{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T06:06:50Z","timestamp":1760249210326},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2009,2,3]],"date-time":"2009-02-03T00:00:00Z","timestamp":1233619200000},"content-version":"vor","delay-in-days":3139,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2000,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Background:<\/jats:italic> Spontaneous echo contrast (SEC) is a phenomenon that is commonly seen in areas of blood stasis. It is a slowly moving, cloud\u2010like swirling pattern of \u201csmoke\u201d or increased echogenicity recorded on echocardiography. SEC is commonly seen in the left atrium of patients with mitral stenosis or atrial fibrillation. The prescence of SEC has been shown to be a marker of increased thromboembolic risk.<\/jats:p><jats:p><jats:italic>Hypothesis:<\/jats:italic> By using transesophageal echocardiography during percutaneous balloon mitral valvotomy (PBMV), the study investigated the relationship between SEC and varying left atrial appendage (LAA) blood flow velocity in the human heart.<\/jats:p><jats:p><jats:italic>Methods:<\/jats:italic> Thirty\u2014five patients with rheumatic mitral stenosis underwent percutaneous balloon mitral valvotomy with intraoperative transesophageal echocardiography monitoring. We alternatively measured LAA velocities and observed the left atrium for various grades of SEC (0 = none to 4 = severe) before and after each balloon inflation.<\/jats:p><jats:p><jats:italic>Results:<\/jats:italic> Left atrial appendage maximal ejection velocity was reduced from 35 \u00b1 14 to 6 \u00b1 2 mm\/s at peak balloon inflation and increased to 40 \u00b1 16 mm\/s after balloon deflation. In comparison with the values before balloon inflation and after balloon deflation, LAA velocities were significantly lower (p &lt; 0.001). New or increased SEC grade was observed during 54 of 61 (88%) inflations and unchanged in 7 (12%) inflations at peak balloon inflation. Spontaneous echo contrast became lower in grade after 55 balloon deflations (90%), completely disappeared after 18 deflations (30%), and remained unchanged after 6 deflations (10%). The mean time to achieve maximal SEC grade (2.5 \u00b1 1.2 s) coincided with the mean time to trough LAA velocities (2.3 \u00b11.1 s) after balloon inflation. Upon deflation, the mean time to lowest SEC grade (2.9 \u00b1 1.8 s) coincided with mean time to achieve maximal LAA velocities (2.7 \u00b1 1.6s).<\/jats:p><jats:p><jats:italic>Conclusion:<\/jats:italic> During balloon inflation, the severity of SEC was enhanced with corresponding reduction in LAA flow velocity. Upon balloon deflation, SEC lightens or disappears with increase in LAA flow velocity.<\/jats:p>","DOI":"10.1002\/clc.4960230708","type":"journal-article","created":{"date-parts":[[2009,2,4]],"date-time":"2009-02-04T04:32:33Z","timestamp":1233721953000},"page":"501-506","source":"Crossref","is-referenced-by-count":5,"title":["The effect of transient balloon occlusion of the mitral valve on left atrial appendage blood flow velocity and spontaneous echo contrast"],"prefix":"10.1002","volume":"23","author":[{"given":"Jianan","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel Chung Ann","family":"Choo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianglan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tangchao","family":"Xian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duan","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shan","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,2,3]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.4960090603"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.95.4.912"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(88)90283-5"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(91)90592-W"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)00146-6"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.74.3.296"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(14)80009-6"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004424-198101000-00013"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.66.4.755"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.1870110103"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004424-198409000-00022"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90463-W"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.96.3.889"},{"key":"e_1_2_1_15_2","first-page":"194","volume-title":"Hemodynamic information derived from echocardiography. 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