Left Ventricular Apical Thrombus and Myocardial Viability: A Dobutamine Stress Echocardiographic Study

Cusick, David A.; Bonow, Robert O.; Chaudhry, Farooq A.

doi:10.1046/j.1540-8175.2000.00547.x

Cited by 9 publications

(5 citation statements)

References 27 publications

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“…Left ventricular wall motion abnormality (LVWMA) has been suggested as a low or an uncertain risk factor in terms of cerebral embolic risk [ 42 ]. LVWMA is associated with regional blood stasis and incomplete ventricular emptying, which may increase thrombogenicity and induce intraventricular thrombus formation [ 43 - 45 ]. However, as LVWMA may be an epiphenomenon of underlying cardiac diseases, such as myocardial infarction or dilated cardiomyopathy, it is difficult to evaluate the risk of stroke for LVWMA itself.…”

Section: Relationship Between Hf and Neurologic Diseasesmentioning

confidence: 99%

Heart Failure as a Risk Factor for Stroke

Kim

2018

J Stroke

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Heart failure (HF) is one of the major causes of death worldwide. Despite the high incidence of stroke in patients with HF, there has been a controversy as to whether HF itself is a risk factor for stroke. Recently, there is a great deal of evidence that HF itself increases the risk of stroke. In previous studies, the benefit of warfarin for stroke prevention in patients with HF was offset by the risk of bleeding. In the era of non-vitamin K antagonist oral anticoagulants with low bleeding profiles, we can expect a more effective stroke prevention in patients with HF by selective anticoagulation. The purpose of this review is to describe the relationship between stroke and HF, which could be an unconventional risk factor and a potential intervention target for stroke prevention.

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Section: Relationship Between Hf and Neurologic Diseasesmentioning

confidence: 99%

Heart Failure as a Risk Factor for Stroke

Kim

2018

J Stroke

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“…In agreement with our study, Cusick et al reported no complications during moderate dobutamine stress echocardiography in 55 LV thrombus patients. However, the study fails to achieve an adequately high heart rate response (peak heart rate 114/min) and does not include postprocedural observations or outcome [ 55 , 56 ].…”

Section: Discussionmentioning

confidence: 99%

Safety of dobutamine or adenosine stress cardiac magnetic resonance imaging in patients with left ventricular thrombus

Weberling,

Seitz,

Salatzki

et al. 2023

Clin Res Cardiol

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Background Left ventricular (LV) thrombus formation is a common but potentially serious complication, typically occurring after myocardial infarction. Due to perceived high thromboembolic risk and lack of safety data, stress cardiac magnetic resonance (CMR) imaging especially with dobutamine is usually avoided despite its high diagnostic yield. This study aimed to investigate the characteristics, safety and outcome of patients with LV thrombus undergoing dobutamine or vasodilator stress CMR. Methods Patients undergoing stress CMR with concomitant LV thrombus were retrospectively included. Risk factors, comorbidities, and previous embolic events were recorded. Periprocedural safety was assessed for up to 48 h following the examination. Major adverse cardiac events (MACE) 12 months before the diagnosis were compared to 12 months after the exam and between patients and a matched control group. Additionally, patients were followed up for all-cause mortality. Results 95 patients (78 male, 65 ± 10.7 years) were included. Among them, 43 patients underwent dobutamine (36 high-dose, 7 low-dose) and 52 vasodilator stress CMR. Periprocedural safety was excellent with no adverse events. During a period of 24 months, 27 MACE (14.7%) occurred in patients and controls with no statistical difference between groups. During a median follow-up of 33.7 months (IQR 37.6 months), 6 deaths (6.3%) occurred. Type of stress agent, thrombus mobility, or protrusion were not correlated to embolic events or death. Conclusion The addition of a stress test to a CMR exam is safe and does increase the generally high cardioembolic event rate in LV thrombus patients. Therefore, it is useful to support reperfusion decision-making. Graphical Abstract

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“…It is well known that wall thinning is associated with the loss of viable myocardial tissue and fibrosis 28,29 .…”

Section: Discussionmentioning

confidence: 99%

Apical Longitudinal Strain Can Help Predict the Development of Left Ventricular Thrombus after Anterior Myocardial Infarction

Ali-Barman

Atıcı

Ertürk³

et al. 2020

RIC

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Background: Left ventricular (LV) thrombus formation is a common complication of anterior myocardial infarction (ANT-MI). The aim of this study was to investigate the relationship between apical longitudinal strain (ALS) and LV apical thrombus after ANT-MI. Methods: The cross-sectional study included a total of 235 patients who were followed up after primary percutaneous coronary intervention performed for ANT-MI and had a reduced LV ejection fraction (LVEF) (≤40%). Of these patients, 24 were excluded from the study, and the remaining 211 patients were included in the analysis. Patients were divided into two groups based on the presence (n = 42) or absence (n = 169) of LV thrombus detected by echocardiography. ALS was measured using speckle-tracking echocardiography. Results: Thrombus was detected in 42 of 211 patients. There was no significant difference between the groups regarding age or gender. Apical strain (AS), global longitudinal strain (GLS), apical wall thickness (AWT), and EF were significantly lower in patients with LV apical thrombus when compared to those without LV apical thrombus (AS,-5.00 ± 2.30% vs. −8.54 ± 2.48%, p < 0.001; GLS, −10.6 ± 3.54% vs. −12.1 ± 2.84%, p = 0.013; AWT, 4.71 ± 1.11 vs. 6.33 ± 1.78 mm, p < 0.001; EF, 31.40 ± 4.10% vs. 37.75 ± 3.17%, p < 0.001). On univariate and multivariate analyses, aneurysm (AA), AS, and AWT were found to be independent predictors of LV apical thrombus (AA, odds ratio [OR] 4.649, p = 0.010; AS, OR 1.749, p < 0.001; AWT, OR 0.729, p = 0.042). Conclusion: ALS is highly sensitive and specific for predicting LV thrombus after ANT-MI. An early and accurate evaluation of LV thrombus may prevent embolic complications, particularly cerebrovascular events. (REV INVEST CLIN. [AHEAD OF PRINT]

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Left Ventricular Apical Thrombus and Myocardial Viability: A Dobutamine Stress Echocardiographic Study

Cited by 9 publications

References 27 publications

Heart Failure as a Risk Factor for Stroke

Heart Failure as a Risk Factor for Stroke

Safety of dobutamine or adenosine stress cardiac magnetic resonance imaging in patients with left ventricular thrombus

Apical Longitudinal Strain Can Help Predict the Development of Left Ventricular Thrombus after Anterior Myocardial Infarction

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