Microembolic load in asymptomatic patients with cardiac aneurysm, severe ventricular dysfunction, and atrial fibrillation

Darius G. Nabavi, Susanne Arato, Dirk W. Droste, Gernot Schulte-Altedorneburg, V. Kemény, Holger Reineck, Martin Borggrefe, Günter Breithardt, E. Bernd Ringelstein

Research output: Contribution to journalArticle

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Abstract

Transcranial Doppler sonography has become a widely used method for detecting cerebral circulating microemboli (ME) arising from the carotid arteries or the heart. Yet, studies on subgroups of patients with distinct cardiac sources of embolism are still limited. The same holds true for investigations on the relationship between microembolization and hemorheological parameters. A total of 142 patients suffering from left ventricular aneurysm (LVA, n = 52), severe left ventricular dysfunction (LVD, n = 43), or chronic atrial fibrillation (AF, n = 47) were enrolled in this study. All patients had been neurologically asymptomatic for at least 1 month. Further relevant embolic disorders of the carotid arteries and the heart had been excluded. Unilateral monitoring for ME over the middle cerebral artery was performed for 30 min. Blood was drawn after each monitoring for determination of plasmatic coagulation parameters, as well as plasma viscosity, and platelet reactivity. The overall prevalence of ME was 31%, with a slightly higher prevalence in patients with LVA (37%) compared to patients suffering from AF (30%) or LVD (26%). With single-factor analysis, a trend towards higher ME prevalences was found with (a) a history of remote embolic events, (b) ineffective anticoagulation, (c) increased platelet aggregation, or (d) increased plasma viscosity (all p > 0.1). The combination of ineffective anticoagulation in conjunction with increased platelet aggregation, however, was significantly associated with higher ME rates even after adjustment for other factors by logistic regression analysis. Our results demonstrate a low ongoing microembolic activity in asymptomatic patients suffering from LVA, LVD and AF. An activated plasmatic coagulation system together with increased platelet aggregation contributes to ME generation.

Original languageEnglish
Pages (from-to)214-221
Number of pages8
JournalCerebrovascular Diseases
Volume8
Issue number4
DOIs
Publication statusPublished - Jul 1998

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Heart Aneurysm
Ventricular Dysfunction
Ventricular Fibrillation
Atrial Fibrillation
Platelet Aggregation
Viscosity
Doppler Transcranial Ultrasonography
Carotid Artery Diseases
Middle Cerebral Artery
Left Ventricular Dysfunction
Embolism
Carotid Arteries
Statistical Factor Analysis
Aneurysm
Blood Platelets
Logistic Models
Regression Analysis

Keywords

  • Coagulation
  • Diagnostic ultrasonography
  • Embolism
  • Hemorheology

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Nabavi, D. G., Arato, S., Droste, D. W., Schulte-Altedorneburg, G., Kemény, V., Reineck, H., ... Ringelstein, E. B. (1998). Microembolic load in asymptomatic patients with cardiac aneurysm, severe ventricular dysfunction, and atrial fibrillation. Cerebrovascular Diseases, 8(4), 214-221. https://doi.org/10.1159/000015854

Microembolic load in asymptomatic patients with cardiac aneurysm, severe ventricular dysfunction, and atrial fibrillation. / Nabavi, Darius G.; Arato, Susanne; Droste, Dirk W.; Schulte-Altedorneburg, Gernot; Kemény, V.; Reineck, Holger; Borggrefe, Martin; Breithardt, Günter; Ringelstein, E. Bernd.

In: Cerebrovascular Diseases, Vol. 8, No. 4, 07.1998, p. 214-221.

Research output: Contribution to journalArticle

Nabavi, DG, Arato, S, Droste, DW, Schulte-Altedorneburg, G, Kemény, V, Reineck, H, Borggrefe, M, Breithardt, G & Ringelstein, EB 1998, 'Microembolic load in asymptomatic patients with cardiac aneurysm, severe ventricular dysfunction, and atrial fibrillation', Cerebrovascular Diseases, vol. 8, no. 4, pp. 214-221. https://doi.org/10.1159/000015854
Nabavi, Darius G. ; Arato, Susanne ; Droste, Dirk W. ; Schulte-Altedorneburg, Gernot ; Kemény, V. ; Reineck, Holger ; Borggrefe, Martin ; Breithardt, Günter ; Ringelstein, E. Bernd. / Microembolic load in asymptomatic patients with cardiac aneurysm, severe ventricular dysfunction, and atrial fibrillation. In: Cerebrovascular Diseases. 1998 ; Vol. 8, No. 4. pp. 214-221.
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