Effect of Low-Intensity Warfarin Therapy on Left Atrial Thrombus Resolution in Patients With Nonvalvular Atrial Fibrillation : A Transesophageal Echocardiographic Study

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概要

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• The presence of left atrial thrombus (LAT) is assosiated with an increased risk of embolic stroke. However, it has yet to be established definitively whether low-intensity warfarin therapy (INR: 1.5-2.0) can prevent LAT formation in patients with nonvalvular atrial fibrillation (NVAF). The present study analyzed the clinical and transesophageal echocardiography (TEE) features of 123 such patients to identify risk factors for LAT formation and the efficacy of prophylactic low-intensity warfarin therapy. Left atrial thrombi were found in 35 patients (28%) in whom systemic hypertension (49% vs 23%; p<0.01) and ischemic heart disease (17% vs 3%; p<0.01) were more frequent. Left ventricular ejection (54±14% vs 60±11%; p<0.05), left ventricular end-diastolic dimension (51±7mm vs 48±5mm; p<0.05), spontaneous echo contrast (2.2±0.7 vs 1.4±0.9; p<0.01), left atrial diameter (50±6mm vs 43±7mm; p<0.01), left atrial appendage blood velocity (22.3±8.7cm/s vs 37.2±21.5cm/s; p<0.01) and the incidence of left ventricular hypertrophy (37% vs 15%; p<0.01) were also significantly different between the groups. Fourteen patients received continuous warfarin therapy (target INR: 1.5-2.0) and on the follow-up TEE study the left atrial thrombus resolved in (71%). There were no thromboembolic events or major hemorrhagic complications in these patients, so it was concluded that low-intensity warfarin therapy is efficacious in treating LAT formation in patients with NVAF.

• 社団法人日本循環器学会の論文
• 2001-03-20

著者

• Iwami Takahiro

  Division of Cardiology, Tokuyama Central Hospital

• Ogawa Hiroshi

  Division Of Cardiology Tokuyama Central Hospital

• Wasaki Yuichiro

  The Division Of Cardiology Tokuyama Central Hospital

• Nakao Fumiaki

  The Second Department Of Internal Medicine Yamaguchi University School Of Medicine Yamaguchi

• Nakao Fumiaki

  The Second Department Of Internal Medicine

• Wakeyama Takatoshi

  Division Of Cardiology Tokuyama Central Hospital

• Iwami Takahiro

  Division Of Cardiology Tokuyama Central Hospital

• MATSUZAKI Masunori

  the Second Department of Internal Medicine, Yamaguchi University School of Medicine

• Iwami Takahiro

  Tokuyama Central Hospital

• Kanemoto Masashi

  滋賀医科大学 呼吸循環器内科

• Kimura Masayasu

  The Second Department of Internal Medicine, Yamaguchi University School of Medicine, Yamaguchi

• Ogawa Hiroshi

  The Division of Cardiology, Tokuyama Central Hospital

• Nakatsuka Masami

  The Division of Cardiology, Tokuyama Central Hospital

• Wakeyama Takatoshi

  The Division of Cardiology, Tokuyama Central Hospital

• Iwami Takahiro

  The Division of Cardiology, Tokuyama Central Hospital

• Ono Kaoru

  The Second Department of Internal Medicine, Yamaguchi University School of Medicine, Yamaguchi

• Iwami Takahiro

  The Division Of Cardiology Tokuyama Central Hospital

• Ogawa Hiroshi

  Division Of Cardiovascular Medicine Department Of Medical Bioregulation Yamaguchi University School

• Matsuzaki Masunori

  The Second Department Of Internal Medicine University Of Yamaguchi

• Ono Kaoru

  The Second Department Of Internal Medicine Yamaguchi University School Of Medicine Yamaguchi

• Nakatsuka Masami

  The Division Of Cardiology Tokuyama Central Hospital

• Kimura Masahiro

  Division Of Cardiovascular Medicine The Department Of Medical Bioregulation Yamaguchi University Sch

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