title: Left atrial appendage functions in patients with severe rheumatic mitral regurgitation.
abstract: OBJECTIVE
  The left atrial appendage (LAA) function was evaluated in patients with severe rheumatic mitral regurgitation, having sinus rhythm or atrial fibrillation, by standard and tissue Doppler echocardiographic examinations.
  
  
  RESULTS
  Sixty patients with rheumatic severe mitral regurgitation were enrolled. The patients (14 females and 6 males) having sinus rhythm were selected as group I and 20 patients (15 females and 5 males) with atrial fibrillation formed group II. 20 healthy subjects (15 female and 5 males) served as the control group (group III). In order to determine the LAA functions, LAA peak filling flow velocity (LAAPFV), LAA peak emptying flow velocity (LAAPEV) and percentage of LAA area change (LAAAC %) were measured. In the TDI records of the subjects with sinus rhythm, the first positive wave identical to the LAA late emptying wave (LEW) following the P-wave was accepted as LAA late systolic wave (LSW), and the second negative wave identical to the LAA late filling flow was accepted as late diastolic wave (LDW). In patients with atrial fibrillation, the positive wave was accepted as LAA late systolic wave (LSW), and the second negative wave identical to the LAA late filling flow was accepted as late diastolic wave (LDW). LAA outflow and inflow velocities were lower in the group having atrial fibrillation (P < 0.002, and P < 0.007, respectively). LAAAC% was also reduced in group II (P < 0.0001). The pulsed Doppler LSW and LDW velocities, measured with TDI method were found to be quite reduced in patients with AF (P: 0.002 and P: 0.001, respectively). The study parameters were statistically similar in patients with normal sinus rhythm and controls.
  
  
  CONCLUSIONS
  In this study, we found that the LAA functions are impaired in patients with severe mitral regurgitation, having AF, whereas preserved in patients with normal sinus rhythm, compared to controls.
authors.affiliation: Department of Cardiology, Kartal Koşuyolu Yüksek Ihtisas Research Hospital, Denizer Str, kartal-Cevizli, Istanbul, 80840, Turkey. bitigen@yahoo.com
authors.forename: Atila
authors.initials: A
authors.lastname: Bitigen
authors.forename: Mustafa
authors.initials: M
authors.lastname: Bulut
authors.forename: Ali C
authors.initials: AC
authors.lastname: Tanalp
authors.forename: Cevat
authors.initials: C
authors.lastname: Kirma
authors.forename: Irfan
authors.initials: I
authors.lastname: Barutçu
authors.forename: Selcuk
authors.initials: S
authors.lastname: Pala
authors.forename: Ayhan
authors.initials: A
authors.lastname: Erkol
authors.forename: Bilal
authors.initials: B
authors.lastname: Boztosun
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D020517:Atrial Appendage / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016275:Atrial Function / Q000502:physiology; D001783:Blood Flow Velocity; D016009:Chi-Square Distribution; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012214:Rheumatic Heart Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology