PMID- 26239565
OWN - NLM
STAT- MEDLINE
DCOM- 20161109
LR  - 20170103
IS  - 1540-8175 (Electronic)
IS  - 0742-2822 (Linking)
VI  - 33
IP  - 2
DP  - 2016 Feb
TI  - Predictive Value of D-Dimer Levels and Tissue Doppler Mitral Annular Systolic 
      Velocity for Detection of Left Atrial Appendage Thrombus in Patients with Mitral 
      Stenosis in Sinus Rhythm.
PG  - 264-75
LID - 10.1111/echo.13026 [doi]
AB  - BACKGROUND: Transesophageal echocardiogram (TEE) is a gold standard test for 
      diagnosis of left atrial (LA) thrombus, but it has limited sensitivity for 
      identification of small thrombi within side lobes. Thus, the absence of 
      visualizing a left atrial appendage (LAA) thrombus does not equate with the 
      absence of a LAA thrombus. AIM: To assess the predictive value of mitral annular 
      systolic velocity (Sa) and D-dimer for the detection of LA thrombus and 
      spontaneous echocardiographic contrast (SEC) in mitral stenosis (MS) patients 
      with sinus rhythm (SR). METHODS: Transthoracic echocardiogram, TEE, and D-dimer 
      analysis were performed in 104 severe MS patients and divided them into three 
      groups: Group I:no LA thrombus or SEC; Group II:LA SEC only; and Group III:LA 
      thrombus. RESULTS: Group III had more severe New York Heart Association (NYHA) 
      class (III-IV) dyspnea and lower Sa (6.9 +/- 0.7 vs.10.0 +/- 1.2 cm/sec), lower LAA 
      late emptying velocity (17.7 +/- 2.1 vs. 24.4 +/- 4.2 cm/sec), larger LA transverse 
      dimension, and LAA area (LAAA) than group I+II. Mean D-dimer levels were higher 
      in groups III and II than in group I. In multivariate analysis Sa, D-dimer 
      levels, LAAA, and NYHA class were independent predictors of LA thrombus. ROC 
      curve analysis revealed that higher Sa >8 cm/sec and lower D-dimer levels <370 
      mug/L predict the absence of LA thrombus and lower Sa <8 cm/sec and higher D-dimer 
      levels >510 mug/L predict the presence of LA thrombus. CONCLUSION: Measurement of 
      Sa and D-dimer levels is necessary for better assessment of LA thrombus and SEC, 
      for identification of patients who are at high risk for LA thrombus formation and 
      for initiation of prophylactic anticoagulation.
CI  - (c) 2015, Wiley Periodicals, Inc.
FAU - Kurakula, Naresh
AU  - Kurakula N
AD  - Department of Cardiology, Sri Venkateswara Institute of Medical Sciences, 
      Tirupati, India.
FAU - Durgaprasad, Rajasekhar
AU  - Durgaprasad R
AD  - Department of Cardiology, Sri Venkateswara Institute of Medical Sciences, 
      Tirupati, India.
FAU - Velam, Vanajakshamma
AU  - Velam V
AD  - Department of Cardiology, Sri Venkateswara Institute of Medical Sciences, 
      Tirupati, India.
FAU - Akula, Vidya Sagar
AU  - Akula VS
AD  - Department of Cardiology, Sri Venkateswara Institute of Medical Sciences, 
      Tirupati, India.
FAU - Kasala, Latheef
AU  - Kasala L
AD  - Department of Cardiology, Sri Venkateswara Institute of Medical Sciences, 
      Tirupati, India.
FAU - Muvva, Kalyan Venkateswarlu
AU  - Muvva KV
AD  - Department of Cardiology, Sri Venkateswara Institute of Medical Sciences, 
      Tirupati, India.
LA  - eng
PT  - Journal Article
DEP - 20150802
PL  - United States
TA  - Echocardiography
JT  - Echocardiography (Mount Kisco, N.Y.)
JID - 8511187
SB  - IM
MH  - Adult
MH  - Atrial Appendage/*diagnostic imaging
MH  - Coronary Thrombosis/complications/*diagnostic imaging
MH  - Echocardiography, Doppler
MH  - Echocardiography, Transesophageal
MH  - Female
MH  - Humans
MH  - Male
MH  - Mitral Valve/*diagnostic imaging
MH  - Mitral Valve Stenosis/complications/*diagnostic imaging
MH  - Predictive Value of Tests
MH  - ROC Curve
MH  - Reproducibility of Results
MH  - Systole
OTO - NOTNLM
OT  - D-dimer
OT  - left atrial appendage thrombus
OT  - mitral annular systolic velocity
EDAT- 2015/08/05 06:00
MHDA- 2016/11/10 06:00
CRDT- 2015/08/05 06:00
PHST- 2015/08/05 06:00 [entrez]
PHST- 2015/08/05 06:00 [pubmed]
PHST- 2016/11/10 06:00 [medline]
AID - 10.1111/echo.13026 [doi]
PST - ppublish
SO  - Echocardiography. 2016 Feb;33(2):264-75. doi: 10.1111/echo.13026. Epub 2015 Aug 
      2.