Role of Transesophageal Echocardiography in the Prediction of Thromboembolism in Patients With Chronic Nonvalvular Atrial Fibrillation
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概要
- 論文の詳細を見る
The purpose of this study was to determine whether parameters derived from transesophageal echocardiography(TEE)could predict thromboembolism in patients with chronic nonvalvular atrial fibrillation(AF). Eighty-nine patients, mean age 66±9 years, who underwent TEE in 1996 to 1999 were studied. The clinical endpoint was a thromboembolic event, including transient ischemic attack(TIA). Sixty-seven patients(75%)were anticoagulated with warfarin after TEE. After a follow-up period of 29±10 months, 1 patient died suddenly, 4 had a thromboembolism, and 3 had a TIA; the annual embolic event rate was 3.3%. Left atrial appendage(LAA)thrombus(86% vs 17%, p<0.001), LAA dysfunction(LAA velocity<20cm/s; 71% vs 25%, p=0.009), and severe LA spontaneous echo contrast(29% vs 2%, p=0.002)were more prevalent in patients with an embolic event than in those without. In patients with LAA thrombus, the annual event rate was 11% as compared with 1.2% in those without(p=0.004). On the Cox proportional hazards model analysis, LAA thrombus(chi-square 7.0, p=0.008), severe LA spontaneous echo contrast(chi-square 7.0, p=0.008), and LAA dysfunction(chi-square 5.9, p=0.015)were significantly related to thromboembolism. Multivariate analysis revealed that LAA thrombus(chi-square 5.5, p=0.019)and LAA dysfunction(chi-square 4.0, p=0.045)were the independent predictors. In conclusion, TEE parameters, particularly the presence of LAA thrombus, can be used to assess thromboembolic potential in patients with chronic nonvalvular AF.
- 社団法人日本循環器学会の論文
- 2001-09-20
著者
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Suwa M
Hokusetsu General Hospital
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Suwa Michihiro
The Third Division, Department of Internal Medicine
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Kitaura Yasushi
The Third Division, Department of Internal Medicine
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Nakamura Tomomi
The 3rd Division, Department of Internal Medicine
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Ito Takahide
The Third Division, Department of Internal Medicine, Osaka Medical College
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Nakamura Tomomi
The Third Division, Department of Internal Medicine, Osaka Medical College
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Kobashi Ayaka
The Third Division,Department of Internal Medicine,Osaka Medical Colleg
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Miyazaki Sadae
The Third Division, Department of Internal Medicine, Osaka Medical College
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Ito Takahide
Hayama Heart Center
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Suwa Michihiro
Dept. Of Intern. Med. Osaka Medical Colledge.
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Suwa Michihiro
3rd Division Department Of Internal Medicine Osaka Medical College
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Suwa Michihiro
Third Department Of Internal Medicine Osaka Medical College
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Ito Takahide
The Third Division Department Of Internal Medicine Osaka Medical College
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Kobashi Ayaka
The Third Division Department Of Internal Medicine Osaka Medical Colleg
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Miyazaki Sadae
Third Department Of Internal Medicine Osaka Medical College
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Suwa Michihiro
Iii Div Osaka Med. College
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Suwa Michihiro
The Third Division Department Of Internal Medicine Osaka Medical College
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Nakamura Tomomi
The 3rd Division Department Of Internal Medicine
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Suwa Michihiro
大阪医科大学
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Kitaura Yasushi
The Third Department Of Internal Medicine Osaka Medical College
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Kitaura Yasushi
Laboratory Of Pharmacotherapy Osaka University Of Pharmaceutical Sciences
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Ito Takahide
The Third Department Of Internal Medicine Osaka Medical College
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