Author + information
- Sneha Vakamudi,
- Brett Sperry,
- Mazen Hanna,
- Walid Saliba,
- Oussama Wazni and
- Wael Jaber
Background: Cardiac amyloidosis (CA) creates a low flow state that may predispose patients to forming atrial thrombi. We sought to define the prevalence of left and right atrial thrombi in patients with CA.
Methods: A retrospective analysis was performed of consecutive TEEs in patients with known CA. Primary rhythm, CHADS2 score, and anticoagulation status at the time of TEE were defined. Published historical controls from the ACUTE I and II trials were used for comparison.
Results: Overall, 120 studies were analyzed in 93 patients (age 70 +/- 11 years, 71% male, 64% ATTR amyloid). Prevalence of high-risk left atrial appendage (LAA) findings (thrombus, sludge, spontaneous echocontrast) was 44%, and 71% in patients with atrial fibrillation or flutter (AF/AFL). LAA thrombus for patients in AF/AFL was higher than historical controls (28% vs. 13.8%). The CHADS2 score was not significantly associated with high-risk LAA findings after adjusting for AF/AFL, anticoagulation, and ejection fraction (p=0.789).
Conclusions: The prevalence of atrial thrombi in patients with CA is higher than historical controls. CHADS2 score is not associated with high-risk LAA findings after controlling for relevant factors. CHADS2 score may underestimate the true risk of atrial thrombi in patients with CA.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Advances in HCM, PPCM and Other Cardiomyopathies
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1201-268
- 2017 American College of Cardiology Foundation