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E/Ea for the prediction of left atrial appendage thrombi in patients with atrial fibrillation and severe mitral stenosis


Atrial fibrillation (AF), left atrial appendage thrombi (LAAT) and subsequent embolic stroke are the most frequent complications of mitral stenosis .E/Ea is used traditionally for the assessment of left atrium pressure, and besides AF and dilated LA size which promotes stasis of blood in LA, high LA pressure also play a role to clot formation in LA .The receiver operator characteristics (ROC) curve point-coordinates identified an E:e value of ≥ 36.5to have 57.14% sensitivity and 90.91% specificity for LAAT;We find this ratio relatively specific for prediction of LAAT, independent of MVA and LA volume, however it needs to be externally validated.

Credits: Atoosheh Rohani; Hoorak Poorzand; Mohammad R Arefifar



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