Causes, predisposing factors and clinical implications of spontaneous echocardiographic contrast
https://doi.org/10.51523/2708-6011.2022-19-2-02
Abstract
Spontaneous echocardiographic contrast is a manifestation of SLUDGE syndrome in the cavities of the heart. The factors that contribute to the emergence of this phenomenon are atrial fibrillation, mitral stenosis, mitral valve prosthesis, left atrial dilatation, decreased left ventricular ejection fraction, hypercoagulable blood conditions, inflammatory diseases, dyslipidemia. Spontaneous echo contrast is a prothrombogenic condition and increases the risk of thromboembolic events, including cerebrovascular complications. This article presents an analytical review of literary sources on this phenomenon for the purpose of its study and determination of treatment tactics in each clinical case.
About the Authors
N. F. Bakalets
Gomel State Medical University
Belarus
Belarus
Natalia F. Bakalets, PhD (Med), Associate Professor, Head of the Department of Polyclinic Therapy and General Medical Practice
Gomel
A. S. Paremskaya
Gomel Central City Clinical Polyclinic
Belarus
Belarus
Alena S. Paremskaya, Head of the Department of Ultrasound Diagnostics, Gomel Central City Clinical Polyclinic, chief freelance city specialist in ultrasound diagnostics
Gomel
D. S. Yurkovskiy
Gomel State Medical University; Gomel Central City Clinical Polyclinic
Belarus
Belarus
Dmitrie S. Yurkovskiy, diagnostic medical sonographer, Gomel Central City Clinical Polyclinic, Assistant Lecturer at the Department of Radiation Diagnostics with the course of the Faculty of Advanced Training and Retraining
Gomel
References
1. Aric AA, Meine AT, Folkert J, Jos RT, Roelandt C. Spontaneous echocontrast: etiology, technology dependence and clinical implications. In: Nanda N.C SchliefR, Goldberg BB, editors. Advances in echo imaging using contrast enhancement. Springer, Dordrecht; 1997. p. 65-83. DOI: https://doi.org/10.1007/978-94-011-5704-9_4
2. Ozkan M, Kaymaz C, Kirma C, Civelek A, Cenal AR, et al. Predictors of left atrial thrombus and spontaneous echo contrast in rheumatic valve disease before and after mitral valve replacement. Am J Cardiol. 1998 Nov;82(9):1066-1070. DOI: https://doi.org/10.1016/S0002-9149(98)00556-6
3. Fatkin D, Kelly RP, Feneley MP. Relations between left atrial appendage blood flow velocity, spontaneous echocardiographic contrast and thromboembolic risk in vivo. J Am Coll Cardiol. 1994 Mar 15;23(4):961-969. DOI: https://doi.org/10.1016/0735-1097(94)90644-0
4. Lowe BS, Kusunose K, Motoki H, Varr B, Shrestha K, et al. Prognostic significance of left atrial appendage «sludge» in patients with atrial fibrillation: a new transesophageal echocardiographic thromboembolic risk factor. J Am Soc Echocardiogr. 2014 Nov;27(11):1176-1183. DOI: https://doi.org/10.1016/j.echo.2014.08.016
5. Usuku H, Yamamoto E, Yoshimura H, et al. Utility of postural change in differentiating sludge from thrombus in the left atrial appendage: A case report. Echocardiography. 2018;35:573-574. DOI: https://doi.org/10.1111/echo.13850
6. Kwaan HC, Sakurai S, Wang J. Rheological abnormalities and thromboembolic complications in heart disease: spontaneous echo contrast and red cell aggregation. Semin Thromb Hemost. 2003 Oct;29(5):529-534. DOI: https://doi.org/10.1055/s-2003-44559
7. Zotz RJ, Müller M, Genth-Zotz S, Darius H. Spontaneous echo contrast caused by platelet and leukocyte aggregates? Stroke. 2001 May;32(5):1127-1133. DOI: https://doi.org/10.1161/01.str.32.5.1127
8. Vyshlov EV, Batalov RE, Markov VA, Popov SV. Comparative efficacy of enzyme medication with thrombolytic effect in atrium thrombosis and spontaneous echo-contrast phenomenon in patients with atrial fibrillation. Russian Journal of Cardiology. 2015;(9):71-74. (In Russ.). DOI: https://doi.org/10.15829/1560-4071-2015-9-71-74
9. Wang F, Zhu M, Wang X, Zhang W, Su Y, et al. Predictive value of left atrial appendage lobes on left atrial thrombus or spontaneous echo contrast in patients with non-valvular atrial fibrillation. BMC Cardiovasc Disord. 2018 Jul 31;18(1):153. DOI: https://doi.org/10.1186/s12872-018-0889-y
10. González-Torrecilla E, AGarcı́a-Fernández M, Pérez- David E, JavierBermejo J, Moreno M, Delcán JL. Predictors of left atrial spontaneous echo contrast and thrombi in patients with mitral stenosis and atrial fibrillation The American Journal of Cardiology. 2000 Sep;86:529-534. DOI: https://doi.org/10.1016/S0002-9149(00)01007-9
