scholarly journals The significance of the left atrial appendage in rheumatic heart disease.

Circulation ◽  
1976 ◽  
Vol 54 (1) ◽  
pp. 146-153 ◽  
Author(s):  
M J Kelley ◽  
L P Elliott ◽  
S T Shulman ◽  
E M Ayoub ◽  
B E Victorica ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Rheumatic Heart

Role of Lymphocyte Subsets in Pathogenesis of Chronic Rheumatic Heart Disease

1998 ◽  
Vol 6 (2) ◽  
pp. 104-107
Author(s):  
Rajendar K Suri ◽  
Neerod K Jha ◽  
Harpreet Vohra ◽  
Ratna S Manjari ◽  
Rajam Venkateshwaran ◽  
...  
Keyword(s):  
Flow Cytometry ◽  
T Cells ◽  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Lymphocyte Subsets ◽  
Cd4 Cells ◽  
Activated T Cells ◽  
Rheumatic Heart

Analyses of lymphocyte subsets using flow cytometry were conducted to determine the significance of these cells in the pathogenesis of chronic rheumatic heart disease. Lymphocytes (B cells, T cells, CD4 cells, CD8 suppressor or cytotoxic T cells, activated T cells, and natural killer cells) were measured in blood and left atrial appendage samples of 30 patients with rheumatic heart disease and 10 patients with acyanotic congenital heart disease. Monoclonal fluorescent-labeled antibodies were used to identify various cells by flow cytometry. There was a significant increase in CD4 cells and activated T cells with a significant decrease in B cells in the left atrial appendage tissue of patients with rheumatic heart disease compared to those in the control group. There was no significant difference between the two groups in the distribution pattern of T lymphocytes in peripheral blood. These changes in rheumatic heart disease reflect an abnormal immunoregulatory mechanism with an ongoing enhanced immunological process continuing into the chronic phase of the disease. In our opinion, this persistent T cell response may lead to fresh damage to the myocardium and deformation of the heart valves.

scholarly journals Altered left atrial appendage function associated with cardioembolic stroke in patients with rheumatic heart disease

2021 ◽  
Vol 8 (9) ◽  
pp. 1395
Author(s):  
Zeeshan H. Mansuri ◽  
Jit H. Brahmbhatt ◽  
Roopesh R. Singhal ◽  
Karthik Natarajan
Keyword(s):  
Heart Disease ◽  
Flow Velocity ◽  
Rheumatic Heart Disease ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Peak Flow ◽  
Thrombus Formation ◽  
Cardioembolic Stroke ◽  
Peak Flow Velocity ◽  
Rheumatic Heart

Background: Left atrial appendage (LAA) is usually the first site for thrombus formation in rheumatic heart disease (RHD). LAA function is altered in RHD which may predispose it to thrombus formation. The aim of this study was to determine an association between function of LAA and cardioembolic stroke.Methods:Total 132 patients with RHD were studied by means of transthoracic echocardiography and/or transesophageal echocardiography and left atrial (LA) size, LAA ejection fraction (EF) and peak flow velocities were measured. These patients were followed up for 18 months with reference to development of cardioembolic stroke.Results: Seventy nine patients had atrial fibrillation (AF), of which 34 had thrombus in LAA. Out of 53 patients with sinus rhythm, 5 had LAA thrombus. Mean LAA EF was significantly lower in patients with thrombus in LAA, so was the peak flow velocity (both variables p<0.0001). Saw tooth LAA outflow velocity pattern was visible in 30 (80%) patients with LAA thrombus versus 20 (28%) patients without LAA thrombus. Total 14 patients experienced cardioembolic stroke. Patients with cardioembolic stroke had lower mean LAA EF and peak flow velocity as compared to patients without cardioembolic stroke.Conclusions:Increased LAA size, reduced LAA EF and reduced peak flow velocity are associated with increased risk of cardioembolic stroke. LAA evaluation should be mandatory in deciding treatment strategies in patients with RHD and AF. 

