[Latar belakang. Timbulnya stasis darah dan pembesaran atrium kiri menyebabkanpeningkatan angka kejadian trombus di atrium kiri dan apendiks atrium kiri (Left AtrialAppendage-LAA) pada SM. Diameter atrium kiri yang membesar disebutkan sebagai faktorterjadinya pembentukan LASEC dan meningkatkan angka kejadian tromboemboli. Selain ituadanya stasis darah yang dibuktikan dengan penurunan ejeksi fraksi LAA dan kecepatanaliran darah LAA dapat mencetuskan timbulnya trombus. Perubahan moluker adhesi sICAM-1 dan sVCAM-1 berhubungan dengan kejadian tromboemboli. Tetapi apakah terdapathubungan antara peran hemodinamik, terutama terhadap diameter, fraksi ejeksi dan kecepatanaliran darah pada LAA dengan kadar molekul adhesi seperti sICAM-1 dan sVCAM-1 belumterjawab.Metode. Pasien SM derajat sedang-berat (tanpa adanya regurgitasi mitral signifikan) yangmenjalani pemeriksan ekokardiografi transesofageal diikutsertakan secara konsekutif sejakJanuari-April 2014. Penilaian fungsi apendiks atrium kiri dilakukan dengan pemeriksaantransesofageal ekokardiografi. Kadar sICAM-1 dan sVCAM-1 dari vena perifer diukurdengan teknik enzyme-linked immunosorbent assay.Hasil. Sebanyak 26 subyek penelitian dengan rerata usia 38,92±11,93 tahun, 65,3% berjeniskelamin perempuan, dan 46,1% memiliki irama fibrilasi atrium. Dengan sampel tersebut,didapatkan tidak ada hubungan antara komponen fungsi apendiks atrium kiri, baik diameter,ejeksi fraksi, dan kecepatan aliran darah LAA dengan kadar sICAM-1. Tidak terdapathubungan antara fungsi LAA pada variabel diameter dengan kadar sVCAM-1. Terdapathubungan terbalik antara ejeksi fraksi LAA dengan kadar sVCAM-1 (-0,21, p=0.038, 95%KI-0,41- -0,01) dan hubungan terbalik antara kecepatan aliran darah LAA dengan kadarsVCAM-1 (-0,29, p=0,048, 95%KI -0,59- -0,003).Kesimpulan. Semakin rendah ejeksi fraksi dan kecepatan aliran darah LAA maka semakintinggi kadar sVCAM-1.

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Background: Blood stasis and left atrial enlargement increase the incidence of thrombus in

the left atrium and left atrial appendage (LAA). Enlargement of left atrial diameter is a factor

for LASEC formation and increase the incidence of thromboembolism. Blood stasis which

evidenced by a decrease in ejection fraction and LAA blood flow velocity can trigger the

presence of thrombus. Changes in soluble adhesion molecules sICAM-1 and sVCAM-1

associated with thromboembolic events. But relationship between the role of hemodynamics,

especially the ejection fraction and blood flow velocity in the LAA with the levels of

adhesion molecules such as sICAM-1 and sVCAM-1 is not well understood.

Methods: Patient with moderate-severe Mitral Stenosis (in the absence of significant mitral

regurgitation) underwent transesophageal echocardiography from January to April 2014.

Levels of sICAM-1 and sVCAM-1 from peripheral vein were measured by enzyme-linked

immunosorbent technique assay.

Results: A total of 26 subjects with a mean age of 38.92 ± 11.93 years, 65.3% female, and

46.1% had atrial fibrillation. We found no association between components of left atrial

appendage function: diameter, ejection fraction and blood flow velocity of LAA with

sICAM-1 levels. There was no relationship between the LAA function in the variable

diameter of LAA with sVCAM-1 levels. There is an inverse relationship between ejection

fraction of LAA and levels of sVCAM-1 (-0.21, p = 0.038, 95% KI -0,41- -0,01) and an

inverse association between LAA blood flow velocity and levels of sVCAM-1 (-0 , 29, p =

0.048, 95% KI -0.59 - 0.003).

