| Title: |
Club 35 Poster Session Thursday 6 December: Intracardiac flows and pressures |
| Authors: |
Faustino, A; Paiva, L; Providencia, R; Barra, S; Trigo, J; Botelho, A; Costa, G; Costa, M; Leitao-Marques, A; Haavisto, M; Tarkia, M; Stark, C; Vahasilta, T; Savunen, T; Strandberg, M; Lepomaki, V; Saukko, P; Saraste, A; Knuuti, J; Dieden, A; Bech-Hanssen, O; Cameli, M; Lisi, M; D'ascenzi, F; Losito, M; Sparla, S; Righini, FM; Menci, D; Favilli, R; Fineschi, M; Mondillo, S; Eindhoven, JA; Van Den Bosch, AE; Cuypers, JAAE; Witsenburg, M; Boersma, E; Roos-Hesselink, JW; Jalanko, M; Jaaskelainen, P; Laine, M; Nieminen, MS; Laakso, M; Helio, T; Kuusisto, J; Marchel, M; Kochanowski, J; Piatkowski, R; Serafin, A; Madej, A; Filipiak, KJ; Hausmanowa-Petrusewicz, I; Opolski, G; Dipietro, E; Di Panzillo, E Assante; Crispo, S; Spinelli, L; Department of Medicine, Cardiovascular and Immunological Sciences- University of Naples Federico II-Naples (Italy); Buccheri, S; Leggio, S; Monte, IP; Bottari, V; Blundo, A; Licciardi, S; Tamburino, C; Galderisi, M; Maksuti, E; Widman, E; Larsson, M; Bjallmark, A; Caidahl, K; D'hooge, J; Michalski, BW; Szymczyk, E; Westfal, B; Simiera, M; Lipiec, P; Kasprzak, JD; Simova, I; Katova, T; Haralanov, L; Hong, SP; Lee, YS; Lee, JB; Ryu, JK; Choi, JY; Chang, SG; Kim, KS; Montoro Lopez, M; Gemma, D; Lopez Fernandez, T; De Celix, MC Gomez Rubin; Ramirez, U; Mesa, JM; De Torres Alba, F; Iniesta Manjavacas, AM; Moreno Yanguela, M; Lopez Sendon, JL; Acosta Velez, JG; Rodriguez Palomares, JF; Gisela Teixido, GT; Gutierrez, L; Gonzalez-Alujas, T; Carro, A; Moral, SM; Evangelista, AE; Garcia-Dorado, DG; Piazzese, C; Sotaquira, M; Kronzon, I; Lang, RM; Caiani, EG |
| Publisher Information: |
Oxford University Press |
| Publication Year: |
2012 |
| Collection: |
HighWire Press (Stanford University) |
| Subject Terms: |
Thursday 6 December 2012 |
| Description: |
Purpose: Transesophageal echocardiography (TEE) is essential in the practical approach of atrial fibrillation (AF) but is uncomfortable for the patient. This study aims to evaluate the performance of left atrium (LA) areas and volumes, as well as the scores CHADS2 and CHA2DS2-VASC, as predictors of thrombus (Tr) in the LA/left atrial appendage. Methods: Cross sectional study of 525 consecutive patients (P) with non-valvular AF (66.7% male, 68 ± 10 years, CHADS2 of 2.2 ± 1.2 and CHA2DS2-VASC of 3.7 ± 1.7) who underwent transthoracic (TTE) and transesophageal (TEE) echocardiography. The presence of Tr was evaluated in TEE. From the 2D TTE images were obtained the following LA measures indexed to body surface area: area by apical 4C planimetry (A4C), and volumes by the area-length method of 2 planes (V2P) and 1 plane (V1P). The acuity to predict Tr was evaluated trough ROC curves for the LA measures and for the scores CHADS2 and CHA2DS2-VASC. Results: Unlike the CHADS2 and CHA2DS2-VASC scores, all LA measures obtained by TTE were predictors of Tr (Table 1). A specificity (Spec) > 80% was observed for values of A4C> 23.5cm2/m2 (3.9%), V2P> 116.8cm3/m2 (2.1%) and V1P> 126cm3/m2 (2.4%). A sensitivity (Sens) of 100% was identified for values of A4C ≤ 12.92cm2/m2 (32.3%), V2P ≤ 43.1cm3/m2 (27.5%) and V1P≤45.49cm3/m2 (27.5%). The prevalence of LA measures with Sens=100% or Spec>80% for Tr is presented in Table 1. Conclusions: LA measurements performed by TTE were predictive of Tr in TEE and identified P in which, for low or high probability of Tr, the ETE could be avoided: 36.2% by A4C, 29.9% by V1P and 28% by V2P. These data highlight the LA size as an easiest and more convenient method for AF practical approach. The CHADS2 and CHA2DS2-VASC were not useful for this purpose. Table 1 AUC |
| Document Type: |
text |
| File Description: |
text/html |
| Language: |
English |
| Relation: |
http://ehjcimaging.oxfordjournals.org/cgi/content/short/13/suppl_1/i42; http://dx.doi.org/10.1093/ehjci/jes253 |
| DOI: |
10.1093/ehjci/jes253 |
| Availability: |
http://ehjcimaging.oxfordjournals.org/cgi/content/short/13/suppl_1/i42; https://doi.org/10.1093/ehjci/jes253 |
| Rights: |
Copyright (C) 2012, European Society of Cardiology |
| Accession Number: |
edsbas.869B2AD0 |
| Database: |
BASE |