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首页> 外文期刊>Cardiovascular Ultrasound >Contrast enhanced transesophageal echocardiography in patients with atrial fibrillation referred to electrical cardioversion improves atrial thrombus detection and may reduce associated thromboembolic events
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Contrast enhanced transesophageal echocardiography in patients with atrial fibrillation referred to electrical cardioversion improves atrial thrombus detection and may reduce associated thromboembolic events

机译：经电复律的房颤患者经食道超声心动图增强对比可改善心房血栓的检测并可能减少相关的血栓栓塞事件

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Aims Transesophageal echocardiography (TEE) is the gold standard for the detection of thrombi in patients with atrial fibrillation (AF) before undergoing early electrical cardioversion (CV). However, TEE generates inconclusive results in a considerable number of patients. This study investigated the influence of contrast enhancement on interpretability of TEE for the detection of left atrial (LA) thrombi compared to conventional TEE and assessed, whether there are differences in the rate of thromboembolic events after electrical cardioversion. Methods Of 180 patients with AF (51 females, 65.2±13 years) who were referred to CV, 90 were examined with native imaging and contrast enhancement within the same examination (group 1), and 90 were examined with native TEE alone and served as control (group 2). Cineloops of the multiplane examination of the LA and LA appendage (LAA) were stored digitally before and, in group 1, after intravenous bolus application of a transpulmonary contrast agent. Images of group 1 were assessed offline and the diagnosis of LA thrombi was made semi-quantitatively: 1= thrombus present; 2=inconclusive resu 3=no thrombus. The presence of spontaneous echocontrast (SEC) was registered and flow velocity in the LA appendage (LAA-flow) was measured. All patients in whom CV was performed were followed up for 1 year or until relapse of AF. CV related adverse events were defined as any thromboembolic event within 1 week after CV. Results No serious adverse events occurred during TEE and contrast enhanced imaging. In group 1 atrial thrombi were diagnosed in 14 (15.6%) during native and in 10 (11.1%) patients during contrast enhanced imaging (p Conclusion In patients with AF planned for CV contrast enhancement renders TEE images more interpretable, facilitates the exclusion of atrial thrombi and may reduce the rate of embolic adverse events.
机译：目的经食道超声心动图（TEE）是在进行早期心脏电复律（CV）之前检测房颤（AF）患者血栓的金标准。但是，TEE在相当多的患者中产生不确定的结果。这项研究调查了对比增强对TEE解释性的影响，与传统TEE相比，TEE可用于检测左心房（LA）血栓，并评估了心脏电复律后血栓栓塞事件的发生率是否存在差异。方法180例接受CV的AF患者（51名女性，65.2±13岁），在同一次检查中对90例接受了自然成像和对比增强检查（第1组），而90例仅接受了TEE进行了检查。控制（第2组）。在第1组之前和之后，在静脉内推注经肺造影剂后，将LA和LA附件（LAA）的多平面检查的电影胶片数字存储。离线评估第1组的图像，并半定量诊断LA血栓：1 =存在血栓; 2 =不确定的结果; 3 =无血栓。记录自发回声对比度（SEC）的存在，并测量LA附件的流速（LAA流量）。对所有接受过CV的患者进行了1年或直到AF复发的随访。 CV相关不良事件定义为CV后1周内发生的任何血栓栓塞事件。结果TEE和造影剂增强造影期间未发生严重不良事件。在第1组中，有14例（15.6％）的原始血栓患者和10例（11.1％）的造影剂增强影像被诊断出（p结论在计划进行CV的AF患者中，造影剂造影使TEE图像更易解释，有助于排除心房并可能降低栓塞不良事件的发生率。

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