Turk Kardiyol Dern Ars. 2005; 33(1): 2-9
Which Patients with Dilated Cardiomyopathy Have Left Atrial Spontaneous Echo Contrast?
, Ahmet VURAL2
, Meltem ÖZDEN0
, Tayfun ŞAHİN3
, Dilek URAL3
, Ayşen AĞAÇDİKEN2
, Göksel KAHRAMAN0
, Teoman KILIÇ4
, Ertan URAL5
, Baki KOMSUOĞLU6123456
OBJECTIVES Left atrial spontaneous echo contrast (LA-SEC) detected by transesophageal echocardiography (TEE) is a strong predictor for thromboembolic events. Few studies investigated the related conditions that lead to appearance of LA- SEC in dilated cardiomyopathy (DCMP) patients. The aim of the study was to investigate the prevalence of LA-SEC in patients with DCMP and to determine its related parameters.
METHODS Consecutive patients (29 female, 65 male, mean age 60±11 years) with the diagnosis of ischemic (n=56) and non-ischemic (n=38) DCMP underwent laboratory, transthoracic and TEE examination.
RESULTS LA-SEC was established in 48 patients (51%) of study group. LA-SEC was detected in 33 (59%) of ischemic DCMP and 15 (39%) of non- ischemic patients. In ischemic DCMP, restrictive diastolic filling (RDF) was observed 36% of the patients with LA- SEC vs. 22% in the patients without LA-SEC (p=0.05). Atrial fibrillation (AF) was present in 42% vs. 17% (p=0.05), hypertension was present 67% vs 39% of the patients respectively. In patients with ischemic DCMP, another significant correlate of LA-SEC was high fibrinogen level (471±78 mg/dl vs. 392±83 mg/dl, p=0.003). In non-ischemic DCMP group, AF was observed in 53% of the patients with LA-SEC vs. in 13% of the patients without LA-SEC (p=0.01). In patients with non- ischemic DCMP other significant determinants for LA-SEC were increased age (65±6 years vs. 53±12 years, p< 0.001), decreased cardiac index (2.1±0.6 L/min/m2 vs. 2.7±0.6 L/min/m2, p= 0.009) and reduced left atrial appendage velocities (p<0.001).
CONCLUSIONS In patients with DCMP, LA-SEC is frequently detected in patients with AF. In ischemic DCMP frequency of RDF and hypertension, and high fibrinogen level, in non-ischemic DCMP increased age and low cardiac index appeared as other correlates of LA-SEC.
Dilated cardiomyopathy, left atrial spontaneous echo contrast, atrial fibrillation, restrictive diastolic filling
How to cite this article
Güliz KOZDAĞ, Ahmet VURAL, Meltem ÖZDEN, Tayfun ŞAHİN, Dilek URAL, Ayşen AĞAÇDİKEN, Göksel KAHRAMAN, Teoman KILIÇ, Ertan URAL, Baki KOMSUOĞLU. Which Patients with Dilated Cardiomyopathy Have Left Atrial Spontaneous Echo Contrast?. Turk Kardiyol Dern Ars. 2005; 33(1): 2-9