TY - JOUR
T1 - Left Atrial Enlargement on Transthoracic Echocardiography Predicts Left Atrial Thrombus on Transesophageal Echocardiography in Ischemic Stroke Patients
AU - Anaissie, James
AU - Monlezun, Dominique
AU - Seelochan, A.
AU - Siegler, James E.
AU - Chavez-Keatts, Maria
AU - Tiu, Jonathan
AU - Pineda, Denise
AU - George, Alexander
AU - Shaban, Amir
AU - Abi Rafeh, Nidal
AU - Schluter, Laurie
AU - Martin-Schild, Sheryl
AU - El Khoury, Ramy
N1 - Publisher Copyright:
© 2016 James Anaissie et al.
PY - 2016
Y1 - 2016
N2 - Background. 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. Aims. To determine the utility of using left atrial enlargement (LAE) on TTE to predict LAT on TEE. Methods. 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. Results. 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%, p=0.018). LAE on TTE predicted increased odds of LAT on TEE (OR=8.83, 95% CI 1.04-74.83, p=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). Conclusions. 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.
AB - Background. 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. Aims. To determine the utility of using left atrial enlargement (LAE) on TTE to predict LAT on TEE. Methods. 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. Results. 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%, p=0.018). LAE on TTE predicted increased odds of LAT on TEE (OR=8.83, 95% CI 1.04-74.83, p=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). Conclusions. 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.
UR - http://www.scopus.com/inward/record.url?scp=84994558418&partnerID=8YFLogxK
U2 - 10.1155/2016/7194676
DO - 10.1155/2016/7194676
M3 - Article
C2 - 27822477
AN - SCOPUS:84994558418
SN - 2314-6133
VL - 2016
JO - BioMed Research International
JF - BioMed Research International
M1 - 7194676
ER -