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Spontaneous left atrial echo contrast, mitral annular systolic velocity, and left atrial appendage late emptying velocity in predicting improvement of left atrial function after percutaneous balloon mitral valvuloplasty
Author(s) -
Arava Tirumala Naresh,
Durgaprasad Rajasekhar,
Velam Vanajakshamma,
Gajjala Obul Reddy,
Neelam Vinod K.,
Manohar Suchitra N.
Publication year - 2018
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13759
Subject(s) - cardiology , medicine , sinus rhythm , atrial fibrillation , doppler imaging , balloon , percutaneous , diastole , blood pressure
Background Thromboembolic events are the major cause of morbidity and mortality in patients with mitral stenosis ( MS ). This study aims to investigate left atrial spontaneous echo contrast ( LA SEC ), mitral annular systolic velocity (Sa‐wave), left atrial appendage ( LAA ) late emptying velocity ( LAAEV ), LAA filling velocity ( LAAFV ) pre‐ and postpercutaneous balloon mitral valvuloplasty ( PBMV ) for MS . This also aims to study the association of LA SEC with inflammatory marker, high‐sensitivity C‐reactive protein (hs‐ CRP ) in MS . Methods The study population consisted of 100 patients with symptomatic MS with sinus rhythm who underwent PBMV . Transthoracic echo ( TTE ), tissue Doppler imaging ( TDI ), and transesophageal echo ( TEE ) examinations were carried out before and 14 days following PBMV . High‐sensitivity C‐reactive protein (hs‐ CRP ) was measured at the time of admission. Results The mean age was 33.2 ± 10.3 years with female preponderance (71%). There was a decrease in SEC grading, (pre‐ PBMV 2.8 ± 0.9 and post‐ PBMV 0.4 ± 0.1; P < .01), increase in LAAEV (pre‐ PBMV 23.0 ± 7.9 cm/s and post‐ PBMV 40.9 ± 8.4 cm/s; P < .01), and LAAFV (pre‐ PBMV 31.8 ± 9.3 cm/s and post‐ PBMV 51.2 ± 8.7 cm/s; P < .01).A significant positive correlation was present between LAAEV and Sa‐wave ( r = .52, P < .01). Correlation between hs‐ CRP and SEC was positive and significant ( r = .33, P < .01). Optimal cutoff value of hs‐ CRP for prediction of moderate to dense SEC was >2.3 mg/dL, the cutoff value of Sa‐wave was≤ 5.5 cm/s for prediction of the presence of inactive LAA ( LAAEV < 25 cm/s). Conclusion Mitral annular systolic velocity (Sa‐wave) is an independent predictor of inactive LAA and a useful parameter in estimating inactive LAA in MS . Sa‐wave and hs‐ CRP are independent predictors for SEC . PBMV improves LAA function in patients with MS .