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Atrial fibrillation age stroke echo

Kristoffer Grundtvig Skaarup, Hanne Christensen, Nis Høst, Masti Mahdy Mahmoud, Christian Ovesen, Flemming Javier Olsen, Jan Skov Jensen, Tor Biering-Sørensen
Asymptomatic paroxysmal atrial fibrillation (PAF) is often assumed to be the cause of cryptogenic ischemic strokes (IS) and transient ischemic attacks (TIA). We examined the usefulness of measures obtained by 2D speckle tracking echocardiography and novel left atrial measurements, in the diagnosis of PAF in patients with IS and TIA. We retrospectively included 205 patients who after acute IS or TIA underwent an echocardiogram in sinus rhythm. Patients were designated as PAF-patients if they had one or more reported incidents of AF before or after their echocardiographic examination...
June 29, 2017: International Journal of Cardiovascular Imaging
Nathan E Smith, Jeevan Joseph, John Morgan, Saqib Masroor
OBJECTIVE: Atrial fibrillation (AF) is the primary cardiac abnormality associated with ischemic stroke. Atrial fibrillation affects 2.7 million people with a stroke rate of 3.5% per year. Most of the emboli in patients with nonvalvular AF originate in the left atrial appendage (LAA). Surgical exclusion of the LAA decreases the yearly risk of stroke to 0.7% when combined with a Maze procedure. Traditional oversewing the LAA from inside the left atrium is associated with a significant number of recanalizations of LAA...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Pil-Sung Yang, Tae-Hoon Kim, Jae-Sun Uhm, Jong-Youn Kim, Boyoung Joung, Moon-Hyoung Lee, Hui-Nam Pak
BACKGROUND: Although complex aortic plaque (CxAoP) is a component of the CHA2DS2-VASc score in patients with atrial fibrillation (AF), it is underestimated without detection by trans-esophageal echocardiogram (TEE). We have evaluated the incidence and significance of CxAoP among patients with non-valvular AF (NVAF). METHODS: We included 981 patients with NVAF who underwent catheter ablation (59.1±11.1years old, 73.7% male, 70.2% paroxysmal AF). All of the patients underwent pre-procedural TEE evaluation...
March 1, 2017: International Journal of Cardiology
Rogério Teixeira, Ricardo Monteiro, Paulo Dinis, Maria José Santos, Ana Botelho, Nuno Quintal, Nuno Cardim, Lino Gonçalves
Vascular mechanics assessed with two-dimensional speckle tracking echocardiography (2D-STE) could be used as a new imaging surrogate of vascular stiffening. The CHA2DS2-VASc score is considered accurate as an estimate of stroke risk in non-valvular AF, although many potential stroke risk factors have not been included in this scoring method. The purpose of this research is to study the feasibility of evaluating vascular mechanics at the descending aorta in non-valvular AF patients using transesophageal 2D-STE and to analyze the association between descending aortic mechanics and stroke...
November 24, 2016: International Journal of Cardiovascular Imaging
Flemming Javier Olsen, Sune Pedersen, Jan Skov Jensen, Tor Biering-Sørensen
Patients with acute myocardial infarction are at increased risk of developing atrial fibrillation. We aimed to evaluate whether speckle tracking echocardiography improves risk stratification for atrial fibrillation in these patients.The study comprised of 373 patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention. Patients had an echocardiogram performed at a median of 2 days after their STEMI. The echocardiograms consisted of conventional measurements and myocardial strain analysis by speckle tracking from 3 apical projections...
November 2016: Medicine (Baltimore)
Marvin Louis Roy Lu, Shuchita Gupta, Abel Romero-Corral, Magdaléna Matejková, Toni De Venecia, Edinrin Obasare, Vikas Bhalla, Gregg S Pressman
BACKGROUND: Calcium deposits in the aortic valve and mitral annulus have been associated with cardiovascular events and mortality. However, there is no accepted standard method for scoring such cardiac calcifications, and most existing methods are simplistic. The aim of this study was to test the hypothesis that a semiquantitative score, one that accounts for all visible calcium on echocardiography, could predict all-cause mortality and stroke in a graded fashion. METHODS: This was a retrospective study of 443 unselected subjects derived from a general echocardiography database...
December 2016: Journal of the American Society of Echocardiography
Venkatesh Y Anjan, Howard C Herrmann, Philippe Pibarot, William J Stewart, Samir Kapadia, E Murat Tuzcu, Vasilis Babaliaros, Vinod H Thourani, Wilson Y Szeto, Joseph E Bavaria, Susheel Kodali, Rebecca T Hahn, Mathew Williams, D Craig Miller, Pamela S Douglas, Martin B Leon
IMPORTANCE: Low-flow (LF) severe aortic stenosis (AS) is an independent predictor of mortality in patients undergoing aortic valve replacement (AVR). Little is known about improvement in flow after AVR and its effects on survival. OBJECTIVE: To determine whether higher flow (left-ventricular stroke volume index [LVSVI]) after transcatheter AVR (TAVR) would indicate better clinical outcomes in this at-risk population. DESIGN, SETTING, AND PARTICIPANTS: A substudy analysis of data from the Placement of Aortic Transcatheter Valves (PARTNER) randomized clinical trial and continued-access registry was conducted...
