The diagnosis of left atrial thrombus in mitral stenosis

by determination of plasma D-dimer level

Abstract

To determine the utility of D-dimer in the detection of left atrial thrombus in mitral stenosis (MS), we measured the plasma level of D-dimer in 23 patients who had predominant MS with or without other valvular heart diseases. The presence or absence of left atrial thrombi was confirmed at the surgery for mitral valve replacement in all cases. Left atrial thrombi were present in 10 patients (group A) and absent in 13 patients (group B). Atrial fibrillation was found in all cases.
The results were as follows;
1) The level of D-dimer was 697ng/ml (geometric mean) in group A and 101ng/ml in group B. The lowest level of D-dimer in group A was 234ng/ml and the highest one in group B was 200ng/ml. Thus, two groups were clearly separated.
2) The level of D-dimer showed a significant correlation with the weight of left artial thrombi (r=0.80, p<0.05).