Chest
Clinical InvestigationsLeft Atrial Spontaneous Echo Contrast in Patients With Rheumatic Mitral Valve Disease in Sinus Rhythm: Implication of an Altered Left Atrial Appendage Function in Its Formation
Section snippets
Study Patients
A total of 39 patients with rheumatic mitral valve disease in sinus rhythm who were admitted to the National Taiwan University Hospital from January to December 1993 were enrolled in this study. Their diagnosis of rheumatic mitral valve disease was based on clinical, electrocardiographic, roentgenologic, and echocardiographic examinations. All patients underwent cardiac catheterization studies. Four patients had undergone xenograft replacement at the mitral position and had developed xenograft
Clinical, Echocardiographic, and Hemodynamic Characteristics
The LA spontaneous echo contrast was detected in 17 (43.6%) of the 39 patients with rheumatic mitral valve disease in sinus rhythm by transesophageal echocardiography; none was detected by transthoracic echocardiography (p<0.001). All the spontaneous echo contrasts were present concomitantly in the LA and in the LA appendage. No spontaneous echo contrast in the LA appendage alone was observed. Of the 17 patients with spontaneous echo contrast (group 1), 2 were found also to have LA thrombus;
Discussion
The present transesophageal echocardiographic study found LA spontaneous echo contrast in 43.6% of 39 patients with rheumatic mitral valve disease in sinus rhythm. This incidence was lower than in patients who had similar mitral valve lesions, but in atrial fibrillation (32 of 36 patients, 88%) as previously reported from this country.10 Interestingly, however, the spontaneous echo contrast in these patients was found concomitantly in the LA cavity and in the LA appendage; two of those with
Acknowledgment
The authors thank Miss Mei-Huei Feng and Miss Yu-Hui Liu for their continuing help in the echocardiography laboratory.
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Cited by (28)
Role of LA Shape in Predicting Embolic Cerebrovascular Events in Mitral Stenosis: Mechanistic Insights From 3D Echocardiography
2014, JACC: Cardiovascular ImagingCitation Excerpt :These findings demonstrate the role of pathological LA remodeling pattern in predicting ECE. In patients with MS, several studies have demonstrated that LA enlargement is a marker of increased thromboembolic risk (4,6,7,9,11,25,26). However, the great majority of studies considered LA size or volume as an indicator of risk.
The left atrial appendage: Anatomy, function, and noninvasive evaluation
2014, JACC: Cardiovascular ImagingCitation Excerpt :Absence of color flow in the LAA’s distal tip or side lobes may indicate the absence of flow because of the lack of filling from a thrombus. Although a decrease in LAA function has been demonstrated in patients with AF, atrial flutter, or SR (50,53,55,61), its significance has been widely evaluated only in the setting of AF. In patients in SR, the presence of SEC has a greater association with stroke risk than reduced LAA emptying velocities (62).
Usefulness of left atrial volume versus diameter to assess thromboembolic risk in mitral stenosis
2010, American Journal of CardiologyCitation Excerpt :LA size in an important prognostic marker in various diseases such as atrial fibrillation, mitral regurgitation, and coronary artery disease.7,18,19 In patients with MS, several studies have shown that LA diameter is a marker of increased thromboembolic risk,5,15 whereas opposite results have been reported by others.20,21 LA size, as assessed by a single diameter, has indeed a limited accuracy as apparent in our study.
Haematologic determinants of left atrial spontaneous echo contrast in mitral stenosis
2001, International Journal of CardiologyLeft atrial spontaneous echo contrast in patients with rheumatic mitral valve stenosis in sinus rhythm: Relationship to mitral valve and left atrial measurements
2001, International Journal of Cardiology
This study was supported by the following grants: NSC 82-0115-B002-481 from National Science Council, Executive Yuan, ROC, and NTUH-84212-B34 from the National Taiwan University Hospital.
Manuscript revision accepted November 14.