Key result
Higher sVCAM-1 tracks with left atrial thrombosis in mitral stenosis, but AF and MVA drive risk.
Why the study?
The relationship between soluble adhesion molecules sICAM-1 and sVCAM-1 and left atrial thrombosis gradation in mitral stenosis was unknown.
Cross-Sectional (n=39)
No
Answers are grounded in this paper and cite their sources.
sVCAM-1 tracks left atrial thrombosis severity in mitral stenosis but lacks independent association; leaves open its added value beyond AF and MVA.
Background.The relationship between inflammation and coagulation has been widely described, which adhesion molecules play important role in inflammation.Soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) seem to be related to thrombosis in few previous studies.The level of those molecules were increased in mitral stenosis (MS), however their relationship with left atrial thrombosis gradation is still unknown.Methods.Patients with moderate-severe MS (without any significant mitral regurgitation) who underwent transesophageal echocardiography were recruited consecutively in September-October 2013.They were divided into 3 categories of left atrial thrombosis gradation: non-thrombus without dense left atrial spontaneous echo contrast (LASEC) group, and non-thrombus with dense LASEC group, and thrombus group.Results.A total of 39 subjects were enrolled in the study with a mean age of 40.97±9.61year.Moreover, 71.8% of them were female and 67.7% of them had atrial fibrillation (AF).Evaluation on left atrial thrombosis gradation as mentioned above showed that sICAM-1 levels were 284.74 (218.79-321.00)ng/mL, 346.86 (125.68-698.12)ng/mL, and 395.93 (171.44-1021.53)ng/mL, consecutively (p=0.280).While sVCAM-1 levels gradually increased based on those groups consecutively: 729.01 (543.93-967.80)ng/mL, 1066.00 (581.36-2470.60)ng/mL, and 1158.00 (668.66-2498.30)ng/mL (p=0.016).Multivariate analysis showed that AF and mitral valve area (MVA) influence thrombosis gradation.Conclusion.Difference in sVCAM-1 levels were found among left atrial thrombosis gradation groups in mitral stenosis, but its effect on thrombosis gradation was influenced by AF and MVA.
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Elen et al. (2016) conducted a cross-sectional in Mitral Stenosis (n=39). sICAM-1 and sVCAM-1 levels vs. Left atrial thrombosis gradation groups (non-thrombus without dense LASEC, non-thrombus with dense LASEC, thrombus) was evaluated on Difference in sVCAM-1 levels among left atrial thrombosis gradation groups (p=0.016). While sVCAM-1 levels significantly increased across left atrial thrombosis gradations in mitral stenosis (p=0.016), multivariable analysis showed thrombosis was independently driven by AF and MVA.
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