RESUMEN
Background: Mitral stenosis (MS) is a common valvular heart disease. Thromboembolism is one of the most serious consequences of mitral stenosis, particularly when it is accompanied with atrial fibrillation (AF). When linked with Left atrial appendage inactivity (LAAI), patients with sinus rhythm (SR) are also at risk for this condition. In mitral stenosis, LAA inactivity determined by S-wave is an independent predictor of thromboembolism. The aim of the study was to evaluate the Prevalence and Echocardiographic Predictors of Left Atrial Appendage inactivity in patients of Mitral Stenosis.Material & Methods:Sixty MS patients were evaluated by transthoracic echocardiography (TTE) and all patients underwent transesophageal echocardiography (TEE). The annular systolic (S-wave) and diastolic (Em- and Am-waves) velocities were recorded by tissue Doppler imaging (TDI). LAA inactivity was defined as LAA emptying velocity <25 cm/second determined by pulse wave Doppler at the junction of LA & LAA (TEE). Patients were divided into three groups; group A I (n = 18). Sinus rhythm (SR) and LAA emptying velocity ?25 cm/sec, group A II (n -22): SR and LAA emptying velocity <25cm/sec and group B (n = 20): atrial fibrillation.Results:Thrombus was detected in 14 patients and spontaneous echo contrast (SEC) was detected in 43 patients. Both S-wave and peak LAA emptying velocities were decreasing, while SEC frequency and density were increasing from group A to group B. There was a positive correlation between LAA emptying vs. S-wave and LAA emptying vs. Am velocities (p < 0.001, r= 0.708 and p<0.001, r=0.495). Multivariate regression analysis showed that only S-wave is the independent predictor of inactive LAA (p = 0.001, odds ratio = 0.133, 95% Cl =0.032-0.556). In patients with SR, the cutoff value of S-wave was 10 cm/sec for the prediction of the presence of inactive LAA (sensitivity: 92.3%, specificity: 95.3%).Conclusions:In individuals with severe mitral stenosis in sinus rhythm, there is a significant prevalence of left atrial appendage inactivity. The mean pressure gradient across the mitral valve, as well as S-wave are independent predictors of left atrial appendage inactivity. Inactivity of the left atrial appendage is an independent predictor of left atrial/left atrial appendage smoke and associated thrombus.
RESUMEN
Background: obesity was reported to be highly prevalent in KSA. Bariatric surgery is considered as the most effective, beneficial, and permanent method for treatment of obesity and decreasing the long-term mortality
Objectives: evaluating the knowledge and beliefs about the safety and effectiveness of bariatric surgery among adult Saudi population
Methods: a questionnaire based on cross-sectional study was distributed among 790 adult Saudi population forms January 2017- June 2017. The questionnaire was based on 4 aspects including subject's demographics, anthropometric measures, knowledge about obesity and its causes and beliefs about Bariatric surgery
Results: overweight and obesity were found to be high among the studied population. The most common causes for obesity were bad life style habits and genetic factors. There was a good knowledge about obesity but low favorable beliefs about bariatric surgery as 55.7% of subjects have non-favorable beliefs about the Bariatric surgery and 44.3% have favorable beliefs about the surgery. The favorable beliefs about bariatric surgery were significantly associated with female gender and subjects having high BMI scores
Conclusion: the knowledge of subjects about obesity and its preventive measures were high but the favorable perceptions about Bariatric surgeries were low. These results indicated that efficient educational programs about obesity and Bariatric surgeries are needed for control of obesity and its complications as well as increasing the availability of weight loss surgeries