TY - JOUR T1 - Atrial fibrillation: relation between clinical risk factors and transoesophageal echocardiographic risk factors for thromboembolism JF - Heart JO - Heart SP - 165 LP - 168 DO - 10.1136/heart.89.2.165 VL - 89 IS - 2 AU - S Illien AU - S Maroto-Järvinen AU - G von der Recke AU - C Hammerstingl AU - H Schmidt AU - S Kuntz-Hehner AU - B Lüderitz AU - H Omran Y1 - 2003/02/01 UR - http://heart.bmj.com/content/89/2/165.abstract N2 - Objective: To correlate clinical risk factors for thromboembolism with transoesophageal echocardiography (TOE) markers of a thrombogenic milieu. Design: Clinical risk factors for thromboembolism and TOE markers of a thrombogenic milieu were assessed in consecutive patients with non-rheumatic atrial fibrillation. The following TOE parameters were assessed: presence of spontaneous echo contrast, thrombi, and left atrial appendage blood flow velocities. A history of hypertension, diabetes mellitus, or thromboembolic events, patient age > 65 years, and chronic heart failure were considered to be clinical risk factors for thromboembolism. Setting: Tertiary cardiac care centre. Patients: 301 consecutive patients with non-rheumatic atrial fibrillation scheduled for TOE. Results: 255 patients presented with clinical risk factors. 158 patients had reduced left atrial blood flow velocities, dense spontaneous echo contrast, or both. Logistic regression analysis showed that a reduced left ventricular ejection fraction and age > 65 years were the only independent predictors of a thrombogenic milieu (both p < 0.0001). The probability of having a thrombogenic milieu increased with the number of clinical risk factors present (p < 0.0001). 17.4% of the patients without clinical risk factors had a thrombogenic milieu whereas 41.2% of the patients presenting one or more clinical risk factors had none. Conclusion: There is a close relation between clinical risk factors and TOE markers of a thrombogenic milieu. In addition, TOE examination allows for the identification of patients with a thrombogenic milieu without clinical risk factors. ER -