Clinical InvestigationImaging and Diagnostic TestingClinical, imaging, and pathological characteristics of left ventricular thrombus: A comparison of contrast-enhanced magnetic resonance imaging, transthoracic echocardiography, and transesophageal echocardiography with surgical or pathological validation
Section snippets
Methods
The investigation was approved by the institutional review board of the medical center, and the following methods were applied.
Patient characteristics
Based on surgical and/or pathology assessment of the LV, thrombus was present in 106 (29%) of 361 patients with IHD.
There was no significant difference in clinical characteristics between patients with and without LV thrombus (Table I), except for the incidence of a recent systemic embolic event, which was significantly higher in the group with confirmed thrombus (6.1% vs 0.8%, P < .005). In addition, patients with LV thrombus, as compared to patients with no thrombus, cumulatively had a
Discussion
LV thrombus formation after MI is associated with high risk of systemic embolization.4, 13 Anticoagulant therapy may significantly decrease the incidence of embolic events by 33% compared to untreated patients.4, 14 In addition, up to 40% of embolic events occur when thrombi are neither protuberant nor mobile.15 Given the morbidity and mortality associated with systemic embolization, and lack of data supporting routine anticoagulation therapy for patients with heart failure,16 it is important
References (28)
- et al.
Embolic potential, prevention and management of mural thrombus complicating anterior myocardial infarction: a meta-analysis
J Am Coll Cardiol
(1993) - et al.
Incidence and natural history of left ventricular thrombus following anterior wall acute myocardial infarction
Am J Cardiol
(1997) - et al.
Left ventricular thrombus and subsequent thromboembolism in patients with severe systolic dysfunction
Chest
(2000) - et al.
Randomized trial of low molecular weight heparin (dalteparin) in prevention of left ventricular thrombus formation and arterial embolism after acute anterior myocardial infarction: the Fragmin in Acute Myocardial Infarction (FRAMI) Study
J Am Coll Cardiol
(1997) - et al.
Ventricular thrombi and thromboembolism in dilated cardiomyopathy: a prospective follow-up study
Am Heart J
(1992) - et al.
Two dimensional echocardiography in the diagnosis of left ventricular thrombus. A prospective study of 67 patients with anatomic validation
Chest
(1983) - et al.
Usefulness of transesophageal echocardiography in identifying small left ventricular apical thrombus
J Am Coll Cardiol
(1993) - et al.
Improved echocardiographic delineation of left ventricular thrombus with the use of intravenous second-generation contrast image enhancement
J Am Soc Echocardiogr
(1999) - et al.
Tissue harmonic imaging: a new method for predicting left ventricular thrombus?
J Am Soc Echocardiogr
(2000) - et al.
Frequency and embolic potential of left ventricular thrombus in dilated cardiomyopathy: assessment by 2-dimensional echocardiography
Am J Cardiol
(1983)
Predischarge two-dimensional echocardiographic evaluation of left ventricular thrombosis after acute myocardial infarction in the GISSI-3 study
Am J Cardiol
Incidence of left ventricular thrombosis after acute transmural myocardial infarction
N Engl J Med
Increased embolic risk in patients with left ventricular thrombi
Circulation
Detection and characterization of intracardiac thrombi on MR imaging
Am J Roentgenol
Cited by (331)
Ultrashort VIBE-Dixon versus Cine and late gadolinium enhancement MRI sequences for cardiac thrombus detection
2024, European Journal of RadiologyIncremental Utility of First-Pass Perfusion CMR for Prognostic Risk Stratification of Cancer-Associated Cardiac Masses
2024, JACC: Cardiovascular ImagingACR Appropriateness Criteria® Workup of Noncerebral Systemic Arterial Embolic Source
2023, Journal of the American College of RadiologyUtility of cardiac imaging in patients with ventricular tachycardia
2023, Indian Pacing and Electrophysiology Journal