بررسی عوامل همراه در شیوع فیبریلاسیون دهلیزی و ترومبوآمبولی سیستمیک(سکته مغزی) در بیماران مبتلا به بیماری رماتیسمال دریچه‌ای قلب

ABSTRACT: A consecutive Series of 522 patients (mean age 40.36 years ,female 70.9% ,male 29.1% ) with rheumatic valvular heart disease were studied during a period of seven years ,with particular reference to understanding the prevalence and risk factors of atrial fibrillation (AF) and systemic arterial thromboembolism (SAT). AF was observerd in 165 (31.6%) patients .The frequency of AF were 33.3% in pure mitral stenosis, 7.1% in pure mitral regurgitation 48% in mitral stenosis with regurgitation,50.9% in patients with mitral valve surgery and 76.2% in multivalvular surgery. The frequency of AF in pure mitral valve disease was significantly greater than pure aortic valve disease (32.4% vs.23% ,P<0.001). SAT occurred in 31 (5.9% patients 5.5% with stroke and 0.4% with peripheral lower limbs)with 96% mitral valve and 29% aortic valve involvement, that was significantly more common in patients with AF than without AF (15.2% vs 1.7% ,P<0.001). The frequency of anticoagulant therapy in patients with AF but without SAT was significantly more common than patients with AF and SAT (59.3% vs.12% ,P<0.001). Mean age of patients with stroke was significantly greater than other patients (51.3 vs.39.7 year,P<0.01) These data strongly suggest that in the patients with rheumatic valvular heart disease : 1 - AF is frequent in mitral valve disease ,multivalvular disease and history of mitral or multivalvular surgery , 2-SAT (stroke) is more Common in mitral valve disease ,AF ,older age ,and AF without anticoagulation.