Abstract 3564: Association of Spontaneous Echocardiographic Contrast in the Thoracic Aorta With Increased Systemic Inflammatory and Coagulant Activity
Background: Spontaneous echocardiographic contrast (SEC) is a phenomenon of discrete smoke-like reflections appearing in the cardiac chambers or vessels, without previous injection of echo-contrast agent. The purpose of this study was to evaluate the level of inflammatory and coagulant activity in patients with incidentally observed SEC in the thoracic aorta (AoSEC) on transesophageal echocardiography (TEE).
Methods: We studied 299 consecutive patients (age 61 ± 13) without aortic aneurysm or dissection and without rheumatic or inflammatory disease, who underwent TEE in our laboratory. AoSEC was observed in 35 patients (11.7%). We measured C-reactive protein (CRP), serum amyloid A (SAA), factor VII, fibrinogen and fibronectin levels in these patients, as well as in a control group without AoSEC, matched for age, gender, smoking habit, presence of atrial fibrillation and coronary disease, selected among the rest of the patients who underwent TEE.
Results: Patients with AoSEC exhibited significantly higher levels of CRP (30.25 mg/l vs. 4.48 mg/l, p=0.029) and SAA (36.96 μg/ml vs. 8.66μg/ml, p<0.001), as well as increased fibrinogen levels (438 mg/dl vs. 320 mg/dl, p=0.039) [Figure⇓]. Factor VII and fibronectin levels tended to be higher in patients with AoSEC without achieving statistical significance.
Conclusion: These findings strongly associate AoSEC with enhanced inflammatory activity, as well as increased fibrinogen levels. Both are established predictors of adverse cardiovascular events. We conclude that AoSEC is a finding which should prompt a comprehensive cardiovascular risk evaluation of the patient, leading to appropriate risk factor modifications.