ObjectiveTo investigate the effect of rheumatic mitral stenosis (RMS) and persistent atrial fibrillation (PeAF) on morphological and functional ultrasound indices of left atrial appendage. MethodsThe clinical data of 57 patients with RMS and concomitant PeAF (the RMS-PeAF group), 22 patients with simple RMS (the RMS group), 31 patients with simple PeAF (the PeAF group), and 40 normal healthy individuals (the normal control group) were retrospectively analyzed. The morphological ultrasound indices of left atrial appendage in terms of the maximum section area index of left atrial appendage (LAAAImax), minimum section area index of left atrial appendage (LAAAImin), maximum volume index of left atrial appendage (LAAVImax), minimum volume index of left atrial appendage (LAAVImin), maximum orifice dimension index of left atrial appendage (LAAODImax), and left atrial appendage length index (LAALI), as well as functional ultrasound indices of left atrial appendage (peak filling velocity of left atrial appendage ［LAA-PFV］, peak emptying velocity of left atrial appendage ［LAA-PEV］, anterior wall systolic velocity of left atrial appendage ［LAA-AWSV］, anterior wall diastolic velocity of left atrial appendage ［LAA-AWDV］, LAA-PFV/LAA-AWDV value, reduction rate of left atrial appendage area ［LAAAR］, ejection fraction of left atrial appendage ［LAAEF］); moreover, spontaneous echo contrast ［SEC］ grading of left atrial appendage were compared between the four groups. Results(1) The RMS-PeAF group exhibited larger LAAAImax, LAAAImin, LAALI, and LAAODImax as compared with the PeAF and normal control groups, and larger LAAVImax and LAAVImin as compared with the remaining 3 groups (P＜0.05). The RMS and PeAF groups interpreted larger LAAAImin, LAAVImin, LAALI, and LAAODImax as compared with the normal control group, and LAAODImax of the RMS group was larger than that of the PeAF group (P＜0.05). (2) The RMS-PeAF group implied smaller LAA-PFV, LAAAR, LAAEF as compared with the remaining 3 groups, a smaller LAA-PEV as compared with the normal control group, smaller LAA-AWSV and LAA-AWDV as compared with the PeAF and normal control groups, and a larger LAA-PFV/LAA-AWDV value as compared with the PeAF group (P＜0.05). The RMS group yielded smaller LAA-PFV, LAA-PEV, LAAAR, LAAEF as compared with the normal control group, smaller LAA-AWSV and LAA-AWDV as compared with the PeAF and normal control groups, whereas a larger LAA-PFV/LAA-AWDV value as compared with the PeAF and normal control groups (P＜0.05). The PeAF group depicted smaller LAA-PFV, LAA-PEV, LAAAR, LAAEF, and LAA-PFV/LAA-AWDV value as compared with the normal control group (P＜0.05). (3) There was a statistically significant difference in SEC grading of left atrial appendage between the 4 groups, therein SEC grading of left atrial appendage of the RMS-PeAF group was higher than that of the remaining 3 groups (P＜0.05). ConclusionSimple RMS and simple PeAF have similar effect degrees on morphological and partially functional ultrasound indices of left atrial appendage, and the coexistence of the two will produce a superimposed effect; however, RMS exerts a more significant effect on the inhibition of atrial appendage anterior wall movement.

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