Rheumatic mitral valve disease with atrial fibrillation was associated with a significantly larger left atrial appendage maximal area compared to nonrheumatic atrial fibrillation (9.7 vs 5.9 cm2; P<0.001).
Observational (n=119)
Does rheumatic mitral valve disease alter left atrial appendage size and contractile function compared to nonrheumatic cardiovascular conditions?
Rheumatic mitral valve disease is associated with significant enlargement and reduced contractile function of the left atrial appendage, which may contribute to a higher incidence of spontaneous echo contrast and thrombus formation.
Absolute Event Rate: 9.7% vs 5.9%
p-value: p=<0.001
Left atrial thrombi have been considered to be the major source of systemic arterial embolization in patients with rheumatic mitral valve disease. Almost half of the left atrial thrombi are found in the left atrial appendage (LAA). To investigate LAA size and LAA contractile function in patients with rheumatic mitral valve disease, transesophageal echocardiographic and Doppler studies were performed in 61 patients. Among them, 46 patients were in atrial fibrillation (group 1), while the other 15 were in sinus rhythm (group 2). Thirty-six patients with nonrheumatic atrial fibrillation were chosen as control to group 1. Another 22 patients with various cardiovascular diseases and sinus rhythm served as control to group 2. When compared to the patients with nonrheumatic atrial fibrillation (control group), group 1 patients tended to have a larger LAA maximal area (9.7 +/- 5.2 vs. 5.9 +/- 2.8 cm2; p < 0.001). LAA ejection fraction and LAA peak emptying velocity were also lower. A significantly higher incidence of LAA spontaneous echo contrast (SEC) and thrombus formation was also found in these patients. Group 2 patients were also found to have a larger LAA maximal area when compared to the control group (8.8 +/- 3.7 vs. 5.2 +/- 3.0 cm2; p < 0.001). LAA ejection fraction and LAA peak emptying velocity were lower in this group, too. A higher incidence of LAA SEC formation was found in these patients with rheumatic mitral valve disease (4/15 vs. 0/22; p = 0.021). There was no significant difference, however, in LAA thrombus formation between group 2 and its control group (1/15 vs. 1/22; p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
Hwang et al. (Tue,) conducted a observational in Rheumatic mitral valve disease (n=119). Rheumatic mitral valve disease vs. Nonrheumatic atrial fibrillation or other cardiovascular diseases was evaluated on Left atrial appendage (LAA) maximal area in patients with atrial fibrillation (p=<0.001). Rheumatic mitral valve disease with atrial fibrillation was associated with a significantly larger left atrial appendage maximal area compared to nonrheumatic atrial fibrillation (9.7 vs 5.9 cm2; P<0.001).