Prognostic Implications of Left Atrial Spontaneous Echo-contrast in Nonvalvular Atrial Fibrillation

Left atrial spontaneous echo-centrast (LASEC) has been shown to be associated with a history of thromboembolism. We studied the influence of LASEC seen by tronseophageal echocardiography (TEE) in patients with nonvalvular atrial fibrillation (NV AF) on subsequent thromboembolic events and on survival. The study group consisted of 172 patients w ith NV AF, mean age 63 ± ll , 8 men and 84 women. Clinical and echocard iographic data were collected at baseline and patients were progressively followed up, and all new thromboembolic events and deaths were documented. LASEC was present at baseline in 75 (% 43) patients. Two patients were excluded because of left atrial thrombus seen by TEE. The remaining 73 patients with LASEC and 97 patients without LASEC were followed up for a mean of ı5.5 ± 5.3 months (6 to 24 months). Groups were comparable by age, sex, risk factors and treatment protocols. LASEC (+) group had more patients with enlarged (>4.0 cm) LA and lo w ( <% 55) left ventricular ejection fraction . During the follow up, new thromboembolic events (8 cerebral, ı mesenteric artery, ı peripheral vessel) were detected in 8 (% ı ı ) patients with LASEC and 2 (% 2) patients without LASEC (p<0.03). There were no deaths during the follow-up. NV AF patients w ith LASEC, have a significantly higher risk of developing new thromboembolic events and may represent a subgroup which must be followed up more intensively.