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

Goswami, Kewal C.; Yadav, Rakesh Kumar; Rao, Meenakshi; Bahl, Vinay K.; Kk, Talwar; Manchanda, Subhash C.

doi:10.1016/s0167-5273(00)00235-7

Cited by 59 publications

(74 citation statements)

References 23 publications

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“…4 The presence of SEC has been associated with thromboembolic risk and this risk increases with the density of SEC. 1,2,4,5,15 In our study, 47.4% of the patients with dense SEC had thromboembolism. Diagnosis of dense SEC and initiation of anticoagulant therapy are crucial for such patients.…”

Section: Discussionsupporting

confidence: 43%

“…1,2,8,11,16,23,24 Li et al 11 evaluated 39 MS patients with SR. They found that the patients with SEC had smaller MVA and higher MG than those without SEC; but LA size, EF, age and gender were similar.…”

Section: Discussionmentioning

confidence: 99%

“…Left atrial area was taken in two views (parasternal long axis and apical four-chamber view) and these two values were averaged. 1 Mitral valve area (MVA) was measured by the pressure half-time method. Transmitral mean gradient (MG) was recorded.…”

Section: Echocardiographymentioning

confidence: 99%

“…SEC was diagnosed by the presence of dynamic smoke-like echoes in the left atrial cavity and/or left atrial appendage with a characteristic swirling motion. 1 The severity of SEC was graded from 0 to 4+ as previously described. 12 Grade 1 and 2 were accepted as faint SEC and grade 3 and 4 were accepted as dense SEC.…”

Section: Echocardiographymentioning

confidence: 99%

“…1 Although the thromboembolic events are usually seen in MS patients with (AF), those with sinus rhythm (SR) also have an increased thromboembolic risk. 1 -4 Presence of spontaneous echo contrast (SEC) is the strongest predictor of thromboembolic events and the risk increases with the density of SEC.…”

Section: Introductionmentioning

confidence: 99%

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Annular Systolic Velocity Predicts the Presence of Spontaneous Echo Contrast in Mitral Stenosis Patients with Sinus Rhythm

Çaylı¹,

Acartürk²,

Kanadaşı³

et al. 2007

Clinical Cardiology

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SummaryOjectives: Thromboembolism is the major cause of morbidity and mortality in mitral stenosis (MS), even in sinus rhythm (SR). Spontaneous echo contrast (SEC) is the strongest predictor of thromboembolism. The aim of the study was to investigate if the annular velocities obtained with tissue Doppler imaging can predict the presence of SEC in MS patients with SR.Methods: One hundred and five MS patients and 100 controls were included. Annular velocities were recorded. All patients underwent transesophageal echocardiography. Subjects were divided into three groups as controls (Group I), the patients without SEC (Group II) and the patients with SEC (Group III).Results: Group III patients had lower ejection fraction, annular systolic velocity, smaller mitral valve area, higher transmitral gradient and larger left atrial size. The annular systolic velocity was the only independent predictor for SEC. The cutoff values of annular systolic velocity for prediction of the presence of any SEC and dense SEC were 13.5 and 11.8 cm/s, respectively.Conclusion: The annular systolic velocity is an independent predictor for SEC in MS patients with SR.

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