ABSTRACT
The left atrial appendage is a long, tubular and trabecular structure and has a narrow junction with the left atrium. The left atrial appendage has been the focus of clinicians’ interests, because it is a potential site for the development of thrombus in several diseases. Aim: To study the correlation between mitral annular systolic velocity and left atrial appendage function in mitral stenosis. Methods: 60 patient with moderate to severe Mitral Stenosis with MVO <1.5 cm2 were included in the study. All eligible patients underwent a detailed history and clinical examination. A 12 lead electrocardiogram was taken. Echocardiographic evaluation was done for all patients Atrial fibrillation diagnosis was based on the electrocardiogram. Result: There was a positive correlation between these two variables which are statistically significant. (r=0.944, p-value<0.001). There was a positive correlation between left atrial appendage emptying velocity and mitral annular late diastolic velocity in patients in sinus rhythm. (r=0.695(p<0.001) The cut off value of peak annulus systolic velocity which is derived from the analysis of the receiver operator characteristic curve is 13.5cm/sec. The area under the curve is 0.840 with confidence interval 0.689 to 0.936 and the p-value<0.001. This value predicts inactive LAA (Laaev<25cm/sec) with a sensitivity of 92% and specificity of 96.5%. Conclusion: The systolic and diastolic annular velocities obtained by Doppler tissue imaging are reduced in patients with mitral stenosis. There is a positive correlation between annular systolic and left atrial appendage emptying velocities in mitral stenosis. The annular systolic velocity is an independent predictor for the presence of inactive left atrial appendage in mitral stenosis patients with sinus rhythm.
ABSTRACT
Evaluating left atrium volume is a good way to estimate prognosis in acute myocardial infarction patients because it indicates to time and severity of diastolic dysfunction and longer-term results of acute myocardial infarction. Left atrial (LA) volume is a prognostic predictor across a wide spectrum of cardiac and non-cardiac diseases. Aim: To assess the left atrial volume index in Myocardial Infarction & Angiographic correlation and to assess any correlation between with left atrial volume index and outcomes of MI such as heart failure, short term mortality, arrhythmias, and ejection fraction. Methods: 100 patients with ST elevation in ECG, with history, examination, ECG changes and elevated CK-MB, Anterior, Inferior, Right ventricle & Posterior wall Myocardial infarction were included. The patients were studied considering demographic factors, risk factors, echocardiography indexes such as systolic and diastolic functions and left atrium volume and angiography. Results: Among LAVI >34, 22 had (70-90%) of RCA, 7 had (70-90%) of LCX, 29 had (70-90%) of LAD. Among LAVI>34, 14 patients had TVD, 5 had DVD, 29 had SVD, 9 normal coronaries, which are not statistically significant. Among LAVI >34, 22 patients undergone PCI, 7 patients underwent CABG, 1 patient had CHB, 3 patient had VT and 9 patients had AF, which is statistically significant. Among LAVI>34, 24 patients had HF at 30 days follow-up. Among LAVI>34, in 30 days follow up 1 patient expired. When compared with LAVI <34 it was not statistically significant. Conclusion: LA Volume index provides prognostic information incremental to clinical data and standard Echocardiographic predictors of outcome, including LV systolic function and Doppler assessment of Diastolic Function.