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Left atrial size--a risk factor for left atrial thrombi in mitral stenosis

C Conradie1, R Schall, J D Marx

  • 1Department of Cardiology, University of the Orange Free State, Bloemfontein, South Africa.

Clinical Cardiology
|September 1, 1995
PubMed

Insights

Left atrial enlargement, defined as a size of 4.8 cm or greater, significantly increases the risk of left atrial thrombi in patients with mitral stenosis. This finding highlights a key factor in managing this cardiovascular condition.

Area of Science:

  • Cardiology
  • Cardiovascular Research

Background:

  • Mitral stenosis is a significant valvular heart disease.
  • Left atrial (LA) thrombi are a known complication, increasing embolic risk.
  • The specific role of LA enlargement in thrombus formation requires further elucidation.

Purpose of the Study:

  • To investigate the association between left atrial enlargement and the presence of left atrial thrombi in patients with mitral stenosis.
  • To identify left atrial size as an independent risk factor for left atrial thrombi.

Main Methods:

  • A follow-up study involving 77 patients with predominant mitral stenosis.
  • Echocardiographic assessment of left atrial size.
  • Correlation analysis between left atrial size, heart rhythm, and presence of left atrial thrombi.

Main Results:

  • Fifteen patients (19.4%) had left atrial thrombi.
  • A left atrial size of >= 4.8 cm was observed in 93.3% of patients with thrombi.
  • The median left atrial size was significantly larger in patients with thrombi (5.2 cm) compared to those without (4.75 cm; p < 0.01).
  • A left atrial size >= 4.8 cm conferred a 10-fold increased relative risk for left atrial thrombi.

Conclusions:

  • Left atrial enlargement, specifically a size >= 4.8 cm, is an independent risk factor for left atrial thrombi in mitral stenosis patients.
  • Atrial fibrillation was prevalent in patients with left atrial thrombi.
  • These findings underscore the importance of assessing left atrial size in risk stratification for mitral stenosis.

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