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ID 118275
Title Alternative
心房細動患者におけるイソプロテレノール負荷経食道心エコー図法
TEE with isoproterenol in AF
Author
Hayashi, Shuji Tokushima University
Zheng, Robert Tokushima University
Yamaguchi, Natsumi Tokushima University
Morita, Sae Tokushima University
Hirata, Yukina Tokushima University
Nishio, Susumu Tokushima University
Keywords
Echocardiography
Transesophageal echocardiography
Atrial fibrillation
Spontaneous echo contrast
Content Type
Thesis or Dissertation
Description
Purpose: In patients with sludge or severe spontaneous echo contrast (SEC) in the left atrial appendage (LAA), cases with isoproterenol loading transesophageal echocardiography (ISP-TEE) have been reported to identify the presence of thrombus in the LAA. This study aimed to assess the validity and hemodynamic changes of ISP-TEE in the LAA.
Methods: We prospectively enrolled patients with atrial fibrillation (AF) who underwent ISP-TEE. The degree of sludge/SEC was categorized as being either absent (grade 0), mild SEC (grade 1), moderate SEC (grade 2), severe SEC or sludge (grade 3). The hemodynamic evaluation was performed by measuring LAA flow velocity, LAA tissue Doppler imaging (LAA-TDI) velocity, and pulmonary vein systolic forward flow velocity (PVS).
Results: In total, 35 patients (mean age 71 ± 7 years; 71% male) underwent ISP-TEE. Among 35 patients, 30 patients had grade 3 or 2 SEC, 5 patients had grade 1 SEC. After ISP loading, 23 patients (66% of all patients) showed improved sludge/SEC and one patient was diagnosed with thrombus in the LAA. There were 25 patients with grade 1 SEC, or no SEC (classified as Group1), 10 patients had residual sludge or grade 2 to 3 SEC (classified as Group2) after ISP administration. LAA flow, LAA-TDI, and PVS velocities were significantly higher in group 1 than in group 2 after ISP administration. There was no complication during the examination and after 24 hours and 3 months.
Conclusion: ISP infusion may be a potential tool to recognize LAA thrombus under the sludge/SEC during TEE in AF.
Journal Title
The International Journal of Cardiovascular Imaging
ISSN
15695794
18758312
NCID
AA11582413
Publisher
Springer
Volume
39
Issue
3
Start Page
511
End Page
518
Published Date
2022-11-10
Remark
内容要旨・審査要旨・論文本文の公開
本論文は,著者Tomonori Takahashiの学位論文として提出され,学位審査・授与の対象となっている。
This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use,( https://www.springernature.com/gp/open-research/policies/accepted-manuscript-terms ) but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: http://dx.doi.org/10.1007/s10554-022-02749-y
EDB ID
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
ETD
MEXT report number
甲第3692号
Diploma Number
甲医第1557号
Granted Date
2023-03-23
Degree Name
Doctor of Medical Science
Grantor
Tokushima University
departments
University Hospital
Medical Sciences