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Clinical relevance of cerebral emboli detection in patients with nonvalvular atrial fibrillation and prosthetic cardiac valves

The aim of this study was to analyze the prevalence and acoustic properties of cerebral microembolic signals (ES) in patients with nonvalvular atrial fibrillation (AF) and prosthetic cardiac valves (PCV). We studied 65 asymptomatic patients with AF and 20 with mechanical PCV by transcranial Doppler. The intesity of ES were categorised as: <5, 6-11, 12-17, 18-23 and >24 dB. ES of > 12 dB were found in 21 patients with AF (32 %) and 13 with PCV (65 %). The average distribution of ES was 15, 3, 2, 1, 0 in patients with AF, and 2, 5, 23, 45, 21 with PCV (p<0.01). The prevalence and distribution patterns of the ES intensity significantly differ between patients with AF and PCV, indicating different constituents of embolic particles. Patients with high number of lower intensity microembolic signals were at high risk for neurologic symptoms.

cerebral emboli; transcranial Doppler; atrial fibrillation; prosthetic cardiac valves

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