Author + information
- Received June 22, 1987
- Revision received January 6, 1988
- Accepted January 22, 1988
- Published online June 1, 1988.
- Werner G. Daniel, MD∗,
- Ulrich Nellessen, MD,
- Eberhard Schröder, MD,
- Barbara Nonnast-Daniel, MD,
- Piotr Bednarski, MD,
- Peter Nikutta, MD and
- Paul R. Lichtlen, MD, FACC
- ↵∗Address for reprints: Werner G. Daniel, MD, Division of Cardiology, Department of Internal Medicine, Hannover Medical School, Konstanty-Gutschow-Str. 8, D-3000 Hannover 61, West Germany.
The incidence of left atrial spontaneous echo contrast was evaluated in 52 patients with isolated or predominant mitral valve stenosis (Group 1) and 70 other patients who had undergone mitral valve replacement (Group 2). All patients were studied by conventional transthoracic and transesophageal two-dimensional echocardiography. Spontaneous echo contrast could be visualized within the left atrium in 35 Group 1 patients (67.3%) (including 7 patients with sinus rhythm) and 26 Group 2 patients (37.1%) (all with atrial fibrillation).
Patients with spontaneous echo contrast had a significantly larger left atrial diameter and a greater incidence of both left atrial thrombi and a history of arterial embolic episodes than did patients without spontaneous echo contrast. Association between spontaneous echo contrast and left atrial thrombi and a history of arterial embolization (considered individually or in combination) showed a high sensitivity and negative predictive value. It is concluded that spontaneous echo contrast is a helpful finding for identification of an increased thromboembolic risk in patients with mitral stenosis and after mitral valve replacement.
☆ This work was presented in part at the 35th Annual Scientific Session of the American College of Cardiology, Atlanta, Georgia, March 9 to 13, 1986.
- Received June 22, 1987.
- Revision received January 6, 1988.
- Accepted January 22, 1988.