Thromboembolism Risk in Patients with Mitral Stenosis
A total of 168 consecutive patients with predominant rheumatic mitral stenosis were evaluated by transthoracic (TTE) and transesophageal echocardiography (TEE). Of the 168 patients, 35 had previous embolic events (group I) and 133 had no emboli (group II). A total of 77 (45.8%) patients had atrial f...
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| Veröffentlicht in: | Japanese Heart Journal 1997, Vol.38(5), pp.669-675 |
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| creator | ACARTÜRK, Esmeray USAL, Ayhan DEMIR, Mesut AKGÜL, Ferit ÖZEREN, Ali |
| description | A total of 168 consecutive patients with predominant rheumatic mitral stenosis were evaluated by transthoracic (TTE) and transesophageal echocardiography (TEE). Of the 168 patients, 35 had previous embolic events (group I) and 133 had no emboli (group II). A total of 77 (45.8%) patients had atrial fibrillation. The frequency of atrial fibrillation was higher in group I than group II (68.6% vs 39.8%, p |
| doi_str_mv | 10.1536/ihj.38.669 |
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Of the 168 patients, 35 had previous embolic events (group I) and 133 had no emboli (group II). A total of 77 (45.8%) patients had atrial fibrillation. The frequency of atrial fibrillation was higher in group I than group II (68.6% vs 39.8%, p<0.001). The incidence of left atrial enlargement was greater in group I (p<0.001). Mitral valve area was found to be smaller in group I compared to group II (p<0.001). In group I 83.3% and 29.2% of the patients with atrial fibrillation had left atrial spontaneous echo contrast (SEC) and left atrial thrombus, respectively, and 72.7% of the patients with sinus rhythm had left atrial SEC. In group II 79.2% and 20.8% of the patients with atrial fibrillation had left atrial SEC and left atrial thrombus whereas 28.6% and 2.6% of the patients with sinus rhythm had left atrial SEC and left atrial thrombus, respectively. The incidence of left atrial thrombus was significantly different in those patients with compared to those without embolic events (20% vs 9.7%, p<0.01). In groups I and II, 28 of 35 (80%) and 64 of 133 (48.1%) patients had left atrial SEC (p<0.01). Patients with left atrial SEC had a greater left atrial size (p<0.01) and smaller mitral valve area (p<0.01). Left atrial size was normal in 2 patients with left atrial SEC and SEC was not found in 55 patients with enlarged left atrium. Multiple logistic regression analysis showed that atrial fibrillation, mitral valve area and left atrial enlargement were independent predictors of the SEC (p<0.001) and left atrial SEC was the principal determinant of thromboembolism. These data suggest that regardless of rhythm and atrial size, left atrial SEC is a principal determinant of thromboembolic risk in mitral stenosis. TEE may be able to detect those patients with mitral stenosis at risk for emboli and guide appropriate therapy.]]></description><identifier>ISSN: 0021-4868</identifier><identifier>EISSN: 1348-673X</identifier><identifier>DOI: 10.1536/ihj.38.669</identifier><identifier>PMID: 9462416</identifier><identifier>CODEN: JHEJAR</identifier><language>eng</language><publisher>Tokyo: International Heart Journal Association</publisher><subject>Adolescent ; Adult ; Aged ; Atrial Fibrillation - etiology ; Biological and medical sciences ; Cardiology. Vascular system ; Echocardiography, Transesophageal ; Endocardial and cardiac valvular diseases ; Female ; Heart ; Humans ; Male ; Medical sciences ; Middle Aged ; Mitral stenosis ; Mitral Valve Stenosis - complications ; Mitral Valve Stenosis - diagnostic imaging ; Prospective Studies ; Regression Analysis ; Rheumatic Heart Disease - complications ; Rheumatic Heart Disease - diagnostic imaging ; Risk ; Thromboembolism ; Thromboembolism - etiology ; Transesophageal echocardiography</subject><ispartof>Japanese Heart Journal, 1997, Vol.38(5), pp.669-675</ispartof><rights>by International Heart Journal Association</rights><rights>1998 INIST-CNRS</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c473t-6d8abaf9c292264554c3a835295d95c33a4b24954907c3b0c541f060153b001b3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1877,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2142339$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9462416$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ACARTÜRK, Esmeray</creatorcontrib><creatorcontrib>USAL, Ayhan</creatorcontrib><creatorcontrib>DEMIR, Mesut</creatorcontrib><creatorcontrib>AKGÜL, Ferit</creatorcontrib><creatorcontrib>ÖZEREN, Ali</creatorcontrib><title>Thromboembolism