Sampath Kumar, P (2012) Assessment of Prothrombotic burden in patients with Rheumatic Heart Disease using plasma D-dimer assay. Masters thesis, Stanley Medical College, Chennai.
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Abstract
INTRODUCTION : In spite of tremendous and advanced improvement both in preventive aspects as well as therapeutic part Rheumatic Heart Disease forms a part of health hazard in developing countries. A part of complication of RHD puts these patients for a major morbidity leading to mortality. So this preventable complication i.e. thromboembolic manifestation to a extent can be predicted, and it is taken as my study. This study based on plasma D-dimer levels and predicting a major adverse event, thromboembolic manifestation in these patients. Plasma D-dimers are cross linked fibrin derivatives which result from degradation of fibrin by endogenous fibrinolytic system. They reflect both increased coagulation and an active fibrinolytic system and are markers for clot risk. AIMS AND OBJECTIVES : Assessing prothrombotic burden in patients with Rheumatic heart diseases with AF or without AF using plasma D-dimer levels and comparing the D-dimer levels among the Rheumatic heart disease patients with various subsets of patients. Correlation of AF to left atrial size and to age and to D-dimer level in the study sample. Correlation of mitral regurgitation to D-dimer level as a part of systemic hypo fibrinolytic state. Correlating left atrial empting velocity to D-dimer level as a part of Intra atrial hemodynamics. Background : RHD is more common in middle aged in dividuals with stroke manifestation . Among the subset of patients with RHD it is more commonly associated in MS with AF patients. And it is more common when increased LA Size as well as decreaesd LAA empting Velocity. So our study evaluated the correlation Method : Blood sample collected to this patients with RHD with excluding older age, H/o surgery and DVTand Recent trauma. D-dimer assayed by particle enhanced immunoturbidimetry. Echo done to all patients. Results : It was analysed that age distribution is in the range of 33.91to 9.91.With AF Association present in 16.92% of the Individual. Mean LA dimension in all subsets in the range of 4.47+ 0.82. D-dimer level is highest in the subset of MS + MR + AF subgroup 0.53+ 0.04 μgm FEU/ ml. Conclusion : It was concluded the highest D-dimer level found in MS+MR+AF group and lower in MS+SR group. Presensce of MR dose not prevent thromboembolism when associated With AF and MS.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Prothrombotic burden ; patients ; Rheumatic Heart Disease ; plasma D-dimer assay. |
| Subjects: | MEDICAL > Cardiology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 06 Jul 2017 02:54 |
| Last Modified: | 06 Jul 2017 10:13 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1069 |
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