title: Color Doppler tissue imaging to evaluate left atrial appendage function in patients with mitral stenosis in sinus rhythm.
abstract: Two-dimensional color Doppler tissue imaging (CDTI) has so far been used, in general, to evaluate ventricular function. In this study, the left atrial appendage (LAA) tissue velocity was measured by CDTI. LAA function in 38 patients with mitral stenosis in sinus rhythm (SR) and 19 healthy subjects undergoing transesophageal echocardiography were examined by CDTI. Systolic tissue appendage velocity (SaV, m/s) was measured at the tip of the LAA in the basal short-axis view. LAA emptying (LAAEV) and filling (LAAFV) velocities (m/s) were also recorded 1 cm below the orifice of the appendage. LAA ejection fraction was also measured. In addition, two-dimensional imaging was used to determine the presence of thrombus and/or spontaneous echo contrast (SEC). Patients with mitral stenosis in SR had significantly decreased LAAEV, LAAFV, SaV, and LAA ejection fraction compared to controls (0.34 +/- 0.15 vs 0.72 +/- 0.17, 0.37 +/- 0.13 vs 0.63 +/- 0.19, 0.050 +/- 0.015 vs 0.071 +/- 0.093, and 39 +/- 14% vs 69 +/- 13%, respectively, P < 0.001, P < 0.001, P < 0.001, and P < 0.001). Among the patients with mitral stenosis in SR, 10 patients had SEC and one had LAA thrombus. Compared with patients without SEC, patients with SEC had decreased LAAEV, LAAFV, SaV, and LAA ejection fraction (0.24 +/- 0.05 vs 0.37 +/- 0.16, 0.29 +/- 0.05 vs 0.39 +/- 0.14, 0.039 +/- 0.087 vs 0.055 +/- 0.015, and 28 +/- 14% vs 43 +/- 12%, respectively, P = 0.01, P = 0.02, P = 0.01, and P = 0.006). In conclusion, these results suggest that the LAA dysfunction may occur in patients with mitral stenosis in SR and CDTI can successfully be used for the quantification of contraction at the tip of the LAA.
authors.affiliation: Department of Cardiology, Erciyes University, Medical Faculty, Kayseri, Turkey. topsakal@erciyes.edu.tr
authors.forename: Ramazan
authors.initials: R
authors.lastname: Topsakal
authors.forename: Namik Kemal
authors.initials: NK
authors.lastname: Eryol
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ozdoğru
authors.forename: Ergün
authors.initials: E
authors.lastname: Seyfeli
authors.forename: Adnan
authors.initials: A
authors.lastname: Abaci
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Oğuzhan
authors.forename: Emrullah
authors.initials: E
authors.lastname: Başar
authors.forename: Ali
authors.initials: A
authors.lastname: Ergin
authors.forename: Servet
authors.initials: S
authors.lastname: Cetin
mesh_terms: D000328:Adult; D020517:Atrial Appendage / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016279:Atrial Function, Left / Q000502:physiology*; D016022:Case-Control Studies; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology*