Direct Evidence that Sustained Dysfunction of Left Atrial Appendage Contributes to the Occurrence of Cardiogenic Brain Embolism in Patients with Paroxysmal Atrial Fibrillation
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概要
- 論文の詳細を見る
Objective The goal of this study was to investigate transesophageal echocardiographic (TEE) findings after the termination of atrial fibrillation to clarify the direct evidence for occurrence of acute cardiogenic brain embolism (CBE) in patients with paroxysmal atrial fibrillation (PAF). Patients and Methods Among 98 consecutive patients with CBE, we investigated TEE in 16 patients with PAF (Group CBE, 72±10 years) within 7 days of the onset and 2 weeks after the first study, in comparison with 15 age-matched PAF patients without CBE (Group N). The duration from reversal to normal sinus rhythm to first TEE was 6±1 days in both groups. Results There were no significant differences in left atrial dimension and emptying flow velocity of the left atrial appendage (LAA-eV) between groups. Group CBE had significantly larger LAA area (4.3±1.3 cm2vs.3.1±1.0 cm2, p<0.05), smaller LAA fractional area change (LAA-FAC) (43±25% vs. 80±22%, p<0.001), and a higher incidence of left atrial spontaneous echo contrast (LAA-SEC) (25% vs. 7%, p<0.05) than group N, and those abnormalities in group CBE were significantly improved at the second TEE (LAA area: to 3.2±0.9 cm2, p<0.05; LAA-FAC: to 84±26%, p<0.001; LAA-SEC: to 0%, p<0.05), respectively. Conclusion LAA-FAC is a more sensitive marker for LAA dysfunction than the widely used index, LAA-eV, and a sustained deterioration of LAA-FAC may be direct evidence for thrombus formation and occurrence of acute CBE in patients with PAF.(Internal Medicine 42: 1077-1083, 2003)
- 社団法人 日本内科学会の論文
- 2003-11-01
著者
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Takeishi Yasuchika
First department of internal medicine, Fukushima Medical University
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Hirono Osamu
First Department of Internal Medicine Yamagata University School of Medicine
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Kubota Isao
First Department of Internal Medicine Yamagata University School of Medicine
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Kayama Takamasa
Department of Neurosurgery, Yamagata University School of Medicine
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Hirono O
Department Of Cardiology Yamagata Prefectural Shinjo Hospital
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Hirono Osamu
山形大学 医学部第1内科
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Kaneko Kazuyoshi
Department Of Cardiology Okitama Public General Hospital
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Takeishi Yasuchika
First Department Of Internal Medicine Fukushima Medical University
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Tsunoda Yuichi
山形大学 医学部第1内科
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Kayama Takamasa
Department Of Neurosurgery Yamagata University School Of Medicine
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KANEKO Kazuyoshi
First Department of Internal Medicine, Yamagata University
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FATEMA Kaniz
First Department of Internal Medicine, Yamagata University
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ZHANG Xuehua
First Department of Internal Medicine, Yamagata University
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Kaniz Fatema
First Department of Internal Medicine, Yamagata University School of Medicine
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Kaniz Fatema
1st Department Of Internal Medicine Yamagata University School Of Medicine
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Zhang Xuehua
First Department Of Internal Medicine Yamagata University School Of Medicine
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Hirono Osamu
Department Of Cardiology Yamagata Prefectural Shinjo Hospital
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Fatema Kaniz
First Department Of Internal Medicine Yamagata University
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Takeishi Yasuchika
Department Of Cardiology Pulmonology And Nephrology Yamagata University School Of Medicine
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Fatema Kaniz
1st Department Of Internal Medicine Yamagata University School Of Medicine
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Kayama Takamasa
Department Of Neurosurgery Yamagata University Faculty Of Medicine
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Kaneko Kazuyoshi
1st Department Of Internal Medicine Yamagata University School Of Medicine
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Kayama Takamasa
Department Of Neurology Hematology Metabolism Endocrinology And Diabetes Yamagata University School Of Medicine
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