Objective To investigate the independent echocardiographic pathogenesis associated with left atrial spontaneous echo contrast(SEC) formation in patients with atrial fibrillation(AF).Methods Twenty-one patients with valvular AF and twenty-three patients with nonvalvular AF undergoing transthoracic and transesophageal echocardiography(TTE/TEE) were studied.Morphological and functional parameters of the heart in patients with AF were detected by TTE,while the sizes of the left atrial appendage(LAA),its Doppler flow patterns,Doppler flow patterns of the left upper pulmonary vein and integrated backscatter(IBS) values of left atrial SEC relative to those of the left ventricle were measured by TEE.Results There were the following 10 variables significantly associated with the left atrial SEC,some of which associated positively with SEC were left atrial diameter(r=(0.40252),P=(0.0061)),diameter of the open mouth of LAA to the left atrium(r=(0.37816),P=(0.0161)),while the others of which associated negatively with SEC were antegrade/retrograde blood flow velocity peak,integrate(RVi) and retrograde blood flow velocity mean(RVm) values,and S/D wave peak,S wave integrate(Is) and D wave mean(Md) values,their r values ranged from(-0.40379) to(-0.32832),their P values between(0.0018) and(0.0386).Collinearity analyses suggested that RVi,RVm,Is,Md represented completely all the blood flow velocity parameters of LAA and the left upper pulmonary vein,respectively.Multivariate analyses demonstrated that RVm and Md were the independent predictors of the left atrial SEC in patients with AF(both P

OBJECTIVETo determine the incidence and risk factors for in-hospital stroke in patients with acute myocardial infarction (AMI).

METHODSTwo thousand one hundred and thirty-three patients with acute myocardial infarction were studied retrospectively. History, demographic, clinical, thrombolytic and anticoagulant data of AMI were obtained through review of the medical record. The relative risk of in-hospital stroke in patients with AMI was estimated using multiple nonconditional logistic regression to adjust for potential confounding factors.

RESULTSAmong 2,133 consecutive patients admitted with acute myocardial infarction to hospitals in Shandong and Hubei provinces, 98 (4.59%) experienced strokes during hospitalization. In our analysis, anterior infarction was the most important risk factor for in-hospital stroke (ischemic and hemorrhagic) in patients with AMI (RR = 7.04), followed by history of hypertension (RR = 3.41), previous stroke (RR = 1.69), atrial fibrillation (RR = 2.22), advanced age (RR = 1.04), and higher heart rate at enrollment (RR = 1.03).

CONCLUSIONSThe incidence of in-hospital stroke in patients with AMI increased with lower rate of using thrombolytic agents. Thrombolytic therapy was noticed as a protective factor for stroke after AMI. The risk factors for in-hospital stroke with AMI were history of hypertension, previous stroke, atrial fibrillation, advanced age, anterior infarction, and higher heart rate at enrollment.

Adult ; Aged ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction ; complications ; Risk Factors ; Stroke ; epidemiology ; etiology