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In our study, ¹ blood samples were drawn from the antecubital vein at 08.00 and 12.00 am after at least 8-hour fasting period. Tubes containing EDTA were used for collection of blood samples. All blood measurements were performed within 1 hour after venipuncture (both heart failure patients and control group). Collection and analysis of blood samples were done with the same technique in patients with and without thrombus and in control patients. Hematological variables, including mean platelet volume (MPV), platelet count, red blood cells, and white blood cells count, were measured by cell analyzers (BC 5500 Auto Hematology Analyzer, China). So that, we do not think that the blood collection and blood collection tube could affect study results.

Spontaneous echo contrast (SEC) is defined as the presence of characteristic swirling and smoke-like echo-dense shadow with a motion of blood within the cardiac chambers in transthoracic echocardiography or transesophageal echocardiography. This echocardiographic imaging is an important marker for thromboembolic risk. ²

The SEC in the left ventricle (LV) was assessed in patients with dilated cardiomyopathy by transthoracic echocardiography. When heart failure patients are divided into 2 groups, MPV was not significantly different in heart failure patients with and without SEC (Table 1). Due to the nonsignificant results in this study, ¹ we did not mention about LV SEC. Akpek et al have reported that platelet indices, including MPV, are associated with the presence of SEC and are independent risk factors for SEC in patients with mitral stenosis. ³ But according to our study results, MPV was not associated with LV SEC in patients with dilated cardiomyopathy.

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Table 1.

Mean Platelet Volume in Heart Failure Patients With and Without SEC

Variable	Heart Failure Patients With SEC (n = 104)	Heart Failure Patients Without SEC (n = 154)	P Value
Age (years)	68 ± 11	68 ± 12	.82
White blood cells (×103/µL)	7.6 ± 2	7.5 ± 1.9	.67
Platelets (×103/µL)	234 ± 64	237 ± 66	.74
MPV (fL)	9.2 ± 1.2	9.5 ± 4.7	.50

Abbreviations: MPV, mean platelet volume; SEC, spontaneous echocardiographic contrast.