Evidence map›Paper›PMID 42491011›Full record

ArticleAmerican heart journal plus : cardiology research and practice2026

Dobutamine-assisted exclusion of left atrial appendage thrombus in atrial fibrillation patients with sludge.

Kentaro Minami, Tomoko Machino-Ohtsuka, Hiro Yamasaki, Bryan J Mathis, Yu Yamada, Naoto Kawamatsu, Kimi Sato, Masayoshi Yamamoto, Tomoko Ishizu

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Article in American heart journal plus : cardiology research and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Kentaro MinamiDepartment of Cardiology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Tomoko Machino-OhtsukaDepartment of Cardiology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Hiro YamasakiDepartment of Cardiology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Bryan J MathisDepartment of Cardiovascular Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Yu YamadaDepartment of Cardiology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Naoto KawamatsuDepartment of Cardiology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Kimi SatoDepartment of Cardiology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Masayoshi YamamotoDepartment of Cardiology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Tomoko IshizuDepartment of Cardiology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Dense spontaneous echo contrast (SEC) and sludge in the left atrial appendage (LAA) complicate differentiation between sludge and thrombi during transoesophageal echocardiography (TOE). We prospectively evaluated the feasibility, safety, and efficacy of dobutamine to reduce sludge and improve thrombus detection in patients with atrial fibrillation (AF). Methods and results: This was an open-label, single-arm, single-center clinical study. A total of 20 patients with LAA sludge on TOE received intravenous dobutamine infusion, starting at 5 μg/kg/min and increasing to 10 and 20 μg/kg/min at 3-min intervals until sludge resolution. SEC grade and thrombus presence were reassessed at the maximum dose. All patients had LAA sludge at baseline, which improved to SEC grade 2 in 5% of patients, grade 1 in 75%, and completely resolved in 20%. Peak dobutamine doses were 5 μg/kg/min in one patient, 10 μg/kg/min in six patients, and 20 μg/kg/min in 13 patients. Dobutamine significantly increased LAA emptying velocity (median: 13.8 to 18.7 cm/s, Conclusion: By enhancing LAA and LV function, dobutamine infusion during TOE reduces sludge and facilitates LAA thrombus exclusion in patients with AF.

Indexed as

Atrial fibrillationDobutamineLeft atrial appendageSpontaneous echo contrastTransoesophageal echocardiography

Identifiers

PMID42491011
PMCPMC13375923

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