Key result
Left ventricular systolic dysfunction strongly predicted the development of left atrial thrombus (OR 10.6; 95% CI 2.2-51.6) in patients with a recent cerebral ischemic event in sinus rhythm.
Why the study?
What is the prevalence and what are the predictors of left atrial thrombus in patients with a recent cerebral ischemic event who are in sinus rhythm?
Observational (n=238)
No
What is the prevalence and what are the predictors of left atrial thrombus in patients with a recent cerebral ischemic event who are in sinus rhythm?
Left atrial thrombus is present in 5.5% of patients with a recent cerebral ischemic event in sinus rhythm, and is strongly predicted by left ventricular systolic dysfunction, suggesting a role for TEE in this high-risk subgroup.
LV dysfunction may flag TEE candidates after ischemic events in sinus rhythm; hypothesis-generating and requires prospective validation.
BACKGROUND: Left atrial thrombus (LAT) is frequently present in patients with cerebral ischemic events (CIE) who are in atrial fibrillation. The prevalence and predictor of LAT in patients who are in sinus rhythm (SR) is unclear. OBJECTIVE: To determine the prevalence and identify predictors of LAT formation in patients with CIE who are in SR. METHODS: Consecutive patients with CIE who are in SR were evaluated by transesophageal echocardiography (TEE) from July 2000 to August 2001. Patient demographics including cerebrovascular risk factors were recorded. RESULTS: LAT was present in 5.5%. Left ventricular systolic dysfunction (LVSD) was present in 25 (10%). Patients' mean age was 59 +/- 14 years and 119 (50%) were male. In the univariate analysis, LAT was associated with LVSD (odds ratio [OR] 9.24, 95% confidence interval [CI] 2.8; 10.3) and male patients (OR 4.56, 95% CI: 1.6, 12.6) who had coronary artery disease (OR 3.4, 95% CI: 1.3, 8.4). In the multivariate analysis, LVSD (OR 10.6, CI 2.2-51.6) strongly predicted the development of LAT. CONCLUSIONS: LAT is not uncommon in patients CIE, who are in sinus rhythm, especially those with poor left ventricular functions. TEE should be considered in patients with CIE and LVSD for early detection and treatment of LAT.
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Yahia et al. (2009) conducted an observational in Cerebral ischemic events in sinus rhythm (n=238). Left ventricular systolic dysfunction (predictor) vs. Normal left ventricular function was evaluated on Left atrial thrombus (LAT) (OR 10.6, 95% CI 2.2-51.6). Left ventricular systolic dysfunction strongly predicted the development of left atrial thrombus (OR 10.6; 95% CI 2.2-51.6) in patients with a recent cerebral ischemic event in sinus rhythm.
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