Left atrial appendage functions in patients with severe rheumatic mitral regurgitation |
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Authors: | Atila Bitigen Mustafa Bulut Ali C Tanalp Cevat Kirma Irfan Barutçu Selcuk Pala Ayhan Erkol Bilal Boztosun |
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Institution: | (1) Department of Cardiology, Kartal Koşuyolu Yüksek Ihtisas Research Hospital, Denizer Str, kartal-Cevizli, Istanbul, 80840, Turkey |
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Abstract: | Aim The left atrial appendage (LAA) function was evaluated in patients with severe rheumatic mitral regurgitation, having sinus
rhythm or atrial fibrillation, by standard and tissue Doppler echocardiographic examinations.
Methods and results Sixty patients with rheumatic severe mitral regurgitation were enrolled. The patients (14 females and 6 males) having sinus
rhythm were selected as group I and 20 patients (15 females and 5 males) with atrial fibrillation formed group II. 20 healthy
subjects (15 female and 5 males) served as the control group (group III). In order to determine the LAA functions, LAA peak
filling flow velocity (LAAPFV), LAA peak emptying flow velocity (LAAPEV) and percentage of LAA area change (LAAAC %) were
measured. In the TDI records of the subjects with sinus rhythm, the first positive wave identical to the LAA late emptying
wave (LEW) following the P-wave was accepted as LAA late systolic wave (LSW), and the second negative wave identical to the
LAA late filling flow was accepted as late diastolic wave (LDW). In patients with atrial fibrillation, the positive wave was
accepted as LAA late systolic wave (LSW), and the second negative wave identical to the LAA late filling flow was accepted
as late diastolic wave (LDW). LAA outflow and inflow velocities were lower in the group having atrial fibrillation (P < 0.002, and P < 0.007, respectively). LAAAC% was also reduced in group II (P < 0.0001). The pulsed Doppler LSW and LDW velocities, measured with TDI method were found to be quite reduced in patients
with AF (P: 0.002 and P: 0.001, respectively). The study parameters were statistically similar in patients with normal sinus rhythm and controls.
Conclusion In this study, we found that the LAA functions are impaired in patients with severe mitral regurgitation, having AF, whereas
preserved in patients with normal sinus rhythm, compared to controls. |
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Keywords: | Left atrial appendage functions Atrial fibrillation Sinus rhythm Tissue Doppler |
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