Risk in Patients with Mitral Stenosis</title><title>Japanese Heart Journal</title><addtitle>Jpn Heart J</addtitle><description><![CDATA[A total of 168 consecutive patients with predominant rheumatic mitral stenosis were evaluated by transthoracic (TTE) and transesophageal echocardiography (TEE). Of the 168 patients, 35 had previous embolic events (group I) and 133 had no emboli (group II). A total of 77 (45.8%) patients had atrial fibrillation. The frequency of atrial fibrillation was higher in group I than group II (68.6% vs 39.8%, p<0.001). The incidence of left atrial enlargement was greater in group I (p<0.001). Mitral valve area was found to be smaller in group I compared to group II (p<0.001). In group I 83.3% and 29.2% of the patients with atrial fibrillation had left atrial spontaneous echo contrast (SEC) and left atrial thrombus, respectively, and 72.7% of the patients with sinus rhythm had left atrial SEC. In group II 79.2% and 20.8% of the patients with atrial fibrillation had left atrial SEC and left atrial thrombus whereas 28.6% and 2.6% of the patients with sinus rhythm had left atrial SEC and left atrial thrombus, respectively. The incidence of left atrial thrombus was significantly different in those patients with compared to those without embolic events (20% vs 9.7%, p<0.01). In groups I and II, 28 of 35 (80%) and 64 of 133 (48.1%) patients had left atrial SEC (p<0.01). Patients with left atrial SEC had a greater left atrial size (p<0.01) and smaller mitral valve area (p<0.01). Left atrial size was normal in 2 patients with left atrial SEC and SEC was not found in 55 patients with enlarged left atrium. Multiple logistic regression analysis showed that atrial fibrillation, mitral valve area and left atrial enlargement were independent predictors of the SEC (p<0.001) and left atrial SEC was the principal determinant of thromboembolism. These data suggest that regardless of rhythm and atrial size, left atrial SEC is a principal determinant of thromboembolic risk in mitral stenosis. TEE may be able to detect those patients with mitral stenosis at risk for emboli and guide appropriate therapy.]]></description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Atrial Fibrillation - etiology</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Echocardiography, Transesophageal</subject><subject>Endocardial and cardiac valvular diseases</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mitral stenosis</subject><subject>Mitral Valve Stenosis - complications</subject><subject>Mitral Valve Stenosis - diagnostic imaging</subject><subject>Prospective Studies</subject><subject>Regression Analysis</subject><subject>Rheumatic Heart Disease - complications</subject><subject>Rheumatic Heart Disease - diagnostic imaging</subject><subject>Risk</subject><subject>Thromboembolism</subject><subject>Thromboembolism - etiology</subject><subject>Transesophageal echocardiography</subject><issn>0021-4868</issn><issn>1348-673X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kEtLAzEUhYMotVY37oVZiAthat4zWUrxBRVFK7gLmTTjpM6jJinivzdlhlnc3MX5OOfmAHCO4Bwxwm9stZmTfM65OABTRGie8ox8HoIphBilNOf5MTjxfgMh4jgnEzARlGOK-BSwVeW6puhMnNr6Jnmz_juxbfKqgjVt8MmvDVXybINTdfIeTNt560_BUalqb86GPQMf93erxWO6fHl4WtwuU00zElK-zlWhSqGxwJhTxqgmKicMC7YWTBOiaIGpYFTATJMCakZRCTmMnyrirQWZgaved-u6n53xQTbWa1PXqjXdzstMMJYhjCJ43YPadd47U8qts41yfxJBue9Ixo4kyWXsKMIXg-uuaMx6RIdSon456MprVZdOtdr6EcOIYkL2Nose2_igvsyoKxesrs0-EQkO96msf2L4qOpKOWla8g8MjYSu</recordid><startdate>1997</startdate><enddate>1997</enddate><creator>ACARTÜRK, Esmeray</creator><creator>USAL, Ayhan</creator><creator>DEMIR, Mesut</creator><creator>AKGÜL, Ferit</creator><creator>ÖZEREN, Ali</creator><general>International Heart Journal Association</general><general>Japanese Heart Journal Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>1997</creationdate><title>Thromboembolism Risk in Patients with Mitral Stenosis</title><author>ACARTÜRK, Esmeray ; USAL, Ayhan ; DEMIR, Mesut ; AKGÜL, Ferit ; ÖZEREN, Ali</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c473t-6d8abaf9c292264554c3a835295d95c33a4b24954907c3b0c541f060153b001b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Atrial