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Left and right atrial appendage function in patients with chronic atrial fibrillation
New Egyptian Journal of Medicine [The]. 2005; 32 (1): 17-23
in English | IMEMR | ID: emr-73788
Responsible library: EMRO
ABSTRACT
Transoesophageal echocardiography [TEE] has been shown to be a useful technique for assessing left atrial appendage [LAA] function by measuring LAA flow velocities. Recently, right atrial appendage [RAA] thrombi and depressed RAA function have been reported in patients with atrial fibrillation [AF]. To assess right atrial appendage flow and its possible relationship to left atrial appendage flow in patients with chronic AF; also to assess RAA function and its relation to early detection of new right atrial thrombi. This study included 90 patients presenting to the National Heart Institute and to Mataria Teaching Hospital for cardiovascular assessment by TEE 40 patients with chronic non valvular AF, 40 patients with chronic valvular AF and 10 normal individuals acting as controls. All patients included in the study were subjected to the following careful history taking, complete clinical examination, resting 12 lead ECG, plain chest X-ray, transthoracic echocardiography [TTE] and transoesophageal echocardiography [TEE]. Patients with chronic nonvalvular AF were significantly older, and the duration of AF was significantly longer than those with chronic valvular AF. Patients with chronic nonvalvular AF had significantly larger RA and RAA area than those with chronic valvular AF. Patients with chronic valvular AF had larger LA and LAA area than those with chronic nonvalvular AF. RAA and LAA emptying velocities were both reduced in valvular and non-valvular AF patients. TEE showed that 15% of patients with chronic valvular AF had left atrial thrombus 10% of patients with non-valvular AF had atrial thrombus, while none of the controls showed atrial thrombosis. Left atrial spontaneous echo contrast [SEC] was shown in 80% of chronic valvular AF and in 35% of chronic non-valvular AF, while right atrial SEC was shown in 25% of all patients. Our findings suggest that AF can affect both atria equally in nonvalvular AF, in contrast to valvular AF which affects the left atrium only. Therefore, the assessment of RAA and LAA function as well as atrial SEC may be important in patients with chronic nonvalvular AF and are especially so as predictors to intra-atrial thrombosis
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Index: IMEMR (Eastern Mediterranean) Main subject: Atrial Function, Left / Atrial Function, Right / Myocardial Ischemia / Echocardiography, Transesophageal / Atrial Appendage / Diabetes Mellitus / Hypertension Type of study: Screening study Limits: Female / Humans / Male Language: English Journal: New Egypt. J. Med. Year: 2005
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Index: IMEMR (Eastern Mediterranean) Main subject: Atrial Function, Left / Atrial Function, Right / Myocardial Ischemia / Echocardiography, Transesophageal / Atrial Appendage / Diabetes Mellitus / Hypertension Type of study: Screening study Limits: Female / Humans / Male Language: English Journal: New Egypt. J. Med. Year: 2005