Key result
Atrial fibrillation was significantly associated with left atrial thrombus compared to sinus rhythm in tight rheumatic mitral stenosis (60.5% vs 39.5% of thrombus cases; p<0.0001).
Why the study?
What are the clinical and echocardiographic predictors of left atrial thrombus in patients with tight rheumatic mitral stenosis?
Observational (n=250)
What are the clinical and echocardiographic predictors of left atrial thrombus in patients with tight rheumatic mitral stenosis?
Absolute Event Rate: 60.5% vs 39.5%
p-value: p=<0.0001
Atrial fibrillation is a strong clinical predictor of left atrial thrombus in tight rheumatic mitral stenosis, and TEE is superior to TTE for its detection.
Supports heightened thrombus vigilance in AF with tight rheumatic MS; leaves open prospective validation of predictors.
Results: Two hundred and fifty consecutive patients having tight rheumatic mitral stenosis were studied. The mean age of the study population was 26.9 ± 7.5 years. There were more female 128 (51.2%) patients than males 122 (48.8%). Atrial fibrillation (AF) was present less frequently in the study as 33 (13.2%) patients had AF as compared to 217 (86.8%) patients having sinus rhythm. AF was more significantly associated with thrombus formation with 23 (60.5%) patients having thrombus as compared to 15 (39.5%) patients in sinus rhythm having thrombus p < 0.0001. Thrombus in LA was more commonly visualized on TEE as compared to TTE (X 2 =242.3, p=0.0001) and was mostly detected in left atrial appendage (X 2 =211.2, p=0.0001). Spontaneous echo contrast was visualized more frequently on TEE as compared to TTE in both the groups p<0.001.
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Ali et al. (2009) conducted an observational in Rheumatic Mitral Stenosis (n=250). Atrial fibrillation vs. Sinus rhythm was evaluated on Left atrial thrombus formation (p=<0.0001). Atrial fibrillation was significantly associated with left atrial thrombus compared to sinus rhythm in tight rheumatic mitral stenosis (60.5% vs 39.5% of thrombus cases; p<0.0001).
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