title: Mitral annular systolic velocity reflects the left atrial appendage function in mitral stenosis.
abstract: BACKGROUND
  Left atrial appendage (LAA) dysfunction is an independent predictor of thromboembolism in mitral stenosis (MS).
  
  
  OBJECTIVE
  To investigate whether there is a relation between annular velocities obtained by tissue Doppler imaging and LAA function and to determine if the annular velocities can predict the presence of the inactive LAA in MS.
  
  
  METHODS
  Eighty-five MS patients and 80 healthy controls were evaluated by transthoracic echocardiography and all patients underwent transesophageal echocardiography. The annular systolic (S-wave) and diastolic (E- and A-waves) velocities were recorded. Inactive LAA was defined as LAA emptying velocity <25 cm/sec. Patients were divided into three groups; group I (n = 43): sinus rhythm (SR) and LAA emptying velocity > or =25 cm/sec, group II (n = 15): SR and LAA emptying velocity <25 cm/sec and group III (n = 27): atrial fibrillation.
  
  
  RESULTS
  Thrombus was detected in 12 patients and spontaneous echo contrast (SEC) was detected in 48 patients. Both S-wave and peak LAA emptying velocities were decreasing, while SEC frequency and density were increasing from group I to group III. There was a positive correlation between LAA emptying and S-wave velocities (P < 0.001, r = 0.682). Multivariate regression analysis showed that only S-wave is the independent predictor of inactive LAA (P = 0.001, odds ratio = 0.143, 95% CI = 0.047-0.434). In patients with SR, the cutoff value of S-wave was 13.5 cm/sec for the prediction of the presence of inactive LAA (sensitivity: 95.3%, specificity: 93.3%).
  
  
  CONCLUSIONS
  S-wave is an independent predictor of inactive LAA and a useful parameter in estimating inactive LAA in MS with SR.
authors.affiliation: Department of Cardiology, Cukurova University, School of Medicine, Adana, Turkey. drcayli@yahoo.com
authors.forename: Murat
authors.initials: M
authors.lastname: Caylý
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kanadaşi
authors.forename: Mesut
authors.initials: M
authors.lastname: Demir
authors.forename: Esmeray
authors.initials: E
authors.lastname: Acartürk
mesh_terms: D000328:Adult; D020517:Atrial Appendage / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016279:Atrial Function, Left / Q000502:physiology*; D015150:Echocardiography, Doppler / Q000379:methods*; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D009200:Myocardial Contraction / Q000502:physiology*; D012720:Severity of Illness Index; D013599:Systole