Left Atrial Spontaneous Echo Contrast in Patients With Rheumatic Mitral Valve Disease in Sinus Rhythm

Li, Yi‐Heng; Hwang, Juey-Jen; Ko, Yu‐Lin; Lin, Jia Wei; Tseng, Yung Zu; Kuan, Peiliang; Lien, Wen-Pin

doi:10.1378/chest.108.1.99

Cited by 30 publications

(26 citation statements)

References 14 publications

(3 reference statements)

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“…The relationship between SEC and EF has been investigated in MS patients with SR in previous studies, but it was not found to be any significant. 1,11,22 In our study, EF was not an independent predictor for SEC.…”

Section: Discussioncontrasting

confidence: 72%

“…1 -3,5,9,11 -16,22 However, most of these studies included heterogeneous group consisting of both SR and AF and associated with mitral regurgitation. 1 -3,5,9,12 -16 Although those studies have demonstrated that LA size is related to the presence of SEC, 1,2,13,14 such a relationship was not observed in patients with pure MS and SR. 11,16,22 We also found that LA size was not an independent predictor for SEC in MS FIG. 2 The ROC curve of annular systolic velocity for predicting the presence of any SEC in patients.…”

Section: Discussionmentioning

confidence: 58%

“…1,2,8,11,16,23,24 Li et al 11 evaluated 39 MS patients with SR. They found that the patients with SEC had smaller MVA and higher MG than those without SEC; but LA size, EF, age and gender were similar.…”

Section: Discussionmentioning

confidence: 99%

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Annular Systolic Velocity Predicts the Presence of Spontaneous Echo Contrast in Mitral Stenosis Patients with Sinus Rhythm

Çaylı¹,

Acartürk²,

Kanadaşı³

et al. 2007

Clinical Cardiology

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SummaryOjectives: Thromboembolism is the major cause of morbidity and mortality in mitral stenosis (MS), even in sinus rhythm (SR). Spontaneous echo contrast (SEC) is the strongest predictor of thromboembolism. The aim of the study was to investigate if the annular velocities obtained with tissue Doppler imaging can predict the presence of SEC in MS patients with SR.Methods: One hundred and five MS patients and 100 controls were included. Annular velocities were recorded. All patients underwent transesophageal echocardiography. Subjects were divided into three groups as controls (Group I), the patients without SEC (Group II) and the patients with SEC (Group III).Results: Group III patients had lower ejection fraction, annular systolic velocity, smaller mitral valve area, higher transmitral gradient and larger left atrial size. The annular systolic velocity was the only independent predictor for SEC. The cutoff values of annular systolic velocity for prediction of the presence of any SEC and dense SEC were 13.5 and 11.8 cm/s, respectively.Conclusion: The annular systolic velocity is an independent predictor for SEC in MS patients with SR.

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Section: Discussioncontrasting

confidence: 72%

Section: Discussionmentioning

confidence: 58%

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Annular Systolic Velocity Predicts the Presence of Spontaneous Echo Contrast in Mitral Stenosis Patients with Sinus Rhythm

Çaylı¹,

Acartürk²,

Kanadaşı³

et al. 2007

Clinical Cardiology

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“…Leung et al24) examined 88 consecutive patients with mitral stenosis and found a 74% prevalence of left atrial SEC which was associated with a smaller mitral valve area and atrial fibrillation. Left atrial SEC can be found even in patients with a normal sized left atrium and in sinus rhythm.16,25) Li et al 25) found left atrial SEC in 43.6% of 39 patients with rheumatic mitral valve disease in sinus rhythm. We found 34.1% of 91 patients with sinus rhythm had left atrial SEC.…”

Section: Discussionmentioning

confidence: 98%

Thromboembolism Risk in Patients with Mitral Stenosis.

et al. 1997

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SUMMARYA total of 168 consecutive patients with predominant rheumatic mitral stenosis were evaluated by transthoracic (TTE) and transesophageal echocardiography (TEE). Of the 168 patients, 35 had previous embolic events (group I) and 133 had no emboli (group II). A total of 77 (45.8%) patients had atrial fibrillation. The frequency of atrial fibrillation was higher in group I than group II (68.6% vs 39.8%, p<0.001). The incidence of left atrial enlargement was greater in group I (p<0.001). Mitral valve area was found to be smaller in group I compared to group II (p<0.001). In group I 83.3% and 29.2% of the patients with atrial fibrillation had left atrial spontaneous echo contrast (SEC) and left atrial thrombus, respectively, and 72.7% of the patients with sinus rhythm had left atrial SEC. In group II 79.2% and 20.8% of the patients with atrial fibrillation had left atrial SEC and left atrial thrombus whereas 28.6% and 2.6% of the patients with sinus rhythm had left atrial SEC and left atrial thrombus, respectively. The incidence of left atrial thrombus was significantly different in those patients with compared to those without embolic events (20% vs 9.7%, p<0.01). In groups I and II, 28 of 35 (80%) and 64 of 133 (48.1%) patients had left atrial SEC (p<0.01). Patients with left atrial SEC had a greater left atrial size (p<0.01) and smaller mitral valve area (p<0.01). Left atrial size was normal in 2 patients with left atrial SEC and SEC was not found in 55 patients with enlarged left atrium. Multiple logistic regression analysis showed that atrial fibrillation, mitral valve area and left atrial enlargement were independent predictors of the SEC (p<0.001) and left atrial SEC was the principal determinant of thromboembolism.These data suggest that regardless of rhythm and atrial size, left atrial SEC is a principal determinant of thromboembolic risk in mitral stenosis. TEE may be able to detect those patients with mitral stenosis at risk for emboli and guide appropriate therapy. (Jpn Heart J 1997; 38: 669-675)

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“…Some of the studies identified only the MVA as a predictor of LA thrombus formation [35,36]. Kasliwal et al [9] investigated the predictors of spontaneous echo contrast (SEC) in patients with MS and SR, and they demonstrated an association between SEC and smaller MVA, larger LA, and higher mean diastolic mitral pressure gradient.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of the uric acid and CHA2DS2-VASc score in prediction of left atrial thrombosis in patients with mitral stenosis and sinus rhythm

et al. 2015

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Background: The risk of thrombus formation in the left atrium is known to be very high in patients with both mitral stenosis (MS) and atrial fibrillation (AF). However, that risk should not be ignored in patients with MS in sinus rhythm (SR). The aim of this study was to determine the clinical, echocardiographic, and biochemical factors that could have a determining role in the formation of a left atrial (LA) thrombus in patients with MS in SR. Method: A total of 207 consecutive patients with MS who underwent both transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) for diagnosis or to MS in SR. (Cardiol J 2015; 22, 3: 336-342)

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Left Atrial Spontaneous Echo Contrast in Patients With Rheumatic Mitral Valve Disease in Sinus Rhythm

Cited by 30 publications

References 14 publications

Annular Systolic Velocity Predicts the Presence of Spontaneous Echo Contrast in Mitral Stenosis Patients with Sinus Rhythm

Annular Systolic Velocity Predicts the Presence of Spontaneous Echo Contrast in Mitral Stenosis Patients with Sinus Rhythm

Thromboembolism Risk in Patients with Mitral Stenosis.

Usefulness of the uric acid and CHA2DS2-VASc score in prediction of left atrial thrombosis in patients with mitral stenosis and sinus rhythm

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