August 1, 2016: JAMA Cardiology
Tetsuya Watanabe, Yukinori Shinoda, Kuniyasu Ikeoka, Hirooki Inui, Hidetada Fukuoka, Akihiro Sunaga, Takashi Kanda, Masaaki Uematsu, Shiro Hoshida
The presence of spontaneous echo contrast (SEC) in the left atrium has been reported to be an independent predictor of thromboembolic risk in patients with atrial fibrillation (AF). Dabigatran was associated with lower rates of stroke and systemic embolism as compared with warfarin when administered at a higher dose. Between July 2011 and October 2015, nonvalvular AF patients treated with warfarin or dabigatran who had transesophageal echocardiography prior to ablation therapy for AF were enrolled. The intensity of SEC was classified into four grades, from 0 to 3...
March 2017: Heart and Vessels
Jodi D Edwards, Moira K Kapral, Jiming Fang, Gustavo Saposnik, David J Gladstone
BACKGROUND AND PURPOSE: Detection and treatment of atrial fibrillation is a major goal in secondary stroke prevention. Guidelines recommend at least 24 hours of ECG monitoring after stroke. However, it is unclear how often this is done in routine practice. METHODS: In this longitudinal cohort study using data from the Ontario Stroke Registry, we analyzed consecutive patients presenting to designated stroke centers in Ontario, Canada (2003-2013) with a first acute ischemic stroke or transient ischemic attack (TIA) in sinus rhythm and without known atrial fibrillation...
August 2016: Stroke; a Journal of Cerebral Circulation
Makoto Saito, Faisal Khan, Ted Stoklosa, Andrea Iannaccone, Kazuaki Negishi, Thomas H Marwick
OBJECTIVES: This study sought to investigate the associations of left ventricular (LV) strain and its serial change with major adverse cardiac events (MACE) in hypertensive heart disease, independent of and incremental to clinical and LV geometric parameters. BACKGROUND: In patients with hypertensive heart disease, MACE are associated with abnormal LV morphology, but their association with subclinical LV dysfunction is unclear. METHODS: We retrospectively studied 388 asymptomatic nonischemic patients with hypertension who had abnormal LV geometry at a baseline echocardiogram between 2005 and 2014...
August 2016: JACC. Cardiovascular Imaging
Kevser Gülcihan Balcı, Orhan Maden, Mustafa Mücahit Balcı, Fatih Şen, Sefa Ünal, Serdar Kuyumcu, Meryem Kara, Hatice Selçuk, Mehmet Timur Selcuk, Ahmet Temizhan
OBJECTIVE: Although the role of platelet activation has been debated in patients with mitral stenosis (MS) and spontaneous echocardiographic contrast (SEC), data on differences in mean platelet volume (MPV) according to the presence of SEC/left atrial thrombus and the rhythm status are lacking. In this study, MPV was analyzed in patients with MS according to the presence of SEC/left atrial thrombus. METHODS: Between January 2005 and March 2014, 188 symptomatic patients having moderate or severe MS (mean age, 45...
November 2016: Anatolian Journal of Cardiology
Rami Doukky, Enrique Garcia-Sayan, Mita Patel, Rojina Pant, Marwan Wassouf, Saurabh Shah, Oliver D'Silva, Richard F Kehoe
BACKGROUND: In patients with nonvalvular atrial fibrillation (NVAF), the impact of left ventricular diastolic function on the risk for left atrial appendage (LAA) thrombus has not been prospectively studied. METHODS: At two academic medical centers, patients with NVAF were prospectively enrolled to undergo investigational transthoracic echocardiography immediately before clinically indicated transesophageal echocardiography. Mitral inflow E velocity and tissue Doppler septal and lateral mitral annulus velocities (e') were measured, and E/e' ratios were calculated...
June 2016: Journal of the American Society of Echocardiography
Samuel Belok, Leslie Parikh, Jamie Robertson
Pulmonary vein thrombosis (PVT) is a rare but potentially lethal disease. It most commonly occurs as a complication of malignancy, post-lung surgery or atrial fibrillation. Thrombi are typically detected using a variety of imaging modalities including transesophageal echo, CT-scan, magnetic resonance imaging (MRI) or pulmonary angiography. Treatment consists of anticoagulation. Here we report a case of a middle-aged male with systolic left ventricular dysfunction who presented with a stroke due to embolization from a pulmonary vein thrombus diagnosed on CT scan...
February 1, 2016: Rhode Island Medical Journal
Shintaro Sasaki, Tetsu Watanabe, Harutoshi Tamura, Satoshi Nishiyama, Masahiro Wanezaki, Chika Sato, Gensai Yamaura, Mitsunori Ishino, Takanori Arimoto, Hiroki Takahashi, Tetsuro Shishido, Takuya Miyamoto, Isao Kubota
BACKGROUND: Left atrial appendage (LAA) dysfunction predisposes patients with atrial fibrillation (AF) to cardioembolic stroke. Two-dimensional (2D) speckle tracking was reported to be useful for evaluating left atrial (LA) regional function, as well as left ventricular function. However, it remains unclear whether 2D speckle tracking is useful for evaluating LAA dysfunction. Therefore, we investigated whether decreased LA strain may predict LAA dysfunction and thrombus formation in patients with acute ischemic stroke...
December 2014: BBA Clinical
Rafał Kamiński, Adam Kosiński, Mariola Brala, Grzegorz Piwko, Ewa Lewicka, Alicja Dąbrowska-Kugacka, Grzegorz Raczak, Dariusz Kozłowski, Marek Grzybiak
Atrial fibrillation increases the risk of thrombus formation. It is commonly responsible for cerebral stroke whereas less frequently for pulmonary embolism. The aim of the study was to describe the morphology of the left atrial appendage in the human heart with respect to sex, age and weight. Macroscopic examination was carried out on 100 left appendages taken from the hearts of the patients aged 18-77, both sexes. All hearts preserved in 4% water solution of formaldehyde carried neither marks of coronary artery disease nor congenital abnormalities...
2015: PloS One
Rowlens M Melduni, Hon-Chi Lee, Kent R Bailey, Fletcher A Miller, David O Hodge, James B Seward, Bernard J Gersh, Naser M Ammash
BACKGROUND: Left atrial appendage emptying flow velocity (LAAEV) depends largely on left atrioventricular compliance and may play a role in mediating the perpetuation of atrial fibrillation (AF) and AF-related outcomes. METHODS: We identified 3,251 consecutive patients with sustained AF undergoing first-time successful transesophageal echocardiography (TEE)-guided electrical cardioversion who were enrolled in a prospective registry between May 2000 and March 2012...
November 2015: American Heart Journal
Brian Marino, Abhishek Jaiswal, Seth Goldbarg, Gary L Bernardini, Todd Kerwin
BACKGROUND: The utility of transesophageal echocardiography (TEE) subsequent to a normal transthoracic echocardiogram (TTE) in older patients with an unexplained stroke is uncertain. METHODS: Two hundred sixty-three consecutive patients over the age of 50 years hospitalized with a clinical stroke confirmed with brain magnetic resonance imaging and a normal TTE were retrospectively analyzed. Patients with atrial fibrillation, atrial flutter, or any other causative reason for stroke were excluded...
February 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Kevin P Cohoon, Robert D McBane, Naser Ammash, Joshua P Slusser, Diane E Grill, Waldemar E Wysokinski
Atrial fibrillation and obesity are two major growing epidemics in the United States and globally. Obese people are at the increased risk of developing atrial fibrillation. The contribution of obesity as an independent risk factor for stroke in the setting of atrial fibrillation remains unclear. We tested the hypothesis that non-valvular atrial fibrillation (NVAF) patients with increased body mass index (BMI) would be at increased risk for the development of left atrial appendage thrombus (LAAT). Consecutive, anticoagulation naïve patients with NVAF referred for a transesophageal echocardiogram (TEE) between January 1, 2007 and October 21, 2009 were approached for study participation...
May 2016: Journal of Thrombosis and Thrombolysis
Andreas Charidimou, Duncan Wilson, Clare Shakeshaft, Gareth Ambler, Mark White, Hannah Cohen, Tarek Yousry, Rustam Al-Shahi Salman, Gregory Lip, Henry Houlden, Hans R Jäger, Martin M Brown, David J Werring
BACKGROUND AND RATIONALE: The increasing use of oral anticoagulants, mostly to prevent ischemic stroke due to atrial fibrillation in an ageing population, has been associated with a fivefold increased incidence of oral anticoagulant-associated intracerebral hemorrhage: a rare, serious, and unpredictable complication. We hypothesize that cerebral microbleeds and other markers of cerebral small vessel disease on magnetic resonance imaging, and genetic polymorphisms (e.g. influencing cerebral small vessel integrity or anticoagulation stability), are associated with an increased risk of oral anticoagulant-associated intracerebral hemorrhage, with potential to improve risk prediction...
October 2015: International Journal of Stroke: Official Journal of the International Stroke Society
Xiang-Min Shi, Fu-Kun Chen, Zhuo Liang, Jian Li, Kun Lin, Jian-Ping Guo, Zhao-Liang Shan
Atrial fibrillation (AF) is a major cause of thromboembolic (TE) events including stroke and transient ischemic attacks, catheter radiofrequency ablation (CA) has been demonstrated to effectively eliminate AF in majority of patients. During the peri-procedural CA of AF, dabigatran, a reversible direct thrombin inhibitor, has been proved as safe and efficacy as warfarin in the prevention of thromboembolic complication. However, for patients with CHADS2 score ≥3, sometimes dabigatran may not be an ideal substitute of warfarin...
2015: International Journal of Clinical and Experimental Medicine
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