open access

Vol 19, No 3 (2012)
Original articles
Submitted: 2013-01-24
Published online: 2012-05-28
Get Citation

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

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
Cardiol J 2012;19(3):267-273.

open access

Vol 19, No 3 (2012)
Original articles
Submitted: 2013-01-24
Published online: 2012-05-28

Abstract

Background: Intra-cardiac thrombus (ICT) and spontaneous echo contrast (SEC) are considered hypercoagulable and inflammatory conditions. We aimed to determine if high sensitivity C-reactive protein (CRP) and D-dimer (DD), in combination with variables of lower thrombotic risk (normal ejection fraction [NEF], sinus rhythm [NSR]), may predict the absence of ICT/SEC.
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

Background: Intra-cardiac thrombus (ICT) and spontaneous echo contrast (SEC) are considered hypercoagulable and inflammatory conditions. We aimed to determine if high sensitivity C-reactive protein (CRP) and D-dimer (DD), in combination with variables of lower thrombotic risk (normal ejection fraction [NEF], sinus rhythm [NSR]), may predict the absence of ICT/SEC.
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.
Get Citation

Keywords

transesophageal echocardiography; intracardiac thrombus; spontaneous echocardiography contrast; C-reactive protein; D-dimer

About this article
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

Cardiology Journal

Issue

Vol 19, No 3 (2012)

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

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Grupa Via Medica, ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl