Predictive factors of systemic embolism in patients with mitral stenosis in sinus rhythm

Systemic embolism is one of the major complications in patients with mitral stenosis (MS) who are in atrial fibrillation; however, this serious complication can also occur in patients with MS in sinus rhythm. The purpose of the present study was to identify the predictive factors of systemic emboli...

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Bibliographic Details
Published inJournal of the Medical Association of Thailand Vol. 91; no. 1; p. 44
Main Authors Kiatchoosakun, Songsak, Wongvipaporn, Chaiyasith, Silaruks, Songkwan, Tatsanavivat, Pyatat
Format Journal Article
LanguageEnglish
Published Thailand 01.01.2008
Subjects
Adolescent
Adult
Age Factors
Aged
Atrial Fibrillation
Cross-Sectional Studies
Female
Health Status Indicators
Heart Atria - diagnostic imaging
Heart Atria - pathology
Humans
Male
Middle Aged
Mitral Valve Stenosis - complications
Mitral Valve Stenosis - diagnostic imaging
Mitral Valve Stenosis - physiopathology
Risk Factors
Thromboembolism - diagnostic imaging
Thromboembolism - etiology
Thromboembolism - physiopathology
Ultrasonography
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Summary:Systemic embolism is one of the major complications in patients with mitral stenosis (MS) who are in atrial fibrillation; however, this serious complication can also occur in patients with MS in sinus rhythm. The purpose of the present study was to identify the predictive factors of systemic emboli in patients with MS in sinus rhythm. Twenty patients with MS in sinus rhythm with recent cerebral embolism and 32 with MS in sinus rhythm without any history of systemic embolism were studied between January 2004 and May 2006. Clinical and echocardiographic data were assessed using stepwise logistic regression for prediction of systemic embolism. Age (odds ratio [OR], 1.14; 95% confidence interval [CI] 1.04-1.26) and left atrial spontaneous echo contrast (LASEC) grade 3+ and 4+ (OR, 46.42; 95% CI, 5.00-436.49) were associated with, and predictive of systemic emboli, whereas left atrial appendage contraction flow velocities, left atrial size and mitral valve area were not. The present study demonstrates that age and LASEC are the major predictive factors of systemic embolism in patients with MS in sinus rhythm. It would therefore be prudent to give anticoagulants to patients in atrial fibrillation as well as to those in sinus rhythm at risk of systemic embolism.
ISSN:0125-2208