Left ventricular and left atrial thrombi in sinus rhythm patients with dilated ischemic cardiomyopathy
Journal
Medical Archives
Date Issued
2012-06
Author(s)
Bakalli, A
Kocinaj, D
Musliu, N
Zahiti, B
Krasniqi, A
Bekteshi, T
Sejdiu, B
DOI
10.5455/medarh.2012.66.155-158
Abstract
Introduction: Ischemic dilated cardiomyopathy offers a favorable terrain
for left ventricular (LV) thrombus formation; however, left artial appendage (LAA) may be an additional source of thrombi in patients with dilated
heart. The main objectives of this study were to determine the prevalence of
LV and LAA thrombi in patients with chronic ischemic dilated cardiomyopathy in sinus rhythm, as well as to reveal echocardiographic predictors for
thrombus formation. Methods: The study included 57 patients with chronic
dilated ischemic cardiomyopathy in sinus rhythm, who were not under oral
anticoagulation therapy. Exclusion criteria included patients with: swallowing problems, acute myocardial infarction, idiopathic and/or non-ischemic
dilated cardiomyopathy, atrial fibrillation/flatter, severe systolic dysfunction.
Transthoracic echocardiography and transesophageal echocardiography were
obtained for each patient. Results: Mean patient age was 62 ± 10.5 years,
mean LV end diastolic diameter was 67.2 ± 5.8 mm, whereas mean LV ejection fraction (EF) was 37.1 ± 4.3 %. LV thrombus was detected in 11 (19.3%)
patients; while 23 (40.3%) patients had LAA thrombus. In a multiple regression analysis LV size (p=0.05) and lack of aspirin therapy (p=0.02) showed
to be independent LV thrombus predictors, whereas lower LV EF (p=0.02)
and larger LAA maximal area (p=0.004) demonstrated to be independent
predictors of LAA thrombus. Conclusions: We consider that our study
sheds light to the high possibility of LAA thrombi formation in addition to
LV thrombi in patients with chronic dilated ischemic cardiomyopathy in sinus
rhythm. LV size, LV EF, LAA maximal area and lack of aspirin therapy are
shown to be independent predictors of left heart chamber thrombi in this
patient category.
for left ventricular (LV) thrombus formation; however, left artial appendage (LAA) may be an additional source of thrombi in patients with dilated
heart. The main objectives of this study were to determine the prevalence of
LV and LAA thrombi in patients with chronic ischemic dilated cardiomyopathy in sinus rhythm, as well as to reveal echocardiographic predictors for
thrombus formation. Methods: The study included 57 patients with chronic
dilated ischemic cardiomyopathy in sinus rhythm, who were not under oral
anticoagulation therapy. Exclusion criteria included patients with: swallowing problems, acute myocardial infarction, idiopathic and/or non-ischemic
dilated cardiomyopathy, atrial fibrillation/flatter, severe systolic dysfunction.
Transthoracic echocardiography and transesophageal echocardiography were
obtained for each patient. Results: Mean patient age was 62 ± 10.5 years,
mean LV end diastolic diameter was 67.2 ± 5.8 mm, whereas mean LV ejection fraction (EF) was 37.1 ± 4.3 %. LV thrombus was detected in 11 (19.3%)
patients; while 23 (40.3%) patients had LAA thrombus. In a multiple regression analysis LV size (p=0.05) and lack of aspirin therapy (p=0.02) showed
to be independent LV thrombus predictors, whereas lower LV EF (p=0.02)
and larger LAA maximal area (p=0.004) demonstrated to be independent
predictors of LAA thrombus. Conclusions: We consider that our study
sheds light to the high possibility of LAA thrombi formation in addition to
LV thrombi in patients with chronic dilated ischemic cardiomyopathy in sinus
rhythm. LV size, LV EF, LAA maximal area and lack of aspirin therapy are
shown to be independent predictors of left heart chamber thrombi in this
patient category.
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