Dilated cardiomyopathy, spontaneous echo contrast in the aorta and embolic events

Abstract

Background — Spontaneous echocardiographic contrast (SEC) is a frequent finding in patients with dilated cardiomyopathy (DCM). In this study, we have investigated the frequency and clinical correlates of aortic-SEC (Ao-SEC) in patients with DCM.

Methods — Ninety-two consecutive DCM patients (63 men, 29 women, mean age 60 ± 11 years) underwent transthoracic and transoesophageal echocardiography.

Results — Ao-SEC was found in 53 patients (58%). It was associated with: (i) a lower cardiac index (P< 0.001); (ii) left atrial-SEC (P< 0.001); (iii) left ventricular-SEC (P = 0.008); (iv) a larger aortic root (P= 0.02); (v) the presence of complex aortic atherosclerotic plaques (P< 0.001).The significant determinant of thromboembolism was left-atrial SEC (P= 0.03).We did not find a significant correlation between Ao-SEC and thromboembolism.

Conclusion — Most of the patients who developed embolic events in the follow-up period had Ao-SEC.Thromboembolism is rather associated with left-atrial SEC than with Ao-SEC.

Key Words:

• Dilated cardiomyopathy
• spontaneous echo contrast
• aorta
• thromboembolic event
• left atrium