Key result
AF in severe mitral stenosis is linked to ~84% higher LA/LAA thrombus rate versus sinus rhythm.
Why the study?
The interrelationship between rhythm, left atrial size, and thrombus formation in patients with mitral stenosis was studied to better understand their associations.
Observational (n=176)
No
Absolute Event Rate: 48.48% vs 26.36%
p-value: p=0.003
Atrial fibrillation in severe mitral stenosis is strongly associated with left atrial enlargement and thrombus formation, which are better detected by TEE than TTE.
May inform thrombus risk assessment in mitral stenosis; leaves open validation in prospective cohorts.
Objectives: To study the Interrelationship between rhythm, left atrial size and thrombus formation in patients with mitral stenosis. Methodology: This observational study was conducted in cardiology department LRH Peshawar, from February to December 2011. Every patient with severe mitral stenosis presenting for PTMC was evaluated before procedure for spontaneous echo-contrast, left atrial size, LA/LAA thrombus and its types on TTE and TEE. Baseline ECG of each patient was taken. Results: A total of 176 patients with mitral stenosis were divided into 110 patients in group I having sinus rhythm and 66 patients in group II having atrial fibrillation. In group I, 40 (36.36%) were males compare to group II having 14 (21.21%). Mean age of patient in group I was 33.13 years ± 13.82 as compared to 30.97± 8.86 years in group II. In group I, 29 (26.36%) had LA/LAA thrombus as compared to 32(48.48%) in group II on TEE(p-value=0.003). In group I, 60(54.54%) patients had spontaneous echo contrast as compared to 58(87.87%) in group II on TEE ( p-value=0.000). Mean left atrial size in group I was 4.2±0.52cm as compared to 5.3±0.71cm in group II ( p-value=0.000). In patients with AF, LA/LAA thrombus was visualized in 10 (15.15%) on TTE as compared to 32(48.48%) on TEE(p value=0.001). Conclusion: Atrial fibrillation is frequently associated with left atrial enlargement and thrombus formation in patients with mitral stenosis. The accessibility of the left atrial appendage by TEE is better than TTE in detection of thrombi.
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Zeb et al. (2012) conducted an observational in Severe mitral stenosis (n=176). Atrial fibrillation vs. Sinus rhythm was evaluated on LA/LAA thrombus on TEE (p=0.003). Atrial fibrillation in patients with severe mitral stenosis was associated with a higher rate of LA/LAA thrombus on TEE compared to sinus rhythm (48.48% vs 26.36%; p=0.003).
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