Left Atrial Enlargement on Transthoracic Echocardiography Predicts Left Atrial Thrombus on Transesophageal Echocardiography in Ischemic Stroke Patients

James Anaissie; Dominique Monlezun; A Seelochan; James E Siegler; Maria Chavez-Keatts; Jonathan Tiu; Denise Pineda; Alexander George; Amir Shaban; Nidal Abi Rafeh; Laurie Schluter; Sheryl Martin-Schild; Ramy El Khoury

doi:10.1155/2016/7194676

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Left Atrial Enlargement on Transthoracic Echocardiography Predicts Left Atrial Thrombus on Transesophageal Echocardiography in Ischemic Stroke Patients

Journal article

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Left Atrial Enlargement on Transthoracic Echocardiography Predicts Left Atrial Thrombus on Transesophageal Echocardiography in Ischemic Stroke Patients

James Anaissie, Dominique Monlezun, A Seelochan, James E Siegler, Maria Chavez-Keatts, Jonathan Tiu, Denise Pineda, Alexander George, Amir Shaban, Nidal Abi Rafeh, …

BioMed research international, Vol.2016, pp.7194676-6

2016

DOI: 10.1155/2016/7194676

PMCID: PMC5086361

PMID: 27822477

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Abstract

Transesophageal echocardiogram (TEE) is superior to transthoracic echocardiogram (TTE) in detecting left atrial thrombus (LAT), a risk factor for stroke, but is costly and invasive, carrying a higher risk for complications. To determine the utility of using left atrial enlargement (LAE) on TTE to predict LAT on TEE. AIS patients who presented in 06/2008-7/2013 and underwent both TTE and TEE were identified from our prospective stroke registry. Analysis consisted of multivariate logistic regression with propensity score adjustment and receiver operating characteristic (ROC) area under the curve (AUC) analyses. 219 AIS patients underwent both TTE and TEE. LAE on TTE was detected in 113 (51.6%) of AIS patients. Patients with LAE on TTE had higher proportion of LAT on TEE (8.4% versus 1.0%, = 0.018). LAE on TTE predicted increased odds of LAT on TEE (OR = 8.83, 95% CI 1.04-74.83, = 0.046). The sensitivity and specificity for LAT on TEE by LAE on TEE were 88.89% and 52.20%, respectively (AUC = 0.7054, 95% CI 0.5906-0.8202). LAE on TTE can predict LAT detected on TEE in nearly 90% of patients. This demonstrates the utility of LAE on TTE as a potential screening tool for LAT, potentially limiting unneeded costs and complications associated with TEE.

Adult

Aged

Aged, 80 and over

Cardiomegaly - complications

Cardiomegaly - diagnostic imaging

Demography

Echocardiography

Echocardiography, Transesophageal

Embolism - diagnosis

Embolism - diagnostic imaging

Heart Atria - diagnostic imaging

Heart Atria - pathology

Humans

Middle Aged

ROC Curve

Stroke - complications

Stroke - diagnostic imaging

Thrombosis - complications

Thrombosis - diagnostic imaging

Details

Title: Subtitle: Left Atrial Enlargement on Transthoracic Echocardiography Predicts Left Atrial Thrombus on Transesophageal Echocardiography in Ischemic Stroke Patients
Creators: James Anaissie - Tulane University
Dominique Monlezun - Tulane University
A Seelochan - Meharry Medical College
James E Siegler - Tulane University
Maria Chavez-Keatts - Louisiana State University Health Sciences Center New Orleans
Jonathan Tiu - Tulane University
Denise Pineda - Tulane University
Alexander George - Tulane University
Amir Shaban - University Medical Center New Orleans
Nidal Abi Rafeh - Department of Cardiology, Tulane University Medical Center, New Orleans, LA, USA
Laurie Schluter - Tulane University
Sheryl Martin-Schild - Tulane University
Ramy El Khoury - Tulane University
Resource Type: Journal article
Publication Details: BioMed research international, Vol.2016, pp.7194676-6
DOI: 10.1155/2016/7194676
PMID: 27822477
PMCID: PMC5086361
NLM abbreviation: Biomed Res Int
ISSN: 2314-6133
eISSN: 2314-6141
Language: English
Date published: 2016
Academic Unit: Neurology
Record Identifier: 9984303021302771

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