Predictive factors of systemic embolism in patients with mitral stenosis in sinus rhythm.
BACKGROUND
Systemic embolism is one of the major complications in patients with mitral stenosis (MS) who are in atrial fibrillation; however, this serious complication can also occur in patients with MS in sinus rhythm.


OBJECTIVE
The purpose of the present study was to identify the predictive factors of systemic emboli in patients with MS in sinus rhythm.


METHODS
Twenty patients with MS in sinus rhythm with recent cerebral embolism and 32 with MS in sinus rhythm without any history of systemic embolism were studied between January 2004 and May 2006. Clinical and echocardiographic data were assessed using stepwise logistic regression for prediction of systemic embolism.


RESULTS
Age (odds ratio [OR], 1.14; 95% confidence interval [CI] 1.04-1.26) and left atrial spontaneous echo contrast (LASEC) grade 3+ and 4+ (OR, 46.42; 95% CI, 5.00-436.49) were associated with, and predictive of systemic emboli, whereas left atrial appendage contraction flow velocities, left atrial size and mitral valve area were not.


CONCLUSIONS
The present study demonstrates that age and LASEC are the major predictive factors of systemic embolism in patients with MS in sinus rhythm. It would therefore be prudent to give anticoagulants to patients in atrial fibrillation as well as to those in sinus rhythm at risk of systemic embolism.
Kiatchoosakun
Songsak
S
Division of Gardiology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. sonkia@kku.ac.th
Wongvipaporn
Chaiyasith
C
Silaruks
Songkwan
S
Tatsanavivat
Pyatat
P
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation; D003430:Cross-Sectional Studies; D005260:Female; D006305:Health Status Indicators; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D012307:Risk Factors; D013923:Thromboembolism / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D014463:Ultrasonography