Left atrial appendage spontaneous echo contrast in patients with atrial arrhythmias using integrated backscatter and transesophageal echocardiography

Bashir, Mohammad Waqas; Asher, Craig R.; Schaffer, Kevin; Murray, R.Daniel; Apperson-Hansen, Carolyn; Jasper, Susan E.; Thomas, James D.; Klein, Allan L.

doi:10.1016/s0002-9149(01)01911-7

Cited by 5 publications

(2 citation statements)

References 18 publications

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“…These methods include integrated backscatter, contrast-enhanced tissue Doppler imaging, and left atrial strain analysis. [15][16][17][18] However, these techniques require additional training in complex processes (integrated backscatter and left atrial strain analysis), require additional procedural steps (contrast-enhanced tissue Doppler imaging), and are dependent on gain settings (integrated backscatter). This is not the case for our method which is gain independent, requires no additional procedural steps, and involves only two measurements on an LAA image (the LAA tissue wall and the LAA cavity) with the detailed instructions above.…”

Section: Discussionmentioning

confidence: 99%

“…To overcome this subjectivity, previous studies have evaluated more objective techniques to quantify LAA SEC, sludge, and thrombus. These methods include integrated backscatter, contrast‐enhanced tissue Doppler imaging, and left atrial strain analysis 15–18 . However, these techniques require additional training in complex processes (integrated backscatter and left atrial strain analysis), require additional procedural steps (contrast‐enhanced tissue Doppler imaging), and are dependent on gain settings (integrated backscatter).…”

Section: Discussionmentioning

confidence: 99%

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A quantitative gain‐independent assessment of the left atrial appendage as a method of thromboembolic risk stratification

Slostad

Lee

Trybula

et al. 2021

J of Clinical Ultrasound

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Background: Visual assessment of the left atrial appendage (LAA) by echocardiography for the presence of thrombus is inherently qualitative. However, whether quantitative assessments can provide increased value over qualitative assessment has not been thoroughly examined.Methods: One hundred and thirty-eight patients (mean age 59 ± 13 years, 70% male) undergoing transesophageal echocardiography prior to pulmonary vein isolation or electrical cardioversion were retrospectively studied. LAA were examined by two expert readers and identified as thrombus, sludge, spontaneous echocardiograph contrast, or normal.LAA were then separately examined to calculate a gain-independent ratio between the average pixel density of the LAA cavity and that of the LAA wall (C/W ratio).Results: C/W ratio was significantly related with qualitative LAA analysis (p < 0.0001) and with thromboembolic events (OR 1.60, 95% CI 1.095-2.347, p = 0.02). The C/W ratio (AUC 0.73, 95% CI 0.60-0.86) was a reliable predictor for future thromboembolic events when compared to expert reader LAA assessment (Expert Reader 1 AUC = 0.72, 95% CI 0.53-0.90; Expert Reader 2 AUC = 0.69). Conclusions:The C/W ratio may be a complementary method to adjudicate thromboembolic risk in patients with AF that is readily quantifiable at time of TEE.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A quantitative gain‐independent assessment of the left atrial appendage as a method of thromboembolic risk stratification

Slostad

Lee

Trybula

et al. 2021

J of Clinical Ultrasound

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Contrast-enhanced tissue Doppler imaging of the left atrial appendage is a new quantitative measure of spontaneous echocardiographic contrast in atrial fibrillation

Donal

Sallach

Murray

et al. 2006

European Journal of Echocardiography

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Transesophageal Echocardiography and Cardiovascular Sources of Embolism

Tan

Fraser

Warltier³

2007

Anesthesiology

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Transesophageal echocardiography has become an invaluable investigation in patients with cardioembolic events because of its high sensitivity and specificity for defining detailed structure and function of the cardiovascular system. Patients who receive anesthesia and critical care may be at risk of systemic embolism from various cardiovascular sources. The main factors associated with embolism include intracardiac lesions such as thrombi, vegetations, and tumors; cardiac anomalies; and vascular disease, e.g., aortic atheroma. In this review article, the authors describe how transesophageal echocardiography may be used to identify various cardiovascular sources of embolism, provide risk stratification, influence medical therapy, and refine clinical decision making in patients receiving critical care and anesthesia. With these improvements, it is hoped that better patient outcomes may be achieved in the perioperative period.

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Left atrial appendage spontaneous echo contrast in patients with atrial arrhythmias using integrated backscatter and transesophageal echocardiography

Cited by 5 publications

References 18 publications

A quantitative gain‐independent assessment of the left atrial appendage as a method of thromboembolic risk stratification

A quantitative gain‐independent assessment of the left atrial appendage as a method of thromboembolic risk stratification

Contrast-enhanced tissue Doppler imaging of the left atrial appendage is a new quantitative measure of spontaneous echocardiographic contrast in atrial fibrillation

Transesophageal Echocardiography and Cardiovascular Sources of Embolism

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