| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Stroke, Vol 24, 1015-1019, Copyright © 1993 by American Heart Association
MI Chimowitz, MA DeGeorgia, RM Poole, A Hepner and WM Armstrong
BACKGROUND AND PURPOSE: Spontaneous echo contrast is a dynamic smokelike
signal that is detected by transesophageal echocardiography in patients
with stasis of blood in the left atrium. We designed this study to
determine if spontaneous echo contrast is associated with an increased risk
of previous stroke or peripheral embolism. METHODS: Forty-two patients with
spontaneous echo contrast were identified (34 had atrial fibrillation or
mitral stenosis; 8 had neither). Control subjects comprised 40 patients
randomly selected from patients with atrial fibrillation or mitral stenosis
who did not have spontaneous echo contrast at transesophageal
echocardiography. The frequency of vascular risk factors, echocardiographic
features, and stroke or peripheral embolism within 1 year of
echocardiography were compared in the two groups. RESULTS: The frequency of
traditional risk factors for stroke were the same in both groups, yet 9 of
42 patients with spontaneous contrast had stroke or peripheral embolism
compared with only 1 of 40 control subjects (P < .02; relative risk,
10.6; 95% confidence interval, 1.3 to 88.4). In patients with nonvalvular
atrial fibrillation, 6 of 12 patients with spontaneous contrast had a
stroke or peripheral embolism compared with 1 of 28 patients without
spontaneous contrast (P < .001; relative risk, 27.0; 95% confidence
interval, 2.7 to 267.8). CONCLUSIONS: Spontaneous echo contrast is highly
associated with previous stroke or peripheral embolism in patients with
atrial fibrillation or mitral stenosis. Transesophageal echocardiography
may enable stratification of cardioembolic risk in patients with
nonvalvular atrial fibrillation.
ARTICLES
Left atrial spontaneous echo contrast is highly associated with previous stroke in patients with atrial fibrillation or mitral stenosis
Department of Neurology, University of Michigan Medical Center, Ann Arbor 48109.
This article has been cited by other articles:
 |
|
 |
|
  H. Onozuka, M. Muraki, T. Mikami, T. Yoshimoto, T. Yoshizumi, M. Kitaguchi, T. Sugawara, K. Tokuda, S. Kaneko, T. Kashiwaba, et al. Prevalence and Clinical Importance of Spontaneous Echo Contrast Within the Carotid Artery in Patients With Ischemic Cerebrovascular Disease J. Ultrasound Med., February 1, 2007; 26(2): 169 - 177. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Writing Committee Members, V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: full text: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society Europace, September 1, 2006; 8(9): 651 - 745. [Full Text] [PDF]
|
|
|
|
 |
|
 V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society J. Am. Coll. Cardiol., August 15, 2006; 48(4): 854 - 906. [Full Text] [PDF]
|
|
|
|
|
|
V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society J. Am. Coll. Cardiol., August 15, 2006; 48(4): e149 - e246. [Full Text] [PDF]
|
|
|
|
 |
|
 V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society Circulation, August 15, 2006; 114(7): e257 - e354. [Full Text] [PDF]
|
|
|
|
|
|
V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society Circulation, August 15, 2006; 114(7): 700 - 752. [Full Text] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members, V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation executive summary: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients with Atrial Fibrillation) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society Eur. Heart J., August 2, 2006; 27(16): 1979 - 2030. [Full Text] [PDF]
|
|
|
|
 |
|
 H. Austin, M. I. Chimowitz, H. A. Hill, S. Chaturvedi, L. R. Wechsler, R. J. Wityk, E. Walz, J. L. Wilterdink, B. Coull, C. A. Sila, et al. Cryptogenic Stroke in Relation to Genetic Variation in Clotting Factors and Other Genetic Polymorphisms Among Young Men and Women * Editorial Comment Stroke, December 1, 2002; 33(12): 2762 - 2768. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Yamamura, Y. Miyoshi, S. Hiraki, H. Ono, H. Ootaki, J. Fujiyama, and M. Kuriyama Spontaneous Echo Contrast in Descending Aorta Correlates with Low Blood-Flow Velocity in Carotid Arteries and Hemostatic Abnormalities Angiology, November 1, 2001; 52(11): 749 - 758. [Abstract] [PDF]
|
|
|
|
|
|
Guidelines for the management of patients with atrial fibrillation. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to develop guidelines for the management of patients with atrial fibrillation) developed in collaboration with the North American Society of Pacing and Electrophysiology Eur. Heart J., October 2, 2001; 22(20): 1852 - 1923. [PDF]
|
|
|
|
|
|
V. Fuster, L. E. Ryden, R. W. Asinger, D. S. Cannom, H. J. Crijns, R. L. Frye, J. L. Halperin, G. N. Kay, W. W. Klein, S. Levy, et al. ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the North American Society of Pacing and Electrophysiology J. Am. Coll. Cardiol., October 1, 2001; 38(4): 1266 - 1266. [Full Text] [PDF]
|
|
|
|
|
|
R. J. Zotz, M. Muller, S. Genth-Zotz, and H. Darius Spontaneous Echo Contrast Caused by Platelet and Leukocyte Aggregates? Stroke, May 1, 2001; 32(5): 1127 - 1133. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Censori, F. Colombo, M. G. Valsecchi, L. Clivati, A. Zonca, M. Camerlingo, L. Casto, M. S. De Tommasi, and A. Mamoli Early transoesophageal echocardiography in cryptogenic and lacunar stroke and transient ischaemic attack J. Neurol. Neurosurg. Psychiatry, May 1, 1998; 64(5): 624 - 627. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M Oppenheimer and J. Lima Neurology and the heart J. Neurol. Neurosurg. Psychiatry, March 1, 1998; 64(3): 289 - 297. [Full Text] [PDF]
|
|
|
|
|
|
M. D. Cheitlin, J. S. Alpert, W. F. Armstrong, G. P. Aurigemma, G. A. Beller, F. Z. Bierman, T. W. Davidson, J. L. Davis, P. S. Douglas, L. D. Gillam, et al. ACC/AHA Guidelines for the Clinical Application of Echocardiography : A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee on Clinical Application of Echocardiography) Developed in Collaboration With the American Society of Echocardiography Circulation, March 18, 1997; 95(6): 1686 - 1744. [Full Text]
|
|
|
|
 |
|
 T.-M. Lee, N.-K. Chou, S.-F. Su, Y.-J. Lin, M.-F. Chen, C.-S. Liau, Y.-T. Lee, and S.-H. Chu Left Atrial Spontaneous Echo Contrast in Asymptomatic Patients With a Mechanical Valve Prosthesis Ann. Thorac. Surg., December 1, 1996; 62(6): 1790 - 1795. [Abstract] [Full Text]
|
|
|
|
|
|
E. N. Prystowsky, D. W. Benson Jr, V. Fuster, R. G. Hart, G. N. Kay, R. J. Myerburg, G. V. Naccarelli, and D. G. Wyse Management of Patients With Atrial Fibrillation : A Statement for Healthcare Professionals From the Subcommittee on Electrocardiography and Electrophysiology, American Heart Association Circulation, March 15, 1996; 93(6): 1262 - 1277. [Full Text]
|
|
|
|
 |
|
 C M Sudlow, H Rodgers, R A Kenny, and R G Thomson How To Do It: Service provision and use of anticoagulants in atrial fibrillation BMJ, August 26, 1995; 311(7004): 558 - 560. [Full Text]
|
|