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Predictive Value Of Left Atrial Volume Index And Right Ventricular Dilatation In Mitral Stenosis For Atrial Fibrillation.

Year 2014, Volume: 39 Issue: 4, 0 - , 22.07.2014
https://doi.org/10.17826/cutf.27898

Abstract

Purpose: To examine the predictive value of left atrial volume index (LAVI) and right ventricular dilatation in mitral stenosis (MS) for atrial fibrillation (AF) and to determine the cut-off value. Materials and Methods: 14 men, 92 women, a total of 106 cases between the ages of 23-86 (mean: 50.7 ± 12.7) with mitral stenosis were included in the study. All echocardiographic assessments were performed according to the criteria of American Society of Echocardiography (ASE). Patients were divided into two groups as AF and normal sinus rhythm (NSR). 39 patients with AF were classified as AF group and 67 patients with normal sinus rhythm were classified as NSR group. The demographic, clinical, echocardiographic characteristics of these two groups were compared. For the statistical analysis of datas, Kolmogorov-Smirnov, T-test, Mann-Whitney-U test and ROC analysis were used. Results: In mitral valve stenosis, left atrial volume index and right ventricular diastolic diameter increase. LAVI cut-off value for atrial fibrillation is 40,74 ml/m2, the sensitivity and specificity of it was found to be as 80% and 80.6%, respectively (PPV = 69.0%, NPV = 88.5%). Cut-off value of right ventricular diastolic diameter (RVDD) for atrial fibrillation is 36.7 mm, the sensitivity and specificity of it was found to be as 62.9% and 59.7%, respectively (PPV = 46.0%, NPV = 75.5%). Conclusion: It has been concluded that, there are cut-off values of LAVI and RVDD for the development of atrial fibrillation in mitral stenosis and to know those values that were important in determining treatment strategies.

References

  • Carabello BA. Modern Management of Mitral Stenosis. Circulation. 2005;112:432-7
  • Barnes ME,Miyasaka Y,Seward JB,et al. Left atrial volume in the prediction of first ischemic stroke in an elderly cohort without atrial fibrillation. Mayo Clin Proc. 2004;79:1008-14
  • Ristow B, Ali S, Whooley MA, Schiller NB. Usefulness of Left Atrial Volume Index to Predict Heart Failure Hospitalization and Mortality in Ambulatory Patients With Coronary Heart Disease and Comparison to Left Ventricular Ejection Fraction (from the Heart and Soul Study). Am J Cardiol. 2008;102:70-6
  • Tsang TS,Barnes ME,Bailey KR,et al. Left atrial volume: important risk marker of incident atrial fibrillation in 1655 older men and women. Mayo Clin Proc. 2001;76:467-75.
  • Lang RM,Bierig M,Devereux RB,et al. Chamber Quantification Writing Group; American Society of Echocardiography’s Guidelines and Standards Committee; European Association of Echocardiography. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am SocEchocardiogr. 2005;18:1440-63.
  • Fuster V, Rydén LE, Cannom DS, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006;114:257-354
  • Wood P. An appreciation of mitral stenosis. Brit Med J. 1954;1:1113-24.
  • Furberg CD, Psaty BM, Manolio TA, et al. Prevalence of atrial fibrillation in elderly subjects (The Cardiovascular Health Study). Am J Cardiol. 1994;74:236-41.
  • Savage DD,Garrison RJ,Castelli WP,et al. Prevalence of submitral (annular) calcium and its correlates in a general population-based sample (The Framingham Study). Am J Cardiol. 1983;51:1375-8.
  • Schotten U, Verheule S, Kirchhof P, Goette A. Pathophysiological mechanisms of atrial fibrillation: a translational appraisal. Physiol Rev. 2011;91:265-325
  • Selzer A, Cohn KE. Natural history of mitral stenosis: a review. Circulation. 1972;45:878-90
  • Moreyra AE,Wilson AC,Deac R,et al. Factors associated with atrial fibrillation in patients with mitral stenosis: a cardiac catheterization study. Am Heart J 1998;135:138-45
  • Lewis BM, Gorlin R, Houssay HE, et al. Clinical and physiological correlations in patients with mitral stenosis. Am Heart J. 1952;43
  • Ward C, Hancock BW. Extreme pulmonary hypertension caused by mitral valve disease. Natural history and results of surgery. Br Heart J. 1975;37:74-8
  • Vaziri M, Larson MG, Benjamin EJ, Levy D. Echocardiographic predictors of nonrheumatic atrial fibrillation. The Framingham Study. Circulation. 1994;89:724-30
  • Arisoy E, Korkmaz İ, Eren ŞH, et al. Analyses of the Risc Factors for Atrial Fibrillation Among the Patients Who were Admitted to Emergency Service. J Clin Anal Med. 2012;3:143-6
  • Arslan Ş, Büyükkaya Ş, Gündoğdu F, et al. Romatizmal mitral darlığı olan, sinus ritimli veya atriyal fibrilasyonlu hastalarda sağ ventrikül fonksiyonlarının doku Doppler eko kardiyografi ile değerlendirilmesi. Arch Turk Soc Cardiol. 2007;35:475-81
  • Akdemir B,Altekin RE,Küçük M,et al. The significance of the left atrial volume index in cardioversion success and its relationship with recurrence in patients with non-valvular atrial fibrillation subjected to electrical cardioversion: a study on diagnostic accuracy. Anadolu Kardiyol Derg. 2013;13:18-25.
  • Nair A, Fischer A. Atrial fibrillation in hypertrophic cardiomyopathy: mechanisms, embolic risk and prognosis. Anadolu Kardiyol Derg. 2006;6:40-3
  • Sakaguchi E, Yamada A, Sugimoto K, Ito Y, Shiino K, Takada K, Iwase M, Ozaki Y. Prognostic value of left atrial volume index in patients with first acute myocardial infarction. Eur J Echocardiogr. 2011;12:440-4.
  • YazışmaAdresi / Address for Correspondence: Dr. AbdulmelikYıldız Seyit nizam mah.Balıklı çırpıcı sok. Kiptaş merkezevleri 2.Etap A 7 blok No:25 Zeytinburnu / İSTANBUL E-mail: drmelik@hotmail.com G eliştarihi/Received on : 21.04.2014
  • Kabul tarihi/Accepted on: 28.05.2014

Mitral stenozda sol atrial volüm indexi ve Sağ ventrikül dilatasyonunun atrial fibrilasyon için prediktif değeri

Year 2014, Volume: 39 Issue: 4, 0 - , 22.07.2014
https://doi.org/10.17826/cutf.27898

Abstract

Amaç: Mitral stenozda (MS) sol atrial volüm indeksi (LAVİ) ve sağ ventrikül dilatasyonunun atrial fibrilasyon (AF) için prediktif değerini inceleme ve cutoff değerini belirlemektir. Yöntemler: Mitral darlığı olan ve yaşları 23-86 arasında (Ortalama: 50,7±12,7) olan 14 erkek, 89 kadın, toplam 103 vaka çalışmaya alındı. Bütün ekokardiyografik değerlendirmeler Amerikan Ekokardiyografi Cemiyeti (ASE) kriterlerine göre yapıldı. Hastalar AF ve sinüs ritmi (NSR) olmak üzere iki gruba ayrıldı. AF olan 36 hasta AF Grubu ve Sinüs ritminde olan 67 hasta NSR Grubu olarak sınıflandırıldı. Bu iki grubun klinik, demografik, ekokardiyografik özellikleri karşılaştırıldı. İstatistiksel metod yazılacak Bulgular: Mitral kapak alanı azaldıkça sol atrial völüm indeksi ve sağ ventrikül diastolik çapı artmaktadır. Atrial fibrilasyon için LAVİ cut off değeri 40,74 ml/m2 olup sensitivitesi %80 ve spesifitesi %19.4 olarak bulundu. Atrial fibrilasyon sağ ventrikül diastolik çapı (RVDÇ) için cut off değeri 36,7 mm olup sensitivitesi %62,9 ve spesifitesi %40,3 olarak bulundu. Sonuç: Mitral stenozunda atrial fibrilasyon gelişimi için LAVİ ve RVDÇ cut off değerlerinin olduğu ve bu değerleri bilmenin tedavi stratejilerini belirlemede önemli olduğu kanaatine varıldı.

