{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T07:19:04Z","timestamp":1770275944569,"version":"3.49.0"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,12,19]],"date-time":"2019-12-19T00:00:00Z","timestamp":1576713600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Dean Summer Research Fellowship"},{"name":"AHA Scholarship Research"},{"name":"NIND","award":["S00072-R21"],"award-info":[{"award-number":["S00072-R21"]}]},{"name":"Brain Behavior Discovery Research Institute and Cardiology Research"},{"name":"Cardiovascular Discovery Institute"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cardioversion 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective study was conducted on 59 patients who underwent TEE for suspected intra\u2010cardiac thrombi. The TEE indications included acute ischemic stroke (45.7%) and AF or flutter (59.3%). D\u2010dimer level and white blood cell counts were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A negative D\u2010dimer level (&lt;200\u00a0ng\/mL) excluded the presence of intra\u2010cardiac thrombi. Groups with either negative (n\u00a0=\u00a014) or positive (n\u00a0=\u00a045) D\u2010dimer levels had comparable clinical characteristics. Comparing positive D\u2010dimer\u2013level patients with thrombus (n\u00a0=\u00a07) and without thrombus (n\u00a0=\u00a033), patients with thrombus had reduced left atrial appendage (LAA) velocity (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0024), reduced left ventricular ejection fraction (LVEF) (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0263), increased neutrophil percent (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0261), decreased lymphocyte percent (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0216), and increased monocyte counts (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0220). 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Supplementing the gold standard TEE with the analysis of LAA velocity, noninvasive LVEF, D\u2010dimer, 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\u2010cardiac thrombi.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.14562","type":"journal-article","created":{"date-parts":[[2019,12,19]],"date-time":"2019-12-19T09:48:23Z","timestamp":1576748903000},"page":"86-95","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Useful indices of thrombogenesis in the exclusion of intra\u2010cardiac thrombus"],"prefix":"10.1111","volume":"37","author":[{"given":"Uzoma N.","family":"Ibebuogu","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Medicine Augusta University Medical Center Augusta GA USA"},{"name":"Department of Medicine University of Tennessee Health Sciences Center Memphis TN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4513-8348","authenticated-orcid":false,"given":"Joseph H.","family":"Schafer","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Augusta University Medical Center Augusta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6661-3438","authenticated-orcid":false,"given":"Mark J.","family":"Schwade","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Augusta University Medical Center Augusta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer L.","family":"Waller","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Data Science Department of Population Health Sciences Augusta University Medical Center Augusta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gyanendra K.","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Augusta University Medical Center Augusta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3755-6515","authenticated-orcid":false,"given":"Vincent J. 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