Relationship between spontaneous echo contrast and hematological markers in patients with rheumatic mitral stenosis

Abstract

IntroductionSystemic thromboembolism is a serious morbidity and mortality cause for patients with rheumatic mitral stenosis (RMS). Previously conducted researches showed that spontaneous echo contrast (SEC) found in the left atrium can constitute a risk factor for thrombus formation. The aim of this study is to evaluate the role of echocardiographic and hematologic parameters in anticipating the presence of SEC in the left atrium of patients with moderate–severe RMS. MethodsThis retrospective study includes all patients who were diagnosed with moderate–severe RMS and underwent a transesophageal echocardiography between 2011 and 2014. They were then divided in two groups depending on SEC presence; a SEC negative group and a SEC positive group. ResultsThere were 33 patients (32%) in the SEC negative group and 71 patients (68%) in the SEC positive group. The mean platelet volume was found to be significantly higher in the SEC positive group (10.0±1.3 vs. 11.6±1.4, p<0.001). To identify the factors affecting the presence of SEC, a multivariate analysis of the hematologic parameters was conducted and the mean platelet volume was found to be an independent predictor (odds ratio 1.913, 95% confidence interval 1.300–2.814; p=0.001). In the receiver operating characteristics curve analysis, a mean platelet volume >11.8fl had a 55% sensitivity and 92% specificity in predicting SEC in patients with mitral stenosis. ConclusionMean platelet volume constitutes an independent risk factor for the presence of left atrial SEC in patients with moderate–severe mitral valve stenosis.