Thrombus formation in the left ventricle after large myocardial infarction – assessment with cardiac magnetic resonance imaging
| Autor: | Aris Moschovitis, Stephan Windecker, Roberto Corti, Paul Erne, Thomas F. Lüscher, Tiziano Moccetti, Sebastian Kozerke, Robert Manka, Michel Zuber, Valentin Gisler, Daniel Sürder, Catherine Klersy |
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| Přispěvatelé: | University of Zurich, Sürder, Daniel |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Heart Ventricles Myocardial Infarction 610 Medicine & health 2700 General Medicine Coronary thrombosis Myocardial infarction Anticoagulants Magnetic resonance imaging 11171 Cardiocentro Ticino Body Mass Index Cardiac magnetic resonance imaging Internal medicine medicine Humans 10237 Institute of Biomedical Engineering cardiovascular diseases Thrombus Aged medicine.diagnostic_test business.industry Platelet Count Thrombosis General Medicine Odds ratio Left ventricular thrombus medicine.disease Magnetic Resonance Imaging Confidence interval Radiography Echocardiography Cardiology 10209 Clinic for Cardiology cardiovascular system Female Radiology business |
| Zdroj: | Sürder, Daniel; Gisler, Valentin; Corti, Roberto; Moccetti, Tiziano; Klersy, Catherine; Zuber, Michel; Windecker, Stephan; Moschovitis, Aris; Kozerke, Sebastian; Lüscher, Thomas Felix; Erne, Paul; Manka, Robert (2015). Thrombus formation in the left ventricle after large myocardial infarction – assessment with cardiac magnetic resonance imaging. Swiss medical weekly, 145, w14122. EMH Schweizerischer Ärzteverlag 10.4414/smw.2015.14122 Swiss Medical Weekly, 145 |
| ISSN: | 1424-7860 1424-3997 |
| DOI: | 10.7892/boris.75917 |
| Popis: | INTRODUCTION: Left ventricular thrombus (LVT) formation may worsen the post-infarct outcome as a result of thromboembolic events. It also complicates the use of modern antiplatelet regimens, which are not compatible with long-term oral anticoagulation. The knowledge of the incidence of LVT may therefore be of importance to guide antiplatelet and antithrombotic therapy after acute myocardial infarction (AMI). METHODS: In 177 patients with large, mainly anterior AMI, standard cardiac magnetic resonance imaging (CMR) including cine and late gadolinium enhancement (LGE) imaging was performed shortly after AMI as per protocol. CMR images were analysed at an independent core laboratory blinded to the clinical data. Transthoracic echocardiography (TTE) was not mandatory for the trial, but was performed in 64% of the cases following standard of care. In a logistic model, 3 out of 61 parameters were used in a multivariable model to predict LVT. RESULTS: LVT was detected by use of CMR in 6.2% (95% confidence interval [CI] 3.1%–10.8%). LGE sequences were best to detect LVT, which may be missed in cine sequences. We identified body mass index (odds ratio 1.18; p = 0.01), baseline platelet count (odds ratio 1.01, p = 0.01) and infarct size as assessed by use of CMR (odds ratio 1.03, p = 0.02) as best predictors for LVT. The agreement between TTE and CMR for the detection of LVT is substantial (kappa = 0.70). DISCUSSION: In the current analysis, the incidence of LVT shortly after AMI is relatively low, even in a patient population at high risk. An optimal modality for LVT detection is LGE-CMR but TTE has an acceptable accuracy when LGE-CMR is not available. Swiss Medical Weekly, 145 ISSN:1424-7860 ISSN:1424-3997 |
| Databáze: | OpenAIRE |
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