DOI: http://dx.doi.org/10.18203/2349-2902.isj20201011

Factors responsible for left atrial clot formation in patients with mitral stenosis and normal sinus rhythm

Pranay Suresh Mehsae, Mohammad Abid Geelani, Sayyad Ehtesham Hussain Naqui, Soumyaranjan Das

Abstract


Background: The objective of the study was to investigate the factors responsible for left atrial (LA) clot formation in patients with mitral valve stenosis in normal sinus rhythm.

Methods: 79 patients (43 males and 36 females) were included in the study. 9 patients with mitral stenosis in normal sinus rhythm had LA clot or LA smoke in echocardiography included in Group A and rest of 70 patients in Group B. LA size, gradient across mitral valve and mitral valve surface area was studied and compared in patients with or without LA clot/smoke.

Results: Mean LA size was 4.8 (±0.5) and 4.6 (±0.7) in group A and B respectively with (p=0.304) and mean valve gradient was 11.6 (±2.8) and 10.6 (±3.5) in group A and B respectively with (p=0.507), the difference was not significant in both. Mean mitral valve area was 1.01 (±0.3) and 1.12 (±0.5) in group A and B (p=0.36), the difference was not significant.

Conclusions: Study concluded that there was no significant difference in LA size, valve gradient and mitral valve area in patients with or without LA clot having mitral valve stenosis in normal sinus rhythm. Patients with LA clot warrant measures to prevent thromboembolic episodes.


Keywords


LA clot, LA size, Mitral valve, Mitral valve area

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References


Thomas JD, Bonow RO. Mitral valve disease. In Braunwalds Heart Disease. Elsevier. 11th edition. 2018: 1415-1444.

Goswami KC, Yadav R, Rao MB, Bhal VK, Talwar KK, Manchanda SC. Clinical and echocardiographic predictors of left atrial clot and spontaneous echo contrast in patients with severe rheumatic mitral stenosis: a prospective study in 200 patients by transesophageal echocardiography. Int J Cardiol. 2000;73:273-9.

Li YH, Hwag JJ, Ko YL, Lin JL, Tseng YZ, Kuan P, et al. Left atrial spontaneous echo contrast in patients with rheumatic mitral valve disease in sinus rhythm: implication of an altered left atrial appendage function in its formation. Chest. 1995;108:99-103.

Agarwal AK, Venugopalan P. Left atrial spontaneous echo contrast in patients with rheumatic mitral valve stenosis in sinus rhythm: relationship to mitral valve and atrial measurements. Int J Cardiol. 2001;77:63-8.

Acartur K, Usal A, Demir M, Akgul F, Ozeren A. Thromboembolism risk in patients with mitral stenosis. Jpn Heart J. 1997;38:669-75.

Torrecilla GE, Fernandez MA, David E, Bermejo J, Moreno M, Delcan JL. Predictors of left atrial spontaneous echo contrast and thrombi in patients with mitral stenosis and atrial fibrillation. Am J Cardiol. 2000;86:529-34.

Bernstein NE, Demopoulous LA, Tunick PA, Rosenzweig BP, Kronzon I. Correlates of spontaneous echo contrast in patients with mitral stenosis and normal sinus rhythm. Am Heart J. 1994;128:287-92.

Saidi SJ, Motamedi MHK. Incidence and factors influencing left atrial clot in patients with mitral stenosis and normal sinus rhythm. Heart. 2004;90:1342-3.