Malnutrition and severe rheumatic heart disease underscoring failure to thrive in an eleven-year-old boy

1993 ◽  
Vol 3 (1) ◽  
pp. 79-81
Author(s):  
Lurildo Ribeiro Saraiva ◽  
Tacito Barbalho ◽  
Djair Brindeiro Filho
Keyword(s):  
Heart Disease ◽  
Rheumatic Fever ◽  
Rheumatic Heart Disease ◽  
Strong Association ◽  
Failure To Thrive ◽  
Atrial Appendage ◽  
Physical Growth ◽  
Northeast Brazil ◽  
Severe Retardation ◽  
Rheumatic Heart

SummaryWe describe an eleven-year-old boy with severe retardation in physical growth and severe rheumatic valvar disease. At surgery, a sample of the atrial appendage showed Aschoff nodules, although no antecedent of rheumatic fever was recorded. The patient was HLA-DR5 positive. The case emphasizes the strong association of malnutrition with severe rheumatic heart disease in northeast Brazil.

scholarly journals The clinical and etiological profile of atrial fibrillation after echocardiography in a tertiary care centre from North India - a cross sectional observational study

2017 ◽  
Vol 5 (3) ◽  
pp. 847 ◽  
Author(s):  
Ranvijay Singh ◽  
Rajesh Kashyap ◽  
Rajeev Bhardwaj ◽  
Rajeev Marwaha ◽  
Manish Thakur ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Tertiary Care ◽  
Hypertensive Heart Disease ◽  
Atrial Appendage ◽  
North India ◽  
Left Atrial Enlargement ◽  
Atrial Enlargement

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice. In western countries, rheumatic heart disease (RHD) is a rare cause of atrial fibrillation but in developing countries like India it is one of the commonest cause of atrial fibrillation. We studied etiology, left atrial size and the incidence of left atrial appendage clot in patients with atrial fibrillation at our institution so that guidelines could be formulated to manage the patients of AF in the hours of emergency.Methods: 110 consecutive patients of atrial fibrillation coming to emergency, cardiology and medicine outpatient department over a period of one year were enrolled for the study. Ethical committee clearance was taken. Detailed history were taken, clinical presentation reviewed  and examination were carried out. All patients were subjected to transthoracic echocardiography and for transesophageal echocardiography if required.Results: The mean age of patients in the study was 58.42±14.27 years (range 22-90 years). Maximum numbers of patients were in the age group of 61-70 years (26.37%). Out of 110 patients with atrial fibrillation, 72 patients (65.46%) were females and 38 patients (34.54%) were males. Majority of patients presented with more than one symptom. Out of 110, 66 patients (60%) had RHD. Among RHD patients, 50 patients (45.55%) were females and 16 patients (14.55%) were males. Next common causes were hypertensive heart disease and degenerative valvular heart disease.Conclusions: In our study RHD was the most common cause of atrial fibrillation, followed by hypertensive heart disease and degenerative valvular heart disease. Mitral valve involvement was seen in all patients of RHD. Left atrial enlargement was seen in majority of patients, so left atrial enlargement could be a predictor of atrial fibrillation. Patients of left atrial enlargement are more prone to develop left atrial appendage clot.

scholarly journals Spectrum of left atrial thrombus in rheumatic heart disease

2014 ◽  
Vol 2014 (apr30 1) ◽  
pp. bcr2014204370-bcr2014204370
Author(s):  
H. Mahla ◽  
K. K. Harlalka ◽  
S. Bhairappa ◽  
C. N. Manjunath
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Left Atrial ◽  
Left Atrial Thrombus ◽  
Atrial Thrombus ◽  
Rheumatic Heart

Non-obstructive membrane of left atrial appendage orifice: first paediatric report

2020 ◽  
Vol 30 (6) ◽  
pp. 894-895
Author(s):  
Sakshi Sachdeva ◽  
Sushil Azad ◽  
Sitaraman Radhakrishnan
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Left Atrial ◽  
Congenital Heart ◽  
Left Atrial Appendage ◽  
Clinical Course ◽  
Atrial Appendage ◽  
Rare Anomaly ◽  
Paediatric Case

AbstractLeft atrial appendage membrane is a rare anomaly. Its implications on clinical course are unknown. We report the first paediatric case in association with a congenital heart disease.

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