacement developed valvular dysfunction (32 resulted in predominant mitral stenosis and 65 in significant mitral regurgitation). Left atrial SEC was detected in 108 patients (group A) and was absent in 251 (group B). Group A patients showed a higher frequency of left atrial thrombi or history of previous embolization than those in group B (59.3% vs 7.2%; p < 0.001). Group A patients also had a higher frequency of recent (≤1 week before TEE study) and remote (>1 week before TEE study) embolization than did group B patients (recent: 19.4% vs 2.8% [p < 0.001]; remote: 13.0% vs 4.0% [p < 0.001]). Multivariate analysis showed that left atrial SEC (p = 0.01) was the only independent predictor of systemic arterial embolization. It is concluded that patients with left atrial SEC had a significantly higher risk for thromboembolism, and TEE is a useful modality to identify this subset of patients with rheumatic mitral valve disease.

Original languageEnglish
Pages (from-to)880-885
Number of pages6
JournalAmerican Heart Journal
Volume127
Issue number4 PART 1
DOIs
Publication statusPublished - Jan 1 1994
Externally publishedYes

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Mitral Valve
Mitral Valve Stenosis
Mitral Valve Insufficiency
Thromboembolism
Cardiac Catheterization
Heterografts
Thrombosis
Multivariate Analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Significance of left atrial spontaneous echo contrast in rheumatic mitral valve disease as a predictor of systemic arterial embolization : A transesophageal echocardiographic study. / Hwang, Juey Jen; Kuan, Peiliang; Chen, Jin Jer; Ko, Yu Lin; Cheng, Jun Jack; Lin, Jiunn Lee; Tseng, Yung Zu; Lien, Wen Pin.

In: American Heart Journal, Vol. 127, No. 4 PART 1, 01.01.1994, p. 880-885.

Research output: Contribution to journalArticle

Hwang, Juey Jen ; Kuan, Peiliang ; Chen, Jin Jer ; Ko, Yu Lin ; Cheng, Jun Jack ; Lin, Jiunn Lee ; Tseng, Yung Zu ; Lien, Wen Pin. / Significance of left atrial spontaneous echo contrast in rheumatic mitral valve disease as a predictor of systemic arterial embolization : A transesophageal echocardiographic study. In: American Heart Journal. 1994 ; Vol. 127, No. 4 PART 1. pp. 880-885.
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abstract = "The association between left atrial spontaneous echo contrast (SEC) and a history of systemic arterial embolization was evaluated in 359 consecutive patients with rheumatic mitral valve disease during a 3-year period. All patients underwent transesophageal echocardiographic (TEE) and cardiac catheterization studies. Of these, 207 patients had predominant mitral stenosis, 55 had significant mitral regurgitation, and the remaining 97 with xenograft mitral valve replacement developed valvular dysfunction (32 resulted in predominant mitral stenosis and 65 in significant mitral regurgitation). Left atrial SEC was detected in 108 patients (group A) and was absent in 251 (group B). Group A patients showed a higher frequency of left atrial thrombi or history of previous embolization than those in group B (59.3{\%} vs 7.2{\%}; p < 0.001). Group A patients also had a higher frequency of recent (≤1 week before TEE study) and remote (>1 week before TEE study) embolization than did group B patients (recent: 19.4{\%} vs 2.8{\%} [p < 0.001]; remote: 13.0{\%} vs 4.0{\%} [p < 0.001]). Multivariate analysis showed that left atrial SEC (p = 0.01) was the only independent predictor of systemic arterial embolization. It is concluded that patients with left atrial SEC had a significantly higher risk for thromboembolism, and TEE is a useful modality to identify this subset of patients with rheumatic mitral valve disease.",
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