Fibrillation - etiology</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Echocardiography, Transesophageal</topic><topic>Endocardial and cardiac valvular diseases</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mitral stenosis</topic><topic>Mitral Valve Stenosis - complications</topic><topic>Mitral Valve Stenosis - diagnostic imaging</topic><topic>Prospective Studies</topic><topic>Regression Analysis</topic><topic>Rheumatic Heart Disease - complications</topic><topic>Rheumatic Heart Disease - diagnostic imaging</topic><topic>Risk</topic><topic>Thromboembolism</topic><topic>Thromboembolism - etiology</topic><topic>Transesophageal echocardiography</topic><toplevel>online_resources</toplevel><creatorcontrib>ACARTÜRK, Esmeray</creatorcontrib><creatorcontrib>USAL, Ayhan</creatorcontrib><creatorcontrib>DEMIR, Mesut</creatorcontrib><creatorcontrib>AKGÜL, Ferit</creatorcontrib><creatorcontrib>ÖZEREN, Ali</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Japanese Heart Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ACARTÜRK, Esmeray</au><au>USAL, Ayhan</au><au>DEMIR, Mesut</au><au>AKGÜL, Ferit</au><au>ÖZEREN, Ali</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thromboembolism Risk in Patients with Mitral Stenosis</atitle><jtitle>Japanese Heart Journal</jtitle><addtitle>Jpn Heart J</addtitle><date>1997</date><risdate>1997</risdate><volume>38</volume><issue>5</issue><spage>669</spage><epage>675</epage><pages>669-675</pages><issn>0021-4868</issn><eissn>1348-673X</eissn><coden>JHEJAR</coden><abstract><![CDATA[A total of 168 consecutive patients with predominant rheumatic mitral stenosis were evaluated by transthoracic (TTE) and transesophageal echocardiography (TEE). Of the 168 patients, 35 had previous embolic events (group I) and 133 had no emboli (group II). A total of 77 (45.8%) patients had atrial fibrillation. The frequency of atrial fibrillation was higher in group I than group II (68.6% vs 39.8%, p<0.001). The incidence of left atrial enlargement was greater in group I (p<0.001). Mitral valve area was found to be smaller in group I compared to group II (p<0.001). In group I 83.3% and 29.2% of the patients with atrial fibrillation had left atrial spontaneous echo contrast (SEC) and left atrial thrombus, respectively, and 72.7% of the patients with sinus rhythm had left atrial SEC. In group II 79.2% and 20.8% of the patients with atrial fibrillation had left atrial SEC and left atrial thrombus whereas 28.6% and 2.6% of the patients with sinus rhythm had left atrial SEC and left atrial thrombus, respectively. The incidence of left atrial thrombus was significantly different in those patients with compared to those without embolic events (20% vs 9.7%, p<0.01). In groups I and II, 28 of 35 (80%) and 64 of 133 (48.1%) patients had left atrial SEC (p<0.01). Patients with left atrial SEC had a greater left atrial size (p<0.01) and smaller mitral valve area (p<0.01). Left atrial size was normal in 2 patients with left atrial SEC and SEC was not found in 55 patients with enlarged left atrium. Multiple logistic regression analysis showed that atrial fibrillation, mitral valve area and left atrial enlargement were independent predictors of the SEC (p<0.001) and left atrial SEC was the principal determinant of thromboembolism. These data suggest that regardless of rhythm and atrial size, left atrial SEC is a principal determinant of thromboembolic risk in mitral stenosis. TEE may be able to detect those patients with mitral stenosis at risk for emboli and guide appropriate therapy.]]></abstract><cop>Tokyo</cop><pub>International Heart Journal Association</pub><pmid>9462416</pmid><doi>10.1536/ihj.38.669</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Atrial Fibrillation - etiology Biological and medical sciences Cardiology. Vascular system Echocardiography, Transesophageal Endocardial and cardiac valvular diseases Female Heart Humans Male Medical sciences Middle Aged Mitral stenosis Mitral Valve Stenosis - complications Mitral Valve Stenosis - diagnostic imaging Prospective Studies Regression Analysis Rheumatic Heart Disease - complications Rheumatic Heart Disease - diagnostic imaging Risk Thromboembolism Thromboembolism - etiology Transesophageal echocardiography |
| title | Thromboembolism Risk in Patients with Mitral Stenosis |
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