Spontaneous echocardiographic contrast in the descending aorta

Castelló, Ramón; Pearson, Anthony C.; Fagan, Leonard F.; Labovitz, Arthur J.

doi:10.1016/0002-8703(90)90210-o

Cited by 37 publications

(13 citation statements)

References 13 publications

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“…The mechanisms like ly responsible for the spontaneous contrast in the de scending aorta would include a high regurgitant fraction due to the severe mitral regurgitation, in the first and sec ond case, with a low forward stroke volume, and an increase in platelet aggregation [11] associated with an interaction between red blood cells and plasma proteins causing rouleaux formation [ 12,13], The 1 st case present ed in our series, in contrast to the previously reported cases [4], had a complete resolution of his spontaneous contrast in the descending aorta with improvement in the low flow state and repair of his mitral valve disorder ( fig. 2a, b).…”

Section: Discussioncontrasting

confidence: 51%

“…They concluded that SEC was more evi dent secondary to a more sensitive imaging technique, and it may not be restricted to cardiac chambers with low flow states. Additionally, they reported the first 4 cases of SEC in the true lumen of the aorta including 1 patient who had a normal left atrial size and left ventricular function [4], Pearson et al [8] prospectively examined 164 patients referred for TEE for the presence of aortic spontaneous échocardiographie contrast (ASEC). Fifty-eight patients (group 1 ) were sent to rule out a cardiac source of emboli (24 with transient ischemic attacks, 28 with cerebral vas cular accidents, and 6 with evidence of peripheral em boli), and the remaining 106 patients (group 2) were eval uated for other reasons.…”

Section: Discussionmentioning

confidence: 99%

“…Spon taneous echocardiographic contrast (SEC), defined as the presence of dynamic echoes swirling (smoke-like) in a cir cular pattern within the lumen of the aorta or any cham ber of the heart, has recently been demonstrated by the use of TEE [1][2][3][4][5][6][7][8]. This entity is typically seen in low flow states, including patients with an enlarged left atrium and atrial appendage due to mitral stenosis [1], within left ventricular aneurysms [2], in the false lumen of patients with aortic dissection [3], and in the descending thoracic aorta in the absence of dissection [4], Castello et al [5] reported this finding in approximately 20% of patients undergoing TEE. and previous investigators have suggest ed an association with thromboembolism [8,9].…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous Echocardiographic Contrast in the Descending Thoracic Aorta

et al. 1996

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Spontaneous echocardiographic contrast (SEC) is an occasional finding observed in the atria in patients undergoing transesophageal echocardiographic studies, but has rarely been described in the descending thoracic aorta in the absence of an aortic dissection. The pathophysiology of SEC in the cardiac and vascular structures appears to be related to an interaction between red blood cells and plasma proteins in the setting of a low flow state. In this report we present three cases of SEC in the descending thoracic aorta, with one of the cases of SEC resolving with repair of his underlying cardiac disorder.

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Section: Discussioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Spontaneous Echocardiographic Contrast in the Descending Thoracic Aorta

et al. 1996

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“…10 Interestingly, swirling smoke-like echo in the aorta, frequently observed in patients with severe aortic atheroma, could be associated with thromboembolic risk in AF patients. [16][17][18] Aortic SEC could be secondary to aortic dilatation and localized blood stasis, resulting in a hypercoagulable state in patients with AF. Our previous study indicated that nonrheumatic AF patients with aortic SEC have activated coagulation and a high prevalence of thromboembolism.…”

Section: Aortic Atheroma As Thromboembolic Risk In Af Patientsmentioning

confidence: 99%

Thoracic Aortic Plaque Enhances Hypercoagulability in Patients With Nonrheumatic Atrial Fibrillation

Nakagawa

Hirai

Sakurai

et al. 2007

Circ J

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trial fibrillation (AF) is associated with higher thromboembolic risk, possibly because of the hypercoagulable state. 1,2 Elevated levels of hemostatic markers have been shown in patients with nonrheumatic AF. [2][3][4][5][6] During AF, stagnation of blood flow in the left atrial appendage (LAA) could contribute to the hypercoagulable state and clot formation in the fibrillating atria. Hemostatic markers could be therefore used for stratification of patients at high risk vs low risk for thromboembolism as demonstrated in previous studies. [1][2][3][4][5][6] Aortic atheroma is recognized as an important marker of stroke and peripheral embolism in patients with AF. 7-9 The SPAF-III investigators reported that complex aortic plaque emerged as a risk factor of thromboembolism in patients with nonrheumatic AF, and warfarin was effective in reducing stroke in patients with AF and complex aortic plaque. 10 Complex aortic plaques with ulcerated or mobile plaques and superimposed thrombi would activate hemostatic markers. The Framingham Offspring Study raised the possibility that the increases in hemostatic factors in patients with AF were mainly caused by the confounding effect of traditional risk factors and coexistent cardiovascular diseases rather than by AF itself. 2 We recently reported that patients with nonrheumatic AF had elevated levels of D-dimer when complicated with spontaneous echocardiographic contrast (SEC) in the descending thoracic aorta. 11Because AF and aortic atherosclerosis might contribute synergistically to increased levels of hemostatic markers, and could be associated with increased risk of thromboembolism, we determined the relationship between plasma levels of hemostatic markers and atherosclerosis in the descending thoracic aorta assessed by transesophageal echocardiography (TEE) in patients with nonrheumatic AF and in those in sinus rhythm (SR). Methods Study PatientsEchocardiographic and hematologic studies were performed in 106 consecutive patients (79 men, 27 women; mean age of 67±11 years) referred to a university hospital for cardiovascular assessment for stroke risk or identification of the cardiogenic source of recent embolism. Patients who received anticoagulant therapy were not included in the present study. Of these 106 patients, AF was documented electrocardiographically in 60 patients (AF group) but not in the remaining 46 patients (SR group). The study protocol was approved by the institutional ethics committee and written informed consent was given by all patients. Underlying heart diseases included the following: ischemic heart disease (n=8), hypertrophic cardiomyopathy (n=4), dilated cardiomyopathy (n=5), sick sinus syndrome (n=3), atrial septal defect (n=5), post pericarditis (n=6), and miscellaneous diseases (n=20). No apparent underlying diseases were identified in 55 patients. Baseline clinical characteristics, including body mass index, diabetes mellitus, hyperlipidemia, smoking, previous cerebral or peripheral embolic event and the use of oral antiplatelet medication at...

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“…Spontaneous echo contrast (SEC) observed using transesophageal echocardiography (TEE) in a dilated left atrium, particularly in patients with mitral stenosis 1 or thoracic aorta, [2][3][4][5] indicates increased risk for embolic events. [6][7] Dense left atrial SEC has been linked to an increased risk of embolic events.…”

Section: Introductionmentioning

confidence: 99%