11. Drissi S, Sabor H, Ounsy A, Mouine N, Sabry M, et al. Predictive factors of left atrial spontaneous echo contrast in patients with rheumatic mitral valve stenosis: a retrospective study of 159 patients. Int Arch Med. 2014 Jun;7:32. DOI: https://doi.org/10.1186/1755-7682-7-32
12. Lowe BS, Kusunose K, Motoki H, Varr B, Shrestha K, et al. Prognostic significance of left atrial appendage «sludge» in patients with atrial fibrillation: a new transesophageal echocardiographic thromboembolic risk factor. J Am Soc Echocardiogr. 2014 Nov;27(11):1176-1183. DOI: https://doi.org/10.1016/j.echo.2014.08.016
13. Bernhardt P, Schmidt H, Hammerstingl C, Lüderitz B, Omran H. Patients with atrial fibrillation and dense spontaneous echo contrast at high risk: a prospective and serial follow-up qver 12 months with transesophageal echocardiography and cerebral magnetic resonance imaging Journal of the American College of Cardiology 2005 June; 45(11):1807-1812. DOI: https://doi.org/10.1016/j.jacc.2004.11.071
14. Sun P, Guo ZH, Zhang HB. CHA2DS2-VASc Score as a predictor for left atrial thrombus or spontaneous echo contrast in patients with nonvalvular atrial fibrillation: a meta-analysis. BioMed Research International. 2020 Jul;8:2020-2026. DOI: https://doi.org/10.1155/2020/2679539
15. Sadanandan S, Sherrid MV. Clinical and echocardiographic characteristics of left atrial spontaneous echo contrast in sinus rhythm. J Am Coll Cardiol. 2000 Jun;35(7):1932-1938. DOI: https://doi.org/10.1016/s0735-1097(00)00643-4
16. Ito T, Suwa M, Nakamura T, Miyazaki S, Hirota Y, Kawamura K. Influence of warfarin therapy on left atrial spontaneous echo contrast in nonvalvular atrial fibrillation. Am J Cardiol. 1999 Oct 1;84(7):857-9. DOI: https://doi.org/10.1016/s0002-9149(99)00451-8
17. Grantkovskaya AV. Influence of cardioversion on parameters of cerebral microembolia in patients with atrial fibrillation of nonvalvular etiology. Medical literary miscellany. 2016;3:26-31. [date of access 2021 November 28]. Available from: https://cyberleninka.ru/article/n/vliyanie-kardioversii-napokazateli-tserebralnoy-mikroembolii-u-bolnyh-s-fibrillyatsieypredserdiy-neklapannoy-etiologii (in Russ.).
18. Bakalli A, Georgievska-Ismail L, Krasniqi X, Sejdiu B, Bekteshi T, Grbolar A, Sadiku S. Predictors of Spontaneous Echo Contrast in Left Heart Chambers in Patients with Dilated Cardiomyopathy: Slowing Down Might not Always Mean Enjoying Life. J Cardiovasc Echogr. 2020 Apr-Jun;30(2):93-99. DOI: https://doi.org/10.4103/jcecho.jcecho_18_20
19. Unai S, Nguyen ML, Tanaka D, Gorbachuk N, Marhefka GD, Hirose H, Cavarocchi NC. Clinical significance of spontaneous echo contrast on extracorporeal membrane oxygenation. Ann Thorac Surg. 2017 Mar;103(3):773-778. DOI: https://doi.org/10.1016/j.athoracsur.2016.07.019
20. Khan IA. Transient atrial mechanical dysfunction (stunning) after cardioversion of atrial fibrillation and flutter Am Heart J. 2002 Jul;144(1):11-22. DOI: https://doi.org/10.1067/mhj.2002.123113
21. Kim CY, Hong SP, Choi JY. A rare cause of spontaneous echo contrast in echocardiography. J Korean Med Sci. 2019 Dec;34(48): 308. DOI: https://doi.org/10.3346/jkms.2019.34.e308
22. Chibane S, Gibeau G, Poulin F, Tessier P, Goulet M, Carrier M, Lanthier S. Hyperacute multi-organ thromboembolic storm in COVID-19: a case report. J Thromb Thrombolysis. 2021 Jan;51(1):25-28. DOI: https://doi.org/10.1007/s11239-020-02173-w
23. Hammwöhner M, Ittenson A, Dierkes J, Bukowska A, Klein HU, Lendeckel U, Goette A. Platelet expression of CD40/ CD40 ligand and its relation to inflammatory markers and adhesion molecules in patients with atrial fibrillation. Exp Biol Med (Maywood). 2007 Apr;232(4):581-589.
24. Kuang RR, Liu FZ, Li YP, Lin WD, Liang HS, Chen AH. Hemoglobin A1c and risk of left atrial thrombus and spontaneous echo contrast in non-valvular atrial fibrillation patients. Eur J Med Res. 2017 Apr 21;22(1):15. DOI: https://doi.org/10.1186/s40001-017-0257-x
25. Bakalets NF. Phenomenon of spontaneous echo contract of the left atrium in patients with atrial fibrillation. V: Topical problems of medicine: collection of scientific artciles. Republican scientific and practical conference with international participation, Gomel, November 21-22. 2019;5:58-60. [date of access 2021 November 28]. Available from: https://elib.gsmu.by/handle/GomSMU/6877 (in Russ.).
Review
For citations:
Bakalets N.F., Paremskaya A.S., Yurkovskiy D.S. Causes, predisposing factors and clinical implications of spontaneous echocardiographic contrast. Health and Ecology Issues. 2022;19(2):12–24. (In Russ.) https://doi.org/10.51523/2708-6011.2022-19-2-02
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