Conclusion: Low ejection fraction of LAA is associated with higher the levels of sVCAM-1.

Low LAA blood flow velocity is associated with higher the levels of sVCAM-1.;Background: Blood stasis and left atrial enlargement increase the incidence of thrombus in

the left atrium and left atrial appendage (LAA). Enlargement of left atrial diameter is a factor

for LASEC formation and increase the incidence of thromboembolism. Blood stasis which

evidenced by a decrease in ejection fraction and LAA blood flow velocity can trigger the

presence of thrombus. Changes in soluble adhesion molecules sICAM-1 and sVCAM-1

associated with thromboembolic events. But relationship between the role of hemodynamics,

especially the ejection fraction and blood flow velocity in the LAA with the levels of

adhesion molecules such as sICAM-1 and sVCAM-1 is not well understood.

Methods: Patient with moderate-severe Mitral Stenosis (in the absence of significant mitral

regurgitation) underwent transesophageal echocardiography from January to April 2014.

Levels of sICAM-1 and sVCAM-1 from peripheral vein were measured by enzyme-linked

immunosorbent technique assay.

Results: A total of 26 subjects with a mean age of 38.92 ± 11.93 years, 65.3% female, and

46.1% had atrial fibrillation. We found no association between components of left atrial

appendage function: diameter, ejection fraction and blood flow velocity of LAA with

sICAM-1 levels. There was no relationship between the LAA function in the variable

diameter of LAA with sVCAM-1 levels. There is an inverse relationship between ejection

fraction of LAA and levels of sVCAM-1 (-0.21, p = 0.038, 95% KI -0,41- -0,01) and an

inverse association between LAA blood flow velocity and levels of sVCAM-1 (-0 , 29, p =

0.048, 95% KI -0.59 - 0.003).

Conclusion: Low ejection fraction of LAA is associated with higher the levels of sVCAM-1.

Low LAA blood flow velocity is associated with higher the levels of sVCAM-1., Background: Blood stasis and left atrial enlargement increase the incidence of thrombus in

the left atrium and left atrial appendage (LAA). Enlargement of left atrial diameter is a factor

for LASEC formation and increase the incidence of thromboembolism. Blood stasis which

evidenced by a decrease in ejection fraction and LAA blood flow velocity can trigger the

presence of thrombus. Changes in soluble adhesion molecules sICAM-1 and sVCAM-1

associated with thromboembolic events. But relationship between the role of hemodynamics,

especially the ejection fraction and blood flow velocity in the LAA with the levels of

adhesion molecules such as sICAM-1 and sVCAM-1 is not well understood.

Methods: Patient with moderate-severe Mitral Stenosis (in the absence of significant mitral

regurgitation) underwent transesophageal echocardiography from January to April 2014.

Levels of sICAM-1 and sVCAM-1 from peripheral vein were measured by enzyme-linked

immunosorbent technique assay.

Results: A total of 26 subjects with a mean age of 38.92 ± 11.93 years, 65.3% female, and

46.1% had atrial fibrillation. We found no association between components of left atrial

appendage function: diameter, ejection fraction and blood flow velocity of LAA with

sICAM-1 levels. There was no relationship between the LAA function in the variable

diameter of LAA with sVCAM-1 levels. There is an inverse relationship between ejection

fraction of LAA and levels of sVCAM-1 (-0.21, p = 0.038, 95% KI -0,41- -0,01) and an

inverse association between LAA blood flow velocity and levels of sVCAM-1 (-0 , 29, p =

0.048, 95% KI -0.59 - 0.003).

Conclusion: Low ejection fraction of LAA is associated with higher the levels of sVCAM-1.

Low LAA blood flow velocity is associated with higher the levels of sVCAM-1.]