Bakalli Aurora, Georgievska-Ismail Ljubica, Krasniqi Xhevdet, Sejdiu Basri, Bekteshi Tefik, Grbolar Adem, Sadiku Shemsedin
Clinic of Invasive Cardiology and Cardiosurgery, University Clinical Center of Kosova, Pristina, Kosovo.
Deparment of Echocardiograhy, University Clinic of Cardiology, Skopje, Macedoniaa.
J Cardiovasc Echogr. 2020 Apr-Jun;30(2):93-99. doi: 10.4103/jcecho.jcecho_18_20. Epub 2020 Aug 17.
Spontaneous echo contrast(SEC) is usually detected in heart chambers as a result of reduced flow velocity in the cavity. The clinical importance of SEC lies in its association with embolic events. The aim of our study was to determine the frequency of SEC in left heart chambers in sinus rhythm patients with dilated cardiomyopathy and predictors for its emergence.
This was a prospective cross-sectional transesophageal echocardiography study conducted in 101 sinus rhythm patients with dilated heart and mild-to-moderate systolic dysfunction.
Moderate-degree SEC was found in the left ventricle(LV) in around 9% of patients, in the left atrium(LA) in 12% and in left atrial appendage(LAA) in 40%. Multiple regression analysis showed that lower heart rate(95% confidence interval[CI]: 0.845-0.978; = 0.011) and larger LV end-systolic diameter(LVESD)(95% CI: 1.034-1.394; = 0.017) were independent predictors for LV SEC presence. Lower LV ejection fraction(LVEF) (95% CI: [-0.079]-[-0.037]; = 0.0001) was the only independent predictor for SEC in the LA. Whereas, independent predictors for SEC in LAA were lower heart rate(95% CI:[-0.030]-[-0.003]; = 0.018), greater LA indexed diameter (95% CI: 0.016-0.116; = 0.010), and higher value of C-reactive protein(CRP)(95% CI: 0.0026-0.031; = 0.027).
SEC in left heart chambers is a frequent finding in patients with dilated cardiomyopathy in sinus rhythm. Lower heart rate and LVEF, larger LVESD and LA, as well as higher CRP, predict the presence of SEC in left heart chambers. Lower heart rate might be an essential predictor for SEC presence and severity in these patients.
自发性回声增强（SEC）通常是由于心腔内血流速度降低而在心脏腔室中检测到的。SEC的临床重要性在于其与栓塞事件的关联。我们研究的目的是确定扩张型心肌病窦性心律患者左心腔中SEC的发生率及其出现的预测因素。
这是一项前瞻性横断面经食管超声心动图研究，对101例患有扩张型心肌病且有轻度至中度收缩功能障碍的窦性心律患者进行。
约9%的患者左心室（LV）出现中度SEC，12%的患者左心房（LA）出现中度SEC，40%的患者左心耳（LAA）出现中度SEC。多元回归分析显示，较低的心率（95%置信区间[CI]：0.845 - 0.978；P = 0.011）和较大的左心室收缩末期内径（LVESD）（95% CI：1.034 - 1.394；P = 0.017）是左心室SEC存在的独立预测因素。较低的左心室射血分数（LVEF）（95% CI：[-0.079]-[-0.037]；P = 0.0001）是左心房SEC的唯一独立预测因素。而左心耳SEC的独立预测因素是较低的心率（95% CI：[-0.030]-[-0.003]；P = 0.018）、较大的左心房指数直径（95% CI：0.016 - 0.116；P = 0.010）以及较高的C反应蛋白（CRP）值（95% CI：0.0026 - 0.031；P = 0.027）。
窦性心律的扩张型心肌病患者左心腔中SEC较为常见。较低的心率和LVEF、较大的LVESD和左心房以及较高的CRP可预测左心腔中SEC的存在。较低的心率可能是这些患者SEC存在和严重程度的重要预测因素。
