Incidence and Natural History of Left Ventricular Thrombus Following Anterior Wall Acute Myocardial Infarction
| Autor: | Francis J. Menapace, Elliot Rapaport, Sally Greaves, Guang Zhi, Jean G. MacFadyen, Marc A. Pfeffer, Richard T. Lee, Scott D. Solomon, Jean-Lucien Rouleau |
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| Rok vydání: | 1997 |
| Předmět: |
Adult
Male Ramipril medicine.medical_specialty Time Factors Heart Diseases Myocardial Infarction Angiotensin-Converting Enzyme Inhibitors Ventricular Function Left Ventricular Dysfunction Left Reperfusion therapy Afterload Internal medicine medicine Humans Prospective Studies cardiovascular diseases Myocardial infarction Thrombus Prospective cohort study Aged Aged 80 and over business.industry Incidence Thrombosis Middle Aged Left ventricular thrombus medicine.disease Surgery Echocardiography cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine Complication business circulatory and respiratory physiology medicine.drug |
| Zdroj: | The American Journal of Cardiology. 80:442-448 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/s0002-9149(97)00392-5 |
| Popis: | Previous studies have reported left ventricular (LV) thrombus in 20% to 56% of patients after anterior wall acute myocardial infarction (AMI). The Healing and Early Afterload Reducing Therapy (HEART) study was a prospective study comparing effects of early (24 hours) or delayed (14 days) initiation of ramipril, an angiotensin-converting enzyme inhibitor, on LV function after anterior wall AMI. This ancillary study assessed prevalence of LV thrombus. Two-dimensional echocardiography was performed on days 1, 14, and 90 after myocardial infarction. The cohort consisted of 309 patients. Q-wave anterior wall AMI occurred in 78%; 87% received reperfusion therapy. The prevalence of LV thrombus was 2 of 309 (0.6%) at day 1, 11 of 295 (3.7%) at day 14, and 7 of 283 (2.5%) at day 90. One patient had thrombus at 2 examinations. The day 1 echocardiogram was not correlated with thrombus development. LV size increased more in patients with thrombus than in those without thrombus. Patients with thrombus had more wall motion abnormality after day 1 than patients without thrombus (p = 0.03). Thus, the current prevalence of LV thrombus in anterior wall AMI is lower than previously reported, possibly due to changes in AMI management. Preservation of LV function is likely to be an important mechanism. Most thrombi are seen by 2 weeks after AMI. Resolution documented by echocardiography is frequent. |
| Databáze: | OpenAIRE |
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