Clinical characteristics of patients with heart failure and intracardiac thrombus

Abstract

BackgroundHeart failure (HF) patients are in a hypercoagulable state that predisposes them to an intracardiac thrombus. We aim to assess the clinical features of patients with HF and intracardiac thrombus.MethodsPatients diagnosed with HF with intracardiac thrombus were enrolled in this study. Patients' demographics, clinical comorbidities, laboratory tests, and cardiac imaging parameters are recorded. Baseline characteristics are described; the relationship between intracardiac thrombus location and cardiac underlying diseases, New York Heart Association (NYHA) class, and left ventricular ejection fraction (LVEF) are analyzed; and the anticoagulation rate is summarized.ResultsA total of 1,248 patients were included in the study. Most patients were men (72.2%) with a mean age of 54 years. The left ventricle is the most frequently involved (66.8%), and the prevalence of left ventricular thrombus is more in patients complicated with coronary artery diseases, ventricular noncompaction cardiomyopathy, and dilated cardiomyopathy (86.3%, 86.4%, and 78.2%, respectively). When combined with atrial fibrillation, atrial flutter, hypertrophic cardiomyopathy, restrictive cardiomyopathy, or valvular cardiomyopathy, the intracardiac thrombus is mostly likely to occur in the left atrium. The incidence rate of left cardiac thrombosis increased with the decline of LVEF, an increase of NYHA class, and enlargement of a cardiac chamber. Overall, the anticoagulation rate was 56.8%, with warfarin still the mainstay drug (45.1%), while the prescription of non-vitamin K antagonist oral anticoagulants rose year by year. As for imaging modalities for thrombus detection and diagnosis, transthoracic echocardiography was the most widely performed (75.1%).ConclusionThis study summarizes the underlying disease constitution, thrombus location and related factors, imaging modalities, and antithrombotic profile in HF patients with intracardiac thrombus comprehensively.

A nomogram to predict ventricular thrombus in dilated cardiomyopathy patients

“…Our study showed that the risk of intracardiac thrombosis in patients with DCM was 7.08% (90/1270). Consistent with the results of other previous investigators [ 16 , 17 ], the present study also showed that intraventricular thrombus in patients with DCM was predominantly distributed in the left ventricle (67/90), with a higher concentration in the apical region. We also found that, DCM with VT had a significantly higher risk of in-hospital stroke and a significantly longer hospital stay compared with patients without VT.…”

Predictive value of remnant cholesterol level for all-cause mortality in heart failure patients

“…Univariate and multivariate Cox proportional hazards regression were used to evaluate the association of baseline remnant cholesterol levels with time to all-cause mortality. According to our previous studies and guidelines, the selected potential confounders in the multivariable analysis were sex, age, BMI, hypertension, diabetes mellitus, CAD, heart rate, SBP, DBP, hemoglobin, ALB, ALT, AST, TBIL, serum uric, eGFR, hsCRP, logNT-proBNP, LVEF, New York Heart Association (NYHA) Functional Class and pharmacotherapy ( 1 , 10 , 15 – 18 ). Smooth curve fitting with full adjustment of the covariates was employed to explore the dose–response relationship between remnant cholesterol and the risk of all-cause mortality.…”

Direct Oral Anticoagulants for Stroke and Systemic Embolism Prevention in Patients with Left Ventricular Thrombus

“…Hypokinetic/akinetic and aneurismal areas are prone to thrombi formation and are associated with a high risk of thromboembolic events. One study investigating intracardiac thrombosis in patients with heart failure reported that all five patients with HCM and LV aneurysm also had LV thrombosis [ 57 ]. In a cohort of almost 2000 patients with HCM, Rowin et al found that 4.8% of patients (93) had an apical aneurysm [ 58 ].…”