What does this research mean for the field?

New generation transthoracic echocardiography systems can accurately detect left atrial appendage thrombi and assess appendage function in the majority of patients, demonstrating 100% specificity and 91% sensitivity when echogenicity is adequate. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To compare the diagnostic performance of modern transthoracic echocardiography with transoesophageal echocardiography for evaluating left atrial appendage function and detecting thrombi.

February 1, 1999HeartOpen Access

Imaging of thrombi and assessment of left atrial appendage function: a prospective study comparing transthoracic and transoesophageal echocardiography

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Why the study?

Does transthoracic echocardiography accurately assess left atrial appendage function and identify thrombi compared to transoesophageal echocardiography in patients with a stroke or transient neurological deficit?

Key Points

To compare the diagnostic performance of modern transthoracic echocardiography with transoesophageal echocardiography for evaluating left atrial appendage function and detecting thrombi.
Single-blind prospective study of 117 consecutive patients with stroke or transient neurological deficit at a tertiary cardiac and neurological care centre.
Patients underwent transthoracic echocardiography followed by blinded transoesophageal echocardiography by a second investigator to assess appendage visualization, flow velocities, and thrombi.
Appendage visualization was feasible in 75% of patients by transthoracic echocardiography compared with 95% by transoesophageal echocardiography.
In patients with adequate transthoracic acoustic windows, transthoracic echocardiography demonstrated 91% sensitivity and 100% specificity for detecting thrombi, identifying 10 concordant cases while missing one thrombus detected by transoesophageal examination.
Appending velocity measurements were achieved by transthoracic imaging in 69% of cases, and no patient with a velocity greater than 0.3 m/s had left atrial appendage thrombi.

Structured PICO

Population

117 consecutive patients with a stroke or transient neurological deficit at a tertiary cardiac and neurological care centre

Intervention

Transthoracic echocardiography

Comparator

Transoesophageal echocardiography performed by a second investigator

Outcome

Feasibility of imaging the left atrial appendage, recording its velocities, and identifying thrombi within the appendagesurrogate

New generation transthoracic echocardiography allows for accurate detection of left atrial appendage thrombi and function assessment in most patients with neurological deficits, potentially reducing the need for transoesophageal echocardiography.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Supports TTE for LAA thrombus detection with good windows; leaves open whether it reduces TEE need in stroke evaluation.

Cite This Study

Omran et al. (1999) studied this question.

synapsesocial.com/papers/6a1d5f367328fa9a742f6620 https://doi.org/10.1136/hrt.81.2.192

Topics

Echocardiography

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Imaging of thrombi and assessment of left atrial appendage function: a prospective study comparing transthoracic and transoesophageal echocardiography

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Imaging of thrombi and assessment of left atrial appendage function: a prospective study comparing transthoracic and transoesophageal echocardiography

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider