MITRAL-STENOSIS AND SYSTEMIC EMBOLISM - ECHOCARDIOGRAPHIC FEATURES AND CLINICAL CORRELATION

The transthoracic echocardiographic and clinical features of 71 consec utive patients with mitral stenosis were reviewed. Patients were divid ed into either Group 1 (without systemic embolism, n = 54) or Group 2 (with systemic embolism, n = 17). Left atrial dimension (LAD) was slig htly smaller in group 1 than in group 2 (45.2 +/- 8.6 mm vs. 48.8 +/- 8.5 mm; p = NS). Mitral orifice area (MOA) was slightly larger in Grou p 1 than in group 2 (1.39 +/- 0.56 cm(2) vs. 1.32 +/- 0.48 cm(2); p = NS). Left atrial thrombus was detected in 4 (7%) patients in Group 1 a nd in 1 (6%) patient in Group 2 (p = NS). The age of the patients was slightly younger in Group 1 than in Group 2 (49.7 +/- 15.4 vs. 54.4 +/ - 18.2; p = NS). The incidence of systemic embolism was not significan tly different between those patients younger than 40 years of age and those patients older than 40 years of age. The incidence of atrial fib rillation (AF) was significantly higher in those patients older than 4 0 years of age as compared to those patients younger than 40 years of age. AF was noted in 33 (61%) patients in Group 1 and in 12 (71%) pati ents in Group 2 (p = NS). Of 71 patients, 45 were in AF and 26 were in sinus rhythm (SR). LAD was significantly larger in patients with AF t han in patients with SR (49 +/- 7.8 mm vs. 41 +/- 7.8 mm; p < 0.001). MOA was slightly smaller in patients with AF than in patients with SR (1.30 +/- 0.49 cm(2) vs. 1.49 +/- 0.61 cm(2); p = NS). The age of the patients was slightly older in patients with AF than in patients with SR (53.4 +/- 16.0 vs. 46.3 +/- 15.6; p = NS). The overall incidence of systemic embolism in this study was 24% (17/71).