Abstract

ROCA ALVAREZ, Mario  and  AGUILAR APAZA, Steve Roy. THROMBOGENIC FACTORS IN LEFT ATRIUM IN PATIENTS WITH ATRIAL FIBRILATION. Rev. Méd. La Paz [online]. 2015, vol.21, n.1, pp.39-45. ISSN 1726-8958.

Introduction: Previous Works of Agmon and Fatkin, demonstrated that the presence of left atrium (LA) dilatation, spontaneous echocardiographic contrast (SEC) in LA, input and output flow in left atrial appendage (LAA), measured with pulse wave Doppler, less than 20 cm/s are thrombogenic risk factors in patients with atrial fibrillation (af). Aim: To identify the factors associate with thrombi in left atrium in patients with atrial fibrillation in our country. Material and methods: We reviewed studies of patients with atrial fibrillation, subject to transesophageal echocardiography (TOE), realized in the Cardiology Service in Hospital Obrero- C.N.S. of La Paz; they were divided in 2 groups: 1) patients with LA thrombi and 2) patients withouth LA thrombi, comparing them with the presence of LA dilatation, SEC and input and output flow into the LAA with pulsed Doppler wave, we obtained the OR, and its respective confidence interval at 95% (CI) for all these variables. Results: We found 131 studies. Making the relationship with the presence of LA thrombi with dilated LA, we got a 4.84 OR. With SEC in LA an OR of 4.87. Input flow velocities in LAA ≤ 10 cm/s was 4.87, velocities between 11 to 20 cm/s the OR was 3.77, being this value inversely proportional with the existence of LA thrombi. The same occurs with output flow velocities, so with ≤ 10 cm/s we got an OR of 12.3 and with velocities between 11 and 20 cm/s the OR was 9.7. Conclusion: LA dilatation, SEC, input and output flow in LAA ≤ 20 cm/s, are risk factors to the formation of thrombi in LA in patients with af.

Keywords : Atrial fibrillation; spontaneous echocardiographic contrast; thrombosis; transesophageal echocardiography.

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