岩田 亜紀子, 高沢 謙二, 田中 信大, 吉田 マリ子, 田村 忍, 武井 康悦, 山科 章

Akiko IWATA, Kenji TAKAZAWA, Nobuhiro TANAKA, Mariko YOSHIDA, Shinobu TAMURA, Yasuyoshi TAKEI, Akira YAMASHINA

東京医科大学第二内科

Second Department of Internal Medicine Tokyo Medical University

キーワード : contrast echocardiography, left atrial appendage, transesophageal echocardiography

Objectives: We assessed the flow stasis of the left atrial appendage using transesophageal contrast echocardiography with Levovist. Methods and Results: Transesophageal echocardiography was performed in 30 consecutive patients (11 patients with sinus rhythm, 17 with persistent atrial fibrillation, and 2 with atrial flutter). We measured left atrial size, left atrial appendage filling area, and left atrial appendage flow velocity and evaluated degree of opacification of the left atrial appendage using transesophageal contrast echocardiography with intravenous injection of Levovist (300 mg/ml, 3 ml). Degree of opacification (opacification score) of the left atrial appendage was classified as rapid and complete opacification of left atrial appendage with Levovist, score 3; delayed and incomplete opacification, 2; incomplete opacification from base to the middle of left atrial appendage, 1; and no opacification of left atrial appendage, 0. Left atrial appendage flow velocity and opacification score in patients who had experienced previous embolic events (n=9) and patients who had not experienced previous embolic events (n=21) did not differ significantly. Left atrial appendage flow velocity and opacification score was significantly lower in patients with spontaneous echo contrast than in patients who had no spontaneous echo contrast (21賊8 vs 49賊23 cm/sec, 0.4賊0.5 vs 2.4賊0.9 points, pConclusions: Transesophageal contrast echocardiography provides information on degree of opacification in left atrial appendage, which reveals flow stasis of the left atrial appendage.