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Significance of high sensitivity C-reactive protein and D-dimer in evaluating intracardiac thrombus and spontaneous echo contrast in patients referred for transesophageal echocardiography: A prospective study
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Abstract
Methods and Results: Consecutive patients referred for transesophageal echocardiogram (TEE) for evaluation of cardioembolic source were prospectively enrolled. CRP and DD levels were determined at the time of TEE. 124 patients were enrolled, of whom 21 had ICT/SEC. The combination of NSR/NEF had a negative predictive value (NPV) of 98.6% for absence of ICT/SEC. The NPVs of CRP and DD were 93.6% and 85%, respectively. Adding either CRP or DD to NSR/NEF combination increased the NPV to 100%. Log CRP was significantly associated with ICT/SEC.
Conclusions: The presence of NSR and NEF may defer the need for TEE for ICT/SEC evaluation. CRP association with ICT/SEC suggests that inflammation plays a role in ICT/SEC formation. Whether CRP and DD should become routine in the triage process of TEE for ICT/SEC evaluation requires further large scale prospective studies.
Abstract
Methods and Results: Consecutive patients referred for transesophageal echocardiogram (TEE) for evaluation of cardioembolic source were prospectively enrolled. CRP and DD levels were determined at the time of TEE. 124 patients were enrolled, of whom 21 had ICT/SEC. The combination of NSR/NEF had a negative predictive value (NPV) of 98.6% for absence of ICT/SEC. The NPVs of CRP and DD were 93.6% and 85%, respectively. Adding either CRP or DD to NSR/NEF combination increased the NPV to 100%. Log CRP was significantly associated with ICT/SEC.
Conclusions: The presence of NSR and NEF may defer the need for TEE for ICT/SEC evaluation. CRP association with ICT/SEC suggests that inflammation plays a role in ICT/SEC formation. Whether CRP and DD should become routine in the triage process of TEE for ICT/SEC evaluation requires further large scale prospective studies.
Keywords
transesophageal echocardiography; intracardiac thrombus; spontaneous echocardiography contrast; C-reactive protein; D-dimer


Title
Significance of high sensitivity C-reactive protein and D-dimer in evaluating intracardiac thrombus and spontaneous echo contrast in patients referred for transesophageal echocardiography: A prospective study
Journal
Issue
Pages
267-273
Published online
2012-05-28
Page views
968
Article views/downloads
1274
Bibliographic record
Cardiol J 2012;19(3):267-273.
Keywords
transesophageal echocardiography
intracardiac thrombus
spontaneous echocardiography contrast
C-reactive protein
D-dimer
Authors
Mohammed Abu-Mahfouz
João L. Cavalcante
Muhammad Arida
Jose Garcia
Mouaz Al-Mallah
Andrzej Boguszewski
Shamael Haque
Mohammed Rehman
Firas Al Badarin
Eyad Akhras
Lonni Schultz
Panayiotis Mitsias
Mohsin Alam
Karthik Ananthasubramaniam