Muzaffar Ali, Junaid Zafar, Usman Mahmood Butt, Zubair Akram.
Relation of low left atrial appendage velocity with thrombus formation in patients with significant rheumatic mitral stenosis.
J Cardiovascular Dis Jan ;12(1):13-6.

OBJECTIVE: To study low left atrial appendage velocity and its relation with thrombus formation in patients with significant rheumatic mitral stenosis. MATERIAL AND METHOD: A cross sectional study was conducted at a tertiary care hospital from February 2014 to December 2015. Sixty patients with significant mitral stenosis as diagnosed by a 2D ECHO were included in the study. Patient variables and ECHO data was recorded for each patient. Significant mitral valve stenosis classified as severe Mitral Stenosis (MVA) ≤ 1.5 cm2 and very severe Mitral Stenosis (MVA) ≤ 1.0 cm2. Patients were divided into two groups based on values of left atrial appendage velocity (LAAV). Group1 (LAAV< 20cm/sec) Group 2 (LAAV > 50 cm/sec). Data was entered and analyzed in SPSS version: 21.0. p-value less than 0.05 was considered statistically significant. RESULTS: A total of 60 patients were included in the study and divided into two groups. In Group I (LAAV< 20cm/sec), mean age was 26.84 ± 8.531 years, out of which 25 % were male and 75.0% were females. In Group II (LAAV> 50cm/sec), mean age of subjects was 26.18 ± 8.120 years and 50.0% were male and 50.0% were female (X2= 4.019, P< 0.045). Left Atrial Appendage (LAA) clot formation occurred in 34.4% patients in Group I and in 7.1% in Group II (X2= 6.255, P < 0.01). Spontaneous ECHO Contrast (SEC) formation in Group I was 62.5% and in Group II it was 21.4% (P <0.001). Mean Mitral Valve Pressure gradient in Group I was 15.88 ± 2.637 mmHg and in Group II was 12.25 ± 1.076 mmHg. (t=6.792, P =.000). Mean Mitral Valve area in Group I was 0.828 ± 0.0772 cm2 and in Group II was 1.293 ± 0. 1086 cm2 . (t= -19.280, P =.000) CONCLUSION: Our study concluded that low left atrial appendage velocity is associated with Left Atrial thrombus formation in patient with significant rheumatic mitral stenosis.

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