Intracardiac mobile thrombus and D-dimer fragment of fibrin in patients with mitral stenosis.
OBJECTIVE
To investigate the relation between intracardiac thrombus and blood coagulability in patients with mitral stenosis.


METHODS
Prospective study. Cross sectional echocardiography and plasma concentrations of the D-dimer fragment of fibrin were used concurrently to detect intracardiac thrombus in patients with mitral stenosis.


METHODS
Department of Medicine, National Cardiovascular Centre, Osaka, Japan.


METHODS
63 patients with mitral stenosis. None of them had been receiving any anticoagulants or antiplatelet agents.


METHODS
Plasma concentrations of D-dimer in patients with a mobile intracardiac thrombus, those in patients with a non-mobile intracardiac thrombus, and those in patients without an intracardiac thrombus.


RESULTS
A mobile intracardiac thrombus was found in 10 patients and a non-mobile thrombus in eight. The remaining 45 patients had no intracardiac thrombi. Plasma concentrations of D-dimer in the 10 patients with a mobile thrombus were all greater than 300 ng/ml (mean 983.3, 95% confidence interval 498.9 to 1467.7 ng/ml) and they were significantly higher than those in the patients with a non-mobile thrombus (226.2, 33.6 to 418.8 ng/ml) and the patients without an intracardiac thrombus (147.2, 110.4 to 184 ng/ml).


CONCLUSIONS
A high plasma concentration of D-dimer seemed to reflect a hypercoagulable intracardiac state and may be a helpful indicator of the possible presence of mobile intracardiac thrombus in patients with mitral stenosis.
Yasaka
M
M
Department of Medicine, National Cardiovascular Centre, Osaka, Japan.
Miyatake
K
K
Mitani
M
M
Beppu
S
S
Nagata
S
S
Yamaguchi
T
T
Omae
T
T
D000933:Antifibrinolytic Agents / Q000097:blood*; D004452:Echocardiography; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006331:Heart Diseases / Q000097:blood* / Q000000981:diagnostic imaging; D006801:Humans; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000097:blood* / Q000000981:diagnostic imaging; D013927:Thrombosis / Q000097:blood* / Q000000981:diagnostic imaging
D000933:Antifibrinolytic Agents; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D