The Role of Echocardiography in the Management of the Sources of Embolism

Roberta Esposito; Rosa Raia; Daniela De Palma; Ciro Santoro; Maurizio Galderisi

Disclosures

Future Cardiol. 2012;8(1):101-114. 

In This Article

Future Perspective

Over recent years, new echo technologies, mainly RT3DE and STE, have become available and competitive with cardiac MRI in diagnostic accuracy while being less expensive. These tools can be applied in the setting of cardiac sources of emboli.

RT3DE has been successfully used to better identify location, composition, size and relationship to other structures of any kind for cardiac masses during a simple TTE.[64,65] It is expected that RT3DE could even replace TEE in the assessment of large series of cardiac masses including intracardiac thrombi, tumors and vegetations. Preliminary studies describe the good diagnostic accuracy of RT3DE for the detection of PFO.[66,67]

STE is a validated technique for the quantification of regional LV function[68] and could be particularly attractive to identify determinants of LV thrombus formation (e.g., dyskinesia of aneurysmatic myocardial segments). Novel extension of STE application includes the assessment of regional and global LA function. Recent studies have demonstrated the ability of LA STE in predicting embolic stroke in patients with AF.[69,70] This use could become clinically valuable when confirmed in a large population sample. LA STE predicts also the recurrence of AF episodes[27,71] and could potentially replace postcardioversion TEE in the next future.

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