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Published on: February 26, 2013
Left atrial appendage function in mitral stenosis: is it determined by cardiac rhythm?
Serkan Saygi1, Ugur Onsel Turk, Emin Alioglu
1Central Hospital Department of Cardiology, Izmir, Turkey. serkankard@yahoo.com
The Journal of Heart Valve Disease
|August 26, 2011
Summary
Patients with mitral stenosis (MS) in sinus rhythm (SR) have reduced left atrial appendage (LAA) function, similar to those with atrial fibrillation (AF). This diminished LAA contractile function in MS patients in SR increases their risk of thromboembolic events.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Echocardiography
Background:
- Left atrial appendage (LAA) thrombus formation is common in mitral stenosis (MS), leading to systemic embolism.
- Low LAA flow velocities contribute to thrombosis.
- The role of oral anticoagulants in MS patients with sinus rhythm (SR) regarding LAA function is unclear, unlike in those with atrial fibrillation (AF).
Purpose of the Study:
- To compare left atrial appendage (LAA) contractile functions in patients with mitral stenosis (MS) in sinus rhythm (SR) versus atrial fibrillation (AF).
- To assess the risk of thromboembolic events in MS patients with SR.
Main Methods:
- 51 patients with MS underwent transthoracic and transesophageal echocardiography.
- Patients were divided into two groups: SR and AF.
- Ten healthy individuals served as a control group.
Main Results:
- LAA contractile functions were significantly lower in both MS groups (SR and AF) compared to controls.
- LAA contractile function was significantly diminished in the SR group compared to the AF group (p<0.002).
- A strong correlation was found between mitral valve area (MVA) and LAA peak emptying/filling velocity in MS patients in SR (r=0.739, p<0.0001).
Conclusions:
- Moderate-to-severe MS in SR is associated with diminished LAA contractile function, comparable to that seen in AF.
- Patients with moderate-to-severe MS in SR exhibit an elevated risk for thromboembolic events.
- Further investigation into anticoagulation strategies for MS patients in SR is warranted.
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