Evidence map›Paper›PMID 31854027›Full record

ArticleEchocardiography (Mount Kisco, N.Y.)2020

Useful indices of thrombogenesis in the exclusion of intra-cardiac thrombus.

Uzoma N Ibebuogu, Joseph H Schafer, Mark J Schwade, Jennifer L Waller, Gyanendra K Sharma, Vincent J B Robinson

Open access · hybridAbstract read
In one paragraph

Article in Echocardiography (Mount Kisco, N.Y.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.3field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Uzoma N IbebuoguDivision of Cardiology, Department of Medicine, Augusta University Medical Center, Augusta, GA, USA.
Joseph H SchaferDivision of Cardiology, Department of Medicine, Augusta University Medical Center, Augusta, GA, USA.ORCID 0000-0003-4513-8348
Mark J SchwadeDivision of Cardiology, Department of Medicine, Augusta University Medical Center, Augusta, GA, USA.ORCID 0000-0002-6661-3438
Jennifer L WallerDivision of Biostatistics and Data Science, Department of Population Health Sciences, Augusta University Medical Center, Augusta, GA, USA.
Gyanendra K SharmaDivision of Cardiology, Department of Medicine, Augusta University Medical Center, Augusta, GA, USA.
Vincent J B RobinsonDivision of Cardiology, Department of Medicine, Augusta University Medical Center, Augusta, GA, USA.ORCID 0000-0003-3755-6515
Augusta University · USAugusta University Health · USUniversity of Tennessee Health Science Center · US

Funding

AHA Scholarship ResearchBrain Behavior Discovery Research Institute and Cardiology ResearchCardiovascular Discovery InstituteDean Summer Research FellowshipNIND S00072-R21
6 · The paper itself

Abstract

backgroundCardioversion in patients with atrial fibrillation (AF) can cause cardioembolic stroke, and effective clinical management is necessary to reduce morbidity and mortality. Currently, transesophageal echocardiography (TEE) is the accepted standard to diagnose cardiogenic thromboemboli; however, a negative TEE does not eliminate the possibility of left atrial thrombus. The objective of this study was to evaluate the diagnostic value of supplementing the TEE with additional noninvasive markers to ensure thrombus absence.

methodsA prospective study was conducted on 59 patients who underwent TEE for suspected intra-cardiac thrombi. The TEE indications included acute ischemic stroke (45.7%) and AF or flutter (59.3%). D-dimer level and white blood cell counts were assessed.

resultsA negative D-dimer level (<200 ng/mL) excluded the presence of intra-cardiac thrombi. Groups with either negative (n = 14) or positive (n = 45) D-dimer levels had comparable clinical characteristics. Comparing positive D-dimer-level patients with thrombus (n = 7) and without thrombus (n = 33), patients with thrombus had reduced left atrial appendage (LAA) velocity (P = .0024), reduced left ventricular ejection fraction (LVEF) (P = .0263), increased neutrophil percent (P = .0261), decreased lymphocyte percent (P = .0216), and increased monocyte counts (P = .0220). The area under the receiver operating characteristic (ROC) curve for thrombus diagnostics was larger for combinations of clinical and biochemical data than for each parameter individually.

conclusionsSupplementing the gold standard TEE with the analysis of LAA velocity, noninvasive LVEF, D-dimer, and hemostatic markers provided additional useful diagnostic information. Larger studies are needed to further validate the efficacy of supplementing the TEE to better assess patients for intra-cardiac thrombi.

Indexed as

Atrial AppendageAtrial FibrillationBrain IschemiaStrokeThrombosisEchocardiography, TransesophagealHumansProspective StudiesStroke VolumeVentricular Function, Leftatrial fibrillationcardiac thrombusD-dimer assaythrombosistransesophageal echocardiography

Identifiers

PMID31854027
PMCPMC7027915
OpenAlexW2995793511

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.