Brown J, Sadler D B
Harlem Hospital Center, College of Physicians and Surgeons, Columbia University, New York, NY 10037.
Int J Card Imaging. 1993 Mar;9(1):65-72. doi: 10.1007/BF01142934.
To determine the prevalence of left atrial thrombus in hospitalized patients with non-rheumatic atrial fibrillation, 48 patients were consecutively studied with single-plane transesophageal echocardiography. There were 23 males (48%) and 25 females (52%). The mean age was 66 +/- 11 years (range 43-87). Thrombus was detected in 13 patients (27%): 11 were confined to the left atrial appendage, 1 to the atrial body and appendage, and 1 to the left upper pulmonary vein. Prevalence of atrial thrombus was not different among those patients with or without previous stroke [4/16 (25%) vs 9/32 (28%), p = NS] or between patients > 65 years and patients < or = 65 years old (p = NS). Atrial thrombus was detected more frequently in patients with reduced left ventricular global systolic function than in those with normal function [7/14 (50%) vs 6/34 (17%), p < 0.05]. In patients with spontaneous contrast echoes in the left atrium, thrombi were visualized more often than in those without spontaneous echoes [10/24 (41%) vs 3/24 (12%), p < 0.05]. The finding of the atrial spontaneous contrast echoes was more frequent among patients with reduced left ventricular global systolic function [11/14 (78%) vs 13/34 (37%), p < 0.02]. We conclude that in hospitalized patients with non-rheumatic atrial fibrillation the prevalence of left atrial thrombus is high. Reduced left ventricular global systolic function identifies a subset of patients at high risk for formation of thrombus in the left atrium.
为确定非风湿性心房颤动住院患者左心房血栓的发生率，对48例患者连续进行了单平面经食管超声心动图检查。其中男性23例（48%），女性25例（52%）。平均年龄为66±11岁（范围43 - 87岁）。13例患者（27%）检测到血栓：11例局限于左心耳，1例位于心房体和心耳，1例位于左上肺静脉。有或无既往卒中患者的心房血栓发生率无差异[4/16（25%）对9/32（28%），p =无统计学意义]，年龄>65岁和年龄≤65岁的患者之间也无差异（p =无统计学意义）。左心室整体收缩功能降低的患者比功能正常的患者更频繁地检测到心房血栓[7/14（50%）对6/34（17%），p<0.05]。左心房有自发对比回声的患者比无自发回声的患者更常观察到血栓[10/24（41%）对3/24（12%），p<0.05]。左心室整体收缩功能降低的患者中，心房自发对比回声的发现更为频繁[11/14（78%）对13/34（37%），p<0.02]。我们得出结论，在非风湿性心房颤动住院患者中，左心房血栓的发生率很高。左心室整体收缩功能降低可识别出左心房血栓形成高危患者亚组。
