Reduction of left ventricular spontaneous echo contrast in cardiomyopathy by acute inotropic intervention or aggressive therapy

1996 ◽  
Vol 19 (2) ◽  
pp. 105-109 ◽  
Author(s):  
Vijay G. Patel ◽  
Allen B. Weisse ◽  
Martin Feuerman
Keyword(s):  
Left Ventricular ◽  
Aggressive Therapy ◽  
Spontaneous Echo Contrast ◽  
Inotropic Intervention

Effects of acute changes in load and inotropic state on the exponential rate of fiber shortening and other indices of myocardial contractility in the anesthetized intact dog

1987 ◽  
Vol 65 (1) ◽  
pp. 46-53 ◽  
Author(s):  
José Suarez de Lezo ◽  
Pierre Casey ◽  
Anita Casey ◽  
José Luis Carrasco ◽  
José M. Arizon ◽  
...  
Keyword(s):  
Myocardial Contractility ◽  
Wall Stress ◽  
Left Ventricular ◽  
Systemic Resistance ◽  
Exponential Rate ◽  
Ventricular Contractility ◽  
Left Ventricular Contractility ◽  
Inotropic State ◽  
Circumferential Wall Stress ◽  
Inotropic Intervention

The effects of an acute increase in preload, afterload, and inotropic state on several indices of left ventricular contractility were studied in 20 anesthetized intact dogs. The behaviour of the exponential rate of fiber shortening (ERFS), a newly described index, which is based on the instantaneous fiber length – time relationship through ejection, was compared with other classical ejection and isovolumic indices of left ventricular contractility. Acute volume overload by dextran 40 infusion produced a significant increase in preload as reflected by a 103% (p < 0.01) increase in left ventricular end-diastolic pressure and a 121% (p < 0.001) increase in end-diastolic circumferential wall stress. There was also a smaller but significant increase (p < 0.05) of heart rate (30%) and of peak systolic circumferential wall stress (24%). None of the left ventricular contractility indices showed any significant change. Acute pressure overload, produced mechanically by an aortic balloon, increased the afterload significantly as reflected by a 33% (p < 0.05) rise of end-systolic circumferential wall stress and a 43% (p < 0.001) increase in systemic resistance. Stroke volume decreased significantly by 23% (p < 0.05). All ejection indices, including ERFS, were significantly diminished by 30 – 37%; all isovolumic indices showed no significant changes. Positive inotropic intervention was induced by dopamine infusion, which caused a significant 28% (p < 0.05) increase in cardiac output. End-diastolic and end-systolic circumferential wall stress were significantly diminished. All indices of left ventricular contractility increased significantly and ERFS showed the quantitatively greatest change. This study suggests that ERFS is an ejection index of myocardial contractility, which is quite sensitive to inotropic intervention, independent of preload but sensitive to afterload.

A Huge Left Ventricular Spontaneous Echo Contrast during Ventricular Fibrillation

2006 ◽  
Vol 14 (1) ◽  
pp. 36
Author(s):  
Il Suk Sohn ◽  
Jong Chun Park ◽  
Kye Hun Kim ◽  
Hyung Wook Park
Keyword(s):  
Ventricular Fibrillation ◽  
Left Ventricular ◽  
Spontaneous Echo Contrast

scholarly journals Evaluation of endothelialization of left atrial appendage occluder by three-dimensional transesophageal echocardiography and its influence factors

2020 ◽  
Author(s):  
Lihong Wang ◽  
Hongyue Mao ◽  
Lei Shi ◽  
Hongyan Li ◽  
Guifang Song
Keyword(s):  
Risk Factors ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Thrombotic Event ◽  
Three Dimensional ◽  
Influence Factors ◽  
Left Ventricular ◽  
Atrial Appendage ◽  
Spontaneous Echo Contrast ◽  
Three Dimensional Echocardiography

Abstract Background This study evaluated surface endothelialization of Watchman occluder (Boston Scientific) through comparing relevant indicators before and left atrial appendage closure (LAAC) in 68 non-valvular atrial fibrillation (AF) patients.Methods Patients were monitored preoperatively by transthoracic echocardiography (TTE), transesophageal two-dimensional and three-dimensional echocardiography (2D-TEE, 3D-TEE), intraoperatively by 3D-TEE and angiocardiography, and followed at 3 and 6 months after operation by TEE.Result It showed that the inner diameters of LAA ostium measured by TEE at 0°, 90° and 135° before operation were correlated with corresponding maximum diameters measured by angiocardiography. The depth of LAA ostium measured at 90° was correlated with the maximum depth measured by angiocardiography. The left atrial diameter, left ventricular diameter and left ventricular free wall E/E' decreased postoperatively. Compared T-test showed that BNP level and persistent AF might be risk factors for spontaneous echo contrast (SEC) or thrombosis of LAA. Multiple linear regression identified persistent AF, preoperative LAA spontaneous echo contrast or recent thrombotic event, and history of embolism in other parts were the influence factors of occluder endothelialization.Conclusion: BNP level and persistent AF may be risk factors of left atrial appendage thrombosis. Treatment of AF and thrombus in left atrial appendage or other parts are beneficial to the prognosis of LAAC patients.

scholarly journals Left Atrial Spontaneous Echo Contrast Occurring in Patients with Low CHADS2 or CHA2DS2-VASc Scores

2020 ◽  
Author(s):  
Kanako Akamatsu ◽  
Takahide Ito ◽  
Michishige Ozeki ◽  
Masatoshi Miyamura ◽  
Koichi Sohmiya ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Left Atrial ◽  
Large Scale ◽  
Elevated Serum ◽  
Multivariate Logistic Regression Analysis ◽  
Left Ventricular ◽  
Risk Scores ◽  
Considerable Proportion ◽  
Thromboembolic Risk ◽  
Spontaneous Echo Contrast

Abstract Background: Left atrial spontaneous echo contrast (LASEC) is common in patients with atrial fibrillation (AF), although scarce information exists on LASEC occurring in nonvalvular AF patients who have low thromboembolic risk scores. We therefore examined prevalence and determinants of LASEC under low CHADS 2 or CHA 2 DS 2 -VASc scores in these patients. Methods: Among 713 patients who underwent transesophageal echocardiography, 349 with a CHADS 2 score <2 (CHADS 2 group) (93 women, mean age 65 years) and 221 with a CHA 2 DS 2 -VASc score <2 (CHA 2 DS 2 -VASc group) (39 women, mean age 62 years) were separately examined for clinical and echocardiographic findings. Results: LASEC was found in 77 patients of CHADS 2 group (22%) and in 41 of CHA 2 DS 2 -VASc group (19%). Multivariate logistic regression analysis, adjusted for parameters including non-paroxysmal AF, LA diameter ≥50 mm, left ventricular (LV) hypertrophy, and an elevated serum B-type natriuretic peptide (BNP) (≥200 pg/mL), revealed that for CHADS 2 group, non-paroxysmal AF (Odds ratio 5.65, 95%CI 3.08-10.45, P <0.001), BNP elevation (Odds ratio 3.42, 95%CI 1.29-9.06, P = 0.013), and LV hypertrophy (Odds ratio 2.26, 95%CI 1.19-4.28, P = 0.013) were significant independent determinants of LASEC, and that for CHA 2 DS 2 -VASc group, non-paroxysmal AF (Odds ratio 3.38, 95%CI 1.51-7.54, P = 0.003) and LV hypertrophy (Odds ratio 2.53, 95%CI 1.13-5.70, P = 0.025) were significant independent determinants of LASEC.Conclusions: LASEC was present in a considerable proportion of patients with nonvalvular AF under low thromboembolic risk scores. Information on AF chronicity, BNP, and LV hypertrophy may help avoid transesophageal echocardiographic assessment of LASEC, but large-scale studies are necessary to confirm our observations.

scholarly journals Nomogram to Predict Left Atrial Thrombus or Spontaneous Echo Contrast in Patients With Non-valvular Atrial Fibrillation

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhitong Li ◽  
Quanbo Liu ◽  
Fei Liu ◽  
Tesfaldet H. Hidru ◽  
Yuqi Tang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Individual Risk ◽  
Good Prediction ◽  
Left Atrial Thrombus ◽  
Atrial Thrombus ◽  
Ventricular Ejection Fraction ◽  
Spontaneous Echo Contrast

Background: The predictive power of the CHADS2 and CHA2DS2-VASc scores for the presence of Left atrial thrombus (LAT)/ spontaneous echo contrast (SEC) in non-valvular atrial fibrillation (NVAF) is modest. The aim of this analysis is to define clinical and ultrasonic variables associated with LAT/SEC and to propose nomograms for individual risk prediction.Methods: Data on 1,813 consecutive NVAF patients who underwent transesophageal echocardiography (TEE) from January 2016 to January 2021 were collected. The univariate and multivariate logistic regression analyses were used to construct a nomogram. We examined the predictive ability of the risk scores by calculating the area under the curve (AUC). Moreover, the performance of the nomogram was assessed with respect to calibration, discrimination, and clinical usefulness.Results: LAT/SEC was found in 260 (21.0%) and 124 (21.6%) patients in the training and validation cohorts, respectively. On multivariate analysis, independent factors for LAT/SEC were Age, left atrial diameter (LAD), left ventricular ejection fraction (LVEF), hypertension (HTN), previous stroke or transient ischemic attack, Non-paroxysmal AF and a nomogram was built based on these variables. The calibration curve for the probability of LAT/SEC showed good prediction agreement with actual observation. The nomogram achieved good concordance indexes of 0.836 and 0.794 in predicting LAT/SEC in the training and validation cohorts, respectively. Decision curve analysis demonstrated that the nomogram would be clinically useful.Conclusions: In this study, a nomogram was constructed that incorporated six characteristics of NVAF patients. The nomogram may be of great value for the prediction of LAT/SEC in NVAF patients.

scholarly journals Left Atrial Spontaneous Echo Contrast Occurring in Patients with Low CHADS2 or CHA2DS2-VASc Scores

2020 ◽  
Author(s):  
Kanako Akamatsu ◽  
Takahide Ito ◽  
Michishige Ozeki ◽  
Masatoshi Miyamura ◽  
Koichi Sohmiya ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Left Atrial ◽  
Large Scale ◽  
Multivariate Logistic Regression Analysis ◽  
Left Ventricular ◽  
Risk Scores ◽  
Considerable Proportion ◽  
Thromboembolic Risk ◽  
Spontaneous Echo Contrast ◽  
Echocardiographic Assessment

Abstract Background: Left atrial spontaneous echo contrast (LASEC) is common in patients with atrial fibrillation (AF), although scarce information exists on LASEC occurring in nonvalvular AF patients who have low thromboembolic risk scores. We therefore examined prevalence and determinants of LASEC under low CHADS2 or CHA2DS2-VASc scores in these patients.Methods: Among 713 patients who underwent transesophageal echocardiography, 349 with a CHADS2 score <2 (CHADS2 group) (93 women, mean age 65 years) and 221 with a CHA2DS2-VASc score <2 (CHA2DS2-VASc group) (39 women, mean age 62 years) were separately examined for clinical and echocardiographic findings.Results: LASEC was found in 77 patients of CHADS2 group (22%) and in 41 of CHA2DS2-VASc group (19%). Multivariate logistic regression analysis, adjusted for several parameters including non-paroxysmal AF, LA enlargement (LA diameter ≥50 mm), left ventricular (LV) hypertrophy, and an elevated B-type natriuretic peptide (BNP) (BNP ≥200 pg/mL) revealed that for CHADS2 group, non-paroxysmal AF (Odds ratio 5.65, 95%CI 3.08-10.5, P <0.001), BNP elevation (Odds ratio 3.42, 95%CI 1.29-9.06, P = 0.013), and LV hypertrophy (Odds ratio 2.26, 95%CI 1.19-4.28, P = 0.013) were significant independent determinants of LASEC, and that for CHA2DS2-VASc group, non-paroxysmal AF (Odds ratio 3.38, 95%CI 1.51-7.54, P = 0.003) and LV hypertrophy (Odds ratio 2.53, 95%CI 1.13-5.70, P = 0.025) were significant independent determinants of LASEC.　Conclusions: LASEC was present in a considerable proportion of patients with nonvalvular AF under low thromboembolic risk scores. Information on AF chronicity, BNP, and LV hypertrophy may help avoid transesophageal echocardiographic assessment of LASEC, but large-scale studies are necessary to confirm our observations. Information on AF chronicity, BNP, and LV hypertrophy might help identify patients at elevated risk for thromboembolism, although large-scale studies are necessary to confirm our observations.

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