References

  • Carabello BA. Modern Management of Mitral Stenosis. Circulation. 2005;112:432-7
  • Barnes ME,Miyasaka Y,Seward JB,et al. Left atrial volume in the prediction of first ischemic stroke in an elderly cohort without atrial fibrillation. Mayo Clin Proc. 2004;79:1008-14
  • Ristow B, Ali S, Whooley MA, Schiller NB. Usefulness of Left Atrial Volume Index to Predict Heart Failure Hospitalization and Mortality in Ambulatory Patients With Coronary Heart Disease and Comparison to Left Ventricular Ejection Fraction (from the Heart and Soul Study). Am J Cardiol. 2008;102:70-6
  • Tsang TS,Barnes ME,Bailey KR,et al. Left atrial volume: important risk marker of incident atrial fibrillation in 1655 older men and women. Mayo Clin Proc. 2001;76:467-75.
  • Lang RM,Bierig M,Devereux RB,et al. Chamber Quantification Writing Group; American Society of Echocardiography’s Guidelines and Standards Committee; European Association of Echocardiography. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am SocEchocardiogr. 2005;18:1440-63.
  • Fuster V, Rydén LE, Cannom DS, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006;114:257-354
  • Wood P. An appreciation of mitral stenosis. Brit Med J. 1954;1:1113-24.
  • Furberg CD, Psaty BM, Manolio TA, et al. Prevalence of atrial fibrillation in elderly subjects (The Cardiovascular Health Study). Am J Cardiol. 1994;74:236-41.
  • Savage DD,Garrison RJ,Castelli WP,et al. Prevalence of submitral (annular) calcium and its correlates in a general population-based sample (The Framingham Study). Am J Cardiol. 1983;51:1375-8.
  • Schotten U, Verheule S, Kirchhof P, Goette A. Pathophysiological mechanisms of atrial fibrillation: a translational appraisal. Physiol Rev. 2011;91:265-325
  • Selzer A, Cohn KE. Natural history of mitral stenosis: a review. Circulation. 1972;45:878-90
  • Moreyra AE,Wilson AC,Deac R,et al. Factors associated with atrial fibrillation in patients with mitral stenosis: a cardiac catheterization study. Am Heart J 1998;135:138-45
  • Lewis BM, Gorlin R, Houssay HE, et al. Clinical and physiological correlations in patients with mitral stenosis. Am Heart J. 1952;43
  • Ward C, Hancock BW. Extreme pulmonary hypertension caused by mitral valve disease. Natural history and results of surgery. Br Heart J. 1975;37:74-8
  • Vaziri M, Larson MG, Benjamin EJ, Levy D. Echocardiographic predictors of nonrheumatic atrial fibrillation. The Framingham Study. Circulation. 1994;89:724-30
  • Arisoy E, Korkmaz İ, Eren ŞH, et al. Analyses of the Risc Factors for Atrial Fibrillation Among the Patients Who were Admitted to Emergency Service. J Clin Anal Med. 2012;3:143-6
  • Arslan Ş, Büyükkaya Ş, Gündoğdu F, et al. Romatizmal mitral darlığı olan, sinus ritimli veya atriyal fibrilasyonlu hastalarda sağ ventrikül fonksiyonlarının doku Doppler eko kardiyografi ile değerlendirilmesi. Arch Turk Soc Cardiol. 2007;35:475-81
  • Akdemir B,Altekin RE,Küçük M,et al. The significance of the left atrial volume index in cardioversion success and its relationship with recurrence in patients with non-valvular atrial fibrillation subjected to electrical cardioversion: a study on diagnostic accuracy. Anadolu Kardiyol Derg. 2013;13:18-25.
  • Nair A, Fischer A. Atrial fibrillation in hypertrophic cardiomyopathy: mechanisms, embolic risk and prognosis. Anadolu Kardiyol Derg. 2006;6:40-3
  • Sakaguchi E, Yamada A, Sugimoto K, Ito Y, Shiino K, Takada K, Iwase M, Ozaki Y. Prognostic value of left atrial volume index in patients with first acute myocardial infarction. Eur J Echocardiogr. 2011;12:440-4.
  • YazışmaAdresi / Address for Correspondence: Dr. AbdulmelikYıldız Seyit nizam mah.Balıklı çırpıcı sok. Kiptaş merkezevleri 2.Etap A 7 blok No:25 Zeytinburnu / İSTANBUL E-mail: drmelik@hotmail.com G eliştarihi/Received on : 21.04.2014
  • Kabul tarihi/Accepted on: 28.05.2014
There are 22 citations in total.

Details

Primary Language Turkish
Journal Section Research
Authors

Abdulmelik Yıldız This is me

Ahmet Karakurt This is me

Güllü Amikoğlu This is me

Publication Date July 22, 2014
Published in Issue Year 2014 Volume: 39 Issue: 4

Cite

MLA Yıldız, Abdulmelik et al. “Mitral Stenozda Sol Atrial volüm Indexi Ve Sağ ventrikül Dilatasyonunun Atrial Fibrilasyon için Prediktif değeri”. Cukurova Medical Journal, vol. 39, no. 4, 2014, doi:10.17826/cutf.27898.