Mitral darlığında doku doppleri ile sol atrium ve sol atrial apendiks fonksiyonlarının değerlendirilmesi

Abstract

SUMMARY Color doppler tissue imaging for assesment of left atrial appendage function in mitral stenosis: Appendage velocity estimation by real-time color doppler myocardial imaging. Mitral stenosis with atrial fibrillation (AF) is a major risk factor for thromboembolism. Spontaneous echo contrast (SEC) and reduced left atrial appendage (LAA) velocity have been identified as predictors for thromboembolism. Color doppler myocardial imaging (CDMI) is capable of measuring tissue velocities in the myocardium. This technique also offers the adventage of real-time image acquisition with off-line analysis. The aim of the present study was to evaluate whether CDMI was useful for detection of left atrial appendage functions. Methods: Transthorasic echocardiography (TTE) and transesophageal echocardiography (TEE) were performed on thirty-six patients with mitral stenosis (24 women, 12 men; mean age 45±12). Color doppler tissue imaging of LAA was recorded from tip of LAA by TEE. Results: There were 18 (50 %) AF, 11 (30.6%) history of thromboembolism^ (63. 9%) mitral regurgitation, 19 (52.8%) Aortik regurgitation, 31(86.1%) Tricuspit regurgitation and 31 (86,1%) SEC. CDMI velocities of LAA was correlated with LAA emptying velocities and SEC (r=0.6, p<0.001 and r=-0.66, p<0.001, respectively). Left atrial apendage CDMI velocities were significiantly lower in the thromboembolic patients than the people who had not thromboemboli (r=-0.4, p<0.01). In multivariate analysis, CDMI velocities were not affected by mitral valve area, left atrial diameter and mitral regurgitation (p>0.05). Conclusion: LAA emptying velocities were correlated with CDMI systolic velocities of LAA. CDMI systolic velocities of LAA were inversly correlated with SEC and thromboemboli. 50