DOI: 10.36347/sjams.2022.v10i04.016

Pages: 531-535

Background: Mitral stenosis (MS) is a prevalent kind of valvular heart disease. Thromboembolism is one of the most severe complications, particularly when it is accompanied with atrial fibrillation (AF). When associated with Left atrial appendage (LAA) dysfunction, patients with sinus rhythm (SR) are also at risk for this condition. In mitral stenosis, LAA dysfunction is an independent predictor of thromboembolism. The aim of the study was to see if there is an association between mitral annular velocities measured with Doppler tissue imaging (DTI) and LAA function measured with transesophageal echocardiography (TEE), and to see if annular velocities can predict the presence of an inactive LAA in MS. Methods: This was an observational study carried out by the department of cardiology of the National Institute of Cardiovascular Diseases (NICVD). From January 2006 to December 2007, 60 MS patients were evaluated using transthoracic echocardiography and transesophageal echocardiography. The systolic (S-wave) and diastolic (Em- and Am-waves) annular velocities were measured. Inactive LAA was defined as a velocity of <25 cm/sec for LAA emptying. Patients were divided into three groups. Group A (I) (n = 18): Sinus rhythm (SR) and LAA emptying velocity ≥25 cm/sec, group A (II) (n =22): SR and LAA emptying velocity <25cm/sec and group B (n = 20): atrial fibrillation. Results: Thrombus was found in 14 patients, and spontaneous echo contrast (SEC) was found in 43. From group A to group B, S-wave and peak LAA emptying velocities decreased while SEC frequency and density increased. There was a positive correlation between LAA emptying versus S-wave & Am wave velocity (p<0.001, r= 0.708 and p<0.001, r=0.495, respectively). Only S-wave was found to be an independent predictor of inactive LAA in multivariate regression analysis (p = 0.001, odds ratio = 0.133, 95%ci =0.032-0.556). The cutoff value of S-wave in patients with SR for predicting the presence of inactive LAA was.........