Systolic tissue velocity is a useful echocardiographic parameter in assessment of left atrial appendage function in patients with mitral stenosis.
BACKGROUND
The incidence of thromboembolism remains high in patients with mitral stenosis (MS). The left atrial appendage (LAA) is a potential site for development of thrombus and LAA dysfunction is an independent predictor of thromboembolism. The LAA dysfunction is represented by reduced LAA late emptying velocity. But the magnitude of LAA flow velocities is dependent on acute changes in loading conditions.


OBJECTIVE
To investigate the value of the LAA tissue velocities obtained by tissue Doppler imaging (TDI) in assessment of LAA function in MS patients with and without thromboembolic events.


METHODS
The study population consisted of 98 isolated MS patients of 32 age and sex-matched healthy controls. All subjects underwent transesophageal echocardiography (TEE). LAA late peak emptying (LAAEV) and filling (LAAFV) flow velocities were recorded. LAA peak late tissue systolic (LSV) and diastolic (LDV) tissue velocities by TDI were measured. The patients were divided into three groups as Group I (n = 38, sinus rhythm and LAAEV > or = 25 cm/s), Group II (n = 26, sinus rhythm and LAAEV < 25 cm/s), and Group III (n = 34, atrial fibrillation).


RESULTS
Twenty-one patients had thromboembolic events. LAAEV, LAAFV, LSV, and LDV were significantly reduced in patients with embolic events. Spontaneous echo contrast (SEC) density was strongly negative correlated with LSV, whereas weakly negative correlated with LAAEV. Multivariate regression analysis showed that LSV and the presence of SEC were independently associated with embolic events.


CONCLUSIONS
LSV seems more reliable and useful parameter in evaluating LAA function. LAA function is more depressed among patients with embolic events.
Cayli
Murat
M
Department of Cardiology, School of Medicine, Cukurova University, Adana 01330, Turkey. drcayli@yahoo.com
Acartürk
Esmeray
E
Demir
Mesut
M
Kanadaşi
Mehmet
M
D000328:Adult; D000704:Analysis of Variance; D020517:Atrial Appendage / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016279:Atrial Function, Left / Q000502:physiology*; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015588:Observer Variation; D012372:ROC Curve; D013599:Systole