scholarly journals Intensity of Left Atrial Spontaneous Echo Contrast as a Correlate for Stroke Risk Stratification in Patients with Nonvalvular Atrial Fibrillation

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Yuanping Zhao ◽  
Lijing Ji ◽  
Jian Liu ◽  
Juefei Wu ◽  
Yan Wang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Stratification ◽  
Left Atrial ◽  
Stroke Risk ◽  
Nonvalvular Atrial Fibrillation ◽  
Spontaneous Echo Contrast

scholarly journals Hematologic correlates of left atrial spontaneous echo contrast and thromboembolism in nonvalvular atrial fibrillation

1993 ◽  
Vol 21 (2) ◽  
pp. 451-457 ◽  
Author(s):  
Ian W. Black ◽  
Colin N. Chesterman ◽  
Andrew P. Hopkins ◽  
Lincoln C.L. Lee ◽  
Beng H. Chong ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Nonvalvular Atrial Fibrillation ◽  
Spontaneous Echo Contrast

scholarly journals Left atrial appendage occlusion: an alternative to anticoagulation for stroke prevention in kidney disease

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0004082021
Author(s):  
Srikanth Vallurupalli ◽  
Tanya Sharma ◽  
Subhi Al'Aref ◽  
Subodh R. Devabhaktuni ◽  
Gaurav Dhar
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Stroke Risk ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
High Risk Population ◽  
Thromboembolic Stroke ◽  
Nonvalvular Atrial Fibrillation ◽  
Left Atrial Appendage Occlusion ◽  
Pros And Cons

Anticoagulation to reduce thromboembolic stroke risk due to nonvalvular atrial fibrillation in ESRD is associated with increased bleeding. Existing debate in ESRD centers around the pros and cons of anticoagulation. We propose percutaneous left atrial appendage occlusion as a third alternative to balance thrombosis and bleeding risks in this high risk population.

scholarly journals CHA2DS2-VASc Score as a Predictor for Left Atrial Thrombus or Spontaneous Echo Contrast in Patients with Nonvalvular Atrial Fibrillation: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Ping Sun ◽  
Zhi Hao Guo ◽  
Hong Bin Zhang
Keyword(s):  
Atrial Fibrillation ◽  
Sensitivity Analysis ◽  
Publication Bias ◽  
Left Atrial ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Left Atrial Thrombus ◽  
Nonvalvular Atrial Fibrillation ◽  
Atrial Thrombus ◽  
Spontaneous Echo Contrast

Objective. This meta-analysis aimed at exploring the predictive value of CHA2DS2-VASc score for the left atrial thrombus (LAT) or left atrial spontaneous echo contrast (LASEC) in patients with nonvalvular atrial fibrillation (NVAF). Methods. PubMed, Embase, Web of Science, ScienceDirect, Cochrane Library, and Chinese core journals of the CNKI and Wanfang databases were searched to identify all the relevant papers that were published up to January 2020. The data were extracted for pooled odds ratios (ORs) with 95% confidence intervals (CIs), heterogeneity, subgroup, publication bias, and sensitivity analysis. Results. Overall, 15 studies containing 6223 patients with NVAF were enrolled. All studies were evaluated for LAT, and 12 studies were evaluated for LASEC. The pooled analysis using a random-effects model showed that a high CHA2DS2-VASc score was related with LAT/LASEC (pooled OR=1.59, 95% CI: 1.35–1.88, P<0.001) with high heterogeneity (I2=76.9%, P<0.001) and LAT (pooled OR=1.83, 95% CI: 1.44–2.33, P<0.001) with high heterogeneity (I2=79.4%, P<0.001). The subgroup analysis demonstrated that the sample size may be the main source of heterogeneity. Although the Begg’s funnel plot based on 15 studies for LAT/LASEC (P=0.029) and 12 studies for LAT (P=0.046) indicated the presence of publication bias among the included studies, the trim-and-fill method verified the stability of the pooled outcomes. In addition, sensitivity analysis indicated that all effects were stable. Conclusion. The results of this meta-analysis showed that the CHA2DS2-VASc score is related with LAT and LASEC in patients with NVAF. However, more studies are warranted to address this issue.

P1360Association between left atrial appendage dysfunction and thromboembolic risk in nonvalvular atrial fibrillation

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
Y Mao ◽  
M M Ma ◽  
C Yu ◽  
Y Yang ◽  
Y H Wang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Stratification ◽  
Left Atrial ◽  
Strain Analysis ◽  
Roc Curves ◽  
Nonvalvular Atrial Fibrillation ◽  
Discriminative Ability ◽  
Thromboembolic Risk ◽  
Mechanical Dispersion ◽  
Peripheral Embolization

Abstract Background/Introduction:  Atrial fibrillation (AF) is associated with higher risk for thromboembolism , and the discriminative ability of the widely used CHA2DS2-VASc scores for risk stratification is modest. Although the presence of thrombus in the LAA is the most powerful predictors for thromboembolic risk, they are often absent in patients with AF and prior stroke. AF may be related to myocardial fibrosis, and even though left atrial fibrosis is associated with mechanical dispersion, this phenomenon is not well studied in LAA. We hypothesized that detection of LAA dysfunction and mechanical dispersion using strain echocardiography is useful in the identification of cardiac thromboembolism. Purpose The aim of this study was to determine the association of LAA mechanics assessed using strain analysis with previous thromboembolic events in patients with nonvalvular AF and to assess the potential incremental significance of LAA mechanical dispersion over the traditional risk stratification scheme. Methods A group of 116 patients with AF referred for TEE was prospectively analyzed. LAA strain and mechanical dispersion in parallel with other conventional TEE parameters were analyzed in terms of their association with previous embolic stroke and peripheral embolization. Results Patients with embolic events had a higher mean CHA2DS2-VASc score, higher incidence of LAA dense SEC or thrombi, and other clinical data were comparable. Patients with embolic events had greater impairment in the LA standard parameters, and lower global and regional LAA longitudinal strain than those of the controls. LAA MD was significantly higher in patients with embolization than in those without it (18.91 ± 7.19 %vs 13.8 ± 5.54%; P &lt; .001). In ROC analysis, cut-off values for LAA MD,LAEF, LAA GLS for the presence of dense SEC/ thrombus were &gt;20.21 % (p = 0.0076), ≤31.11 % (p = 0.017), and ≤ 7.31 % (p = 0.014), respectively. LAA MD, LAEF, LAA thrombus and CHA2DS2-VASc scores were independently associated with the presence of thromboembolism in multivariate analyses, and LAA MD had additional significance over the CHA2DS2-VASc score. Conclusion LAA MD, LAA thrombi and LAEF had statistically significant meaning for the presence of prior embolism that was independent of the standard planimetric and volumetric measurements. What’s more, LAA MD had an incremental value over CHA2DS2-VASc score in risk stratification and warrants testing in a larger study. Abstract Figure. ROC curves for LAA parameters

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