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The objective of the present study was to identify predictors of left atrial s pontaneous echocardiographic contrast(SEC) or thrombus in patients with stroke w ith sinus rhythm and left ventricular dysfunction. Of 500 consecutive patients w ith stroke, 48 with sinus rhythm and reduced left ventricular ejection fractions (EFs) ≤45%were examined. Ten patients presented with SEC or thrombus. The pati ents with SEC or thrombus had larger left atrial diameters(47±4 vs 42±6 mm, p< 0.05), smaller EFs(30±9%vs 38±8%, p< 0.01), and slower left atrial appendag e(LAA) flow velocities(42±13 vs 61±17 cm/s, p< 0.01). Multivariate analysis id entified EF ≤35%and LAA flow velocity ≤55 cm/s as predictors of SEC or thromb us(p< 0.05). Patients with stroke with sinus rhythm and moderate-to high-grade reduction of the left ventricular EF represent a risk group for a left atrial s ource of embolism and should undergo transesophageal echocardiography.
The objective of the present study was to identify predictors of left atrial s pontaneous echocardiographic contrast (SEC) or thrombus in patients with stroke w ith sinus rhythm and left ventricular dysfunction. Of 500 consecutive patients w ith stroke, 48 with sinus rhythm and reduced left Ten patients presented with SEC or thrombus. The pati ents with SEC or thrombus had larger left atrial diameters (47 ± 4 vs. 42 ± 6 mm, p <0.05), smaller EFs ( 30 ± 9% vs 38 ± 8%, p <0.01), and lower left atrial appendag e (LAA) flow velocities (42 ± 13 vs 61 ± 17 cm / s, p <0.01) % and LAA flow velocity ≤55 cm / s as predictors of SEC or thrombus (p <0.05). Patients with stroke with sinus rhythm and moderate-to high-grade reduction of the left ventricular EF represent a risk group for a left atrial s ource of embolism and should undergo transesophageal echocardiography.