Aortic spontaneous echocardiographic contrast and hemostatic markers in patients with nonrheumatic atrial fibrillation |
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Authors: | Nakagawa Keiko Hirai Tadakazu Shinokawa Noriko Takashima Shutaro Nozawa Takashi Asanoi Hidetsugu Inoue Hiroshi |
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Affiliation: | Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan. |
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Abstract: | OBJECTIVES: To determine the relationship between spontaneous echocardiographic contrast (SEC) in the descending thoracic aorta and plasma levels of hemostatic markers in patients with nonrheumatic atrial fibrillation (AF). DESIGN AND SETTINGS: A cross-sectional study at a university hospital. PATIENTS AND MEASUREMENTS: In 91 consecutive patients (mean +/- SE age, 70 +/- 1 years; 68 men) with nonrheumatic AF who underwent transesophageal echocardiography, plasma levels of markers for platelet activity (platelet factor 4 [PF4] and beta-thromboglobulin [beta-TG]), thrombotic status (thrombin-antithrombin III complex [TAT]), and fibrinolytic status (D-dimer and plasmin-alpha(2)-plasmin inhibitor complex [PIC]) were determined. RESULTS: Forty-three patients who had aortic SEC (AoSEC) were older (72 years vs 68 years; p < 0.05) and had a higher prevalence of chronic AF (88% vs 52%; p < 0.05) than 48 patients without AoSEC. TAT, PIC, and D-dimer levels were significantly higher in patients with AoSEC than in those without AoSEC, whereas PF4 and beta-TG levels were not different between the two groups. Although the prevalence of cerebral embolism did not differ between the two groups (23% vs 29%), the prevalence of peripheral embolism was higher in patients with AoSEC than in those without AoSEC (10% vs 0%; p < 0.05). Multivariate analysis revealed mitral regurgitation (odds ratio, 7.53; p < 0.02), SEC in the left atrium (odds ratio, 2.14; p < 0.02), and aortic atherosclerosis (odds ratio, 1.87; p < 0.04) emerged as independent predictors of AoSEC. CONCLUSIONS: Patients with nonrheumatic AF who have AoSEC appear to have enhanced coagulation activity but not platelet activity. Intensive anticoagulation treatment might be required for these patients. |
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Keywords: | aorta atrial fibrillation embolism hemostatic markers spontaneous echocardiographic contrast transesophageal echocardiography AF" },{" #name" :" keyword" ," $" :{" id" :" cekeyw80" }," $$" :[{" #name" :" text" ," _" :" atrial fibrillation AoSEC" },{" #name" :" keyword" ," $" :{" id" :" cekeyw100" }," $$" :[{" #name" :" text" ," _" :" aortic spontaneous echocardiographic contrast β-TG" },{" #name" :" keyword" ," $" :{" id" :" cekeyw120" }," $$" :[{" #name" :" text" ," _" :" β-thromboglobulin LA" },{" #name" :" keyword" ," $" :{" id" :" cekeyw140" }," $$" :[{" #name" :" text" ," _" :" left atrium LASEC" },{" #name" :" keyword" ," $" :{" id" :" cekeyw160" }," $$" :[{" #name" :" text" ," _" :" spontaneous echocardiographic contrast in the left atrium PF4" },{" #name" :" keyword" ," $" :{" id" :" cekeyw180" }," $$" :[{" #name" :" text" ," _" :" platelet factor 4 PIC" },{" #name" :" keyword" ," $" :{" id" :" cekeyw200" }," $$" :[{" #name" :" text" ," $$" :[{" #name" :" __text__" ," _" :" plasmin-α" },{" #name" :" inf" ," $" :{" loc" :" post" }," _" :" 2" },{" #name" :" __text__" ," _" :" -plasmin inhibitor complex SEC" },{" #name" :" keyword" ," $" :{" id" :" cekeyw220" }," $$" :[{" #name" :" text" ," _" :" spontaneous echocardiographic contrast TAT" },{" #name" :" keyword" ," $" :{" id" :" cekeyw240" }," $$" :[{" #name" :" text" ," _" :" thrombin-antithrombin III complex TEE" },{" #name" :" keyword" ," $" :{" id" :" cekeyw260" }," $$" :[{" #name" :" text" ," _" :" transesophageal echocardiography |
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