title: Association of Left Atrial Spontaneous Echo Contrast to Uric Acid in Patients with Mitral Stenosis.
abstract: OBJECTIVE
  Spontaneous echo contrast (SEC) is the presence of smoke-like echoes with a characteristic swirling motion of the blood in echocardiography. Previous clinical studies have shown that SEC is a risk factor for left atrial thrombus formation and a predictor of potential systemic embolism originating from the heart. There is an association between uric acid and prothrombotic state. Therefore, we aimed to investigate the role of uric acid in SEC in patients with mitral stenosis (MS).
  
  
  METHODS
  A total of 85 consecutive patients with MS were enrolled in the study. Patients were divided into two groups according to whether SEC was present in the left atrium.
  
  
  RESULTS
  There were 41 patients (mean age 46.4 ± 11.4 and 68% female) in the SEC(-) group and 44 patients (mean age 45.7 ± 7.2 and 64% female) in the SEC(+) group. High sensitive C-reactive protein (hs-CRP) levels were significantly higher in the SEC(+) group than in the SEC(-) group (9.5 ± 4.2 vs. 4.7 ± 2.2 mg/L, P < 0.001). Uric acid was also significantly higher in the SEC (+) group (6.3 ± 1.4 vs. 4.5 ± 1.3 mg/dL, P < 0.001). In receiver operating characteristics curve analysis, uric acid >5.2 mg/dL had a 73% sensitivity and 76% specificity in predicting SEC in patients with MS. At multivariate analysis, uric acid (OR 3.919, 95% CI 1.911-8.035; P < 0.002) was an independent risk factor for SEC in patients with MS.
  
  
  CONCLUSIONS
  Uric acid is independently associated with SEC in patients with MS. Our findings suggest that this inexpensive, universally available marker may be a useful biomarker for the stratification of risk in patients with MS.
authors: Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey.|Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey.
authors: Mahmut
authors: M
authors: Akpek
authors: Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey.|Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey.
authors: Omer
authors: O
authors: Sahin
authors: Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey.
authors: Bahadir
authors: B
authors: Sarli
authors: Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey.
authors: Huseyin
authors: H
authors: Arinc
authors: Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey.
authors: Ahmet O
authors: AO
authors: Baktir
authors: Department of Radiology, Erciyes University School of Medicine, Kayseri, Turkey.
authors: Zeynep S
authors: ZS
authors: Akpek
authors: Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey.
authors: Hayrettin
authors: H
authors: Saglam
authors: Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey.
authors: Ali
authors: A
authors: Ergin
authors: Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey.
authors: Mehmet G
authors: MG
authors: Kaya
mesh_terms: D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000097:blood* / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D014527:Uric Acid; D002097:C-Reactive Protein
keywords: mitral stenosis; spontaneous echo contrast; uric acid