Relationship between spontaneous echo contrast in the thoracic aorta and plasma von Willebrand factor

Abstract

Plasma vWF levels correlated to grade of aortic SEC. Characteristics of the coagulation system differ between Ao-SEC and LA-SEC. Ao-SEC offers a clinical indicator of platelet thrombus formation.

Clinical significance of aortic spontaneous echo contrast in patients with nonvalvular atrial fibrillation

“…In contrast to the observation that mobile aortic atheromas are often accompanied by rotational or retrograde blood flow in the aorta, 18 SEC might play a subsidiary role in unusual aortic flows. Elevated plasma levels of coagulation factors such as D‐dimer, von Willebrand factor, and thrombin antithrombin III, might underlie the occurrence of DASEC via their preconditioning role in thrombosis, although those factors were not measured in this study 8,9 . Previous studies have recommended that medical and lifestyle modification of cardiovascular risk factors should be strengthened in patients who have DASEC 5 …”

“…Willebrand factor, and thrombin antithrombin III, might underlie the occurrence of DASEC via their preconditioning role in thrombosis, although those factors were not measured in this study. 8,9 Previous studies have recommended that medical and lifestyle modification of cardiovascular risk factors should be strengthened in patients who have DASEC. 5 Based on the aforementioned descriptions, we would like to discuss the clinical implications of DASEC assessment here.…”

“…These include certain coagulation factors, LA volume index, and recent ischemic stroke, in addition to aortic flow velocity and shear rate. 8,9,15,20,21 For the same reason, aortic conditions in the ascending aorta, arch, and the terminal aorta were not examined. This might have reinforced the current suggestion that SEC in the DA comes from the LA cavity.…”

“…Intra‐aortic SEC is also detectable in patients with cardiovascular disorders such as coronary artery disease 4–9 . SEC in the descending aorta (DASEC) has been reported to be associated with various clinical conditions such as altered hemostatic findings, 8,9 increased aortic diameter, decreased intravascular flow‐velocity and shear rate, and aortic plaques, 4 in addition to left ventricular (LV) dysfunction and presence of arrhythmia 7 . However, little is known about the clinical implications of DASEC in nonvalvular AF (NVAF) patients, such as that which occurs either concomitantly with or separately from LASEC.…”

“…Spontaneous echo contrast (SEC) in the left atrium (LASEC) is a common finding during transesophageal echocardiography (TEE) in patients with atrial fibrillation (AF) 1–3 . Intra‐aortic SEC is also detectable in patients with cardiovascular disorders such as coronary artery disease 4–9 . SEC in the descending aorta (DASEC) has been reported to be associated with various clinical conditions such as altered hemostatic findings, 8,9 increased aortic diameter, decreased intravascular flow‐velocity and shear rate, and aortic plaques, 4 in addition to left ventricular (LV) dysfunction and presence of arrhythmia 7 .…”