Document Detail


Assessment of left atrial appendage filling pattern by using intravenous administration of microbubbles: comparison between mitral stenosis and mitral regurgitation.
MedLine Citation:
PMID:  11696835     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Mitral stenosis (MS) and mitral regurgitation (MR) are the most frequent conditions that cause a dilation and dysfunction of the left atrial appendage (LAA). Despite similarly dilated LAA in patients with MS and MR, the incidence of LAA thrombi and the risk of thromboembolism is different between these patients. The purpose of this study was to characterize the filling pattern of LAA by using intravenous administration of perfluorocarbon-exposed dextrose albumin (PESDA) during transesophageal echocardiographic examination in patients with MS and MR. Twenty-four patients with moderate to severe MS, 12 patients with severe MR, and a control group including 30 patients with conditions other than mitral valve disease underwent transesophageal echocardiographic examination with an intravenous bolus injection of PESDA. LAA emptying and filling velocities and maximal and minimal areas of LAA and LAA ejection fraction were measured. Digital gray-scale intensity (GSI) of the left atrial (LA) and LAA cavity after PESDA injection was measured by off-line analysis. Compared with control patients, patients with MS or MR had larger maximal and minimal areas of LAA and reduced LAA ejection fraction. LAA peak emptying flow velocity was significantly lower in patients with MS compared with those of MR or control patients. LAA peak filling velocity was significantly lower in patients with MS compared with that of control patients. However, there was no significant difference of LAA peak filling velocity between the patients with MS and MR. There was no significant difference of GSI ratio of LAA and LA between patients with MR and control patients; however, GSI ratio of LAA and LA was significantly lower in patients with MS compared with that of MR. The incidence of LAA spontaneous echo contrast and LAA thrombi in patients with MS was significantly higher than that of the patients with MR and control subjects (P <.005). Despite similarly dilated LAA area and depressed contractile function of LAA in patients with MS and MR compared with control patients, profoundly impaired LAA filling with resultant flow stasis was demonstrated by contrast echocardiography in patients with MS. These findings may explain the higher incidence of LAA spontaneous echo contrast and thrombus in patients with MS.
Authors:
J W Ha; B K Lee; H J Kim; W B Pyun; K H Byun; S J Rim; N Chung
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  14     ISSN:  0894-7317     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-11-06     Completed Date:  2001-12-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1100-6     Citation Subset:  IM    
Affiliation:
Cardiology Division, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Appendage / physiopathology*,  ultrasonography
Case-Control Studies
Contrast Media / administration & dosage
Coronary Thrombosis / etiology,  physiopathology
Echocardiography, Transesophageal
Female
Fluorocarbons / administration & dosage,  diagnostic use
Glucose / administration & dosage,  diagnostic use
Humans
Injections, Intravenous
Male
Middle Aged
Mitral Valve Insufficiency / complications,  physiopathology*
Mitral Valve Stenosis / complications,  physiopathology*
Reference Values
Serum Albumin / administration & dosage,  diagnostic use
Stroke Volume
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Fluorocarbons; 0/Serum Albumin; 0/dextrose albumin solution; 50-99-7/Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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