Prevalence of left chamber cardiac thrombi in patients with dilated left ventricle at sinus rhythm: The role of transesophageal echocardiography

Bakalli, Aurora; Georgievska-Ismail, Ljubica; Koçinaj, Dardan; Musliu, Nebi; Krasniqi, Agim; Pllana, Ejup

doi:10.1002/jcu.21953

Cited by 45 publications

(43 citation statements)

References 32 publications

(55 reference statements)

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“…An enlarged LA could be a predictive factor for the occurrence of stroke [26]. A previous study has shown that LA volume was correlated with LAA maximal area, which was an independent predictor for LAA thrombus formation [27]. In the present study, the maximum LA volume (LAVmax) was found to be an independent risk factor for LAAT even after adjusting for other factors such as aging and hypertension.…”

Section: Maximal Left Atrial Volume and The Risk Of Laa Thrombussupporting

confidence: 49%

Renin–angiotensin system inhibition is associated with reduced risk of left atrial appendage thrombosis formation in patients with atrial fibrillation

et al. 2018

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Section: Maximal Left Atrial Volume and The Risk Of Laa Thrombussupporting

confidence: 49%

Renin–angiotensin system inhibition is associated with reduced risk of left atrial appendage thrombosis formation in patients with atrial fibrillation

et al. 2018

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“…More infrequently formation of left ventricular thrombus occurs in patients with myocardial infarction,12 dilated cardiomyopathy1 and acute myocarditis 13…”

Section: Discussionmentioning

confidence: 99%

“…Studies estimate left ventricular thrombus to occur in 13% of patients with dilated cardiomyopathy during sinus rhythm 1. According to guidelines, patients with atrial fibrillation should be treated with anticoagulation therapy.…”

Section: Introductionmentioning

confidence: 99%

Left ventricular mural thrombus despite treatment with dabigatran and clopidogrel

Fredgart¹,

Gill

2018

BMJ Case Reports

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We describe a case with severe heart failure and moderate aortic stenosis. Due to previous atrial fibrillation and ischaemic heart disease, this patient was treated with both dabigatran and clopidogrel. Despite this, a large mural thrombus was found on echocardiography. The treatment was altered to warfarin, but the thrombus did not resolve during the next eight months.Guidelines for the use of anticoagulant treatment in left ventricular thrombus are needed. Previously, a few cases presenting resistance to novel oral anticoagulants have been published and cases with thrombus formation due to dabigatran have been described. Our patient showed resistance to both dabigatran and warfarin, and there was no thrombus resolution when changing the treatment to warfarin.

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“…Dilated cardiomyopathy favours the formation of intracardiac thrombi, a potential source of embolism. The examination of 45 patients with dilated cardiomyopathy with mild to moderate systolic dysfunction, who were at sinus rhythm and without anticoagulation therapy, revealed left ventricular thrombus in 13.3% and left atrial appendage thrombus in 68.9% [12]. Factors that predispose to thromboembolic events in patients with congestive heart failure (CHF) include low cardiac output, with relative stasis of blood in dilated cardiac chambers, poor contractility, and regional wall motion abnormalities [13].…”

Section: Streszczeniementioning

confidence: 99%

Coronary embolism causing acute myocardial infarction. Review of the literature

Zachura¹,

Piątek²,

Kurzawski³

et al. 2016

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Coronary artery embolism (CE) should be considered as a nonatherosclerotic cause of acute myocardial infarction (AMI), especially in patients with conditions favouring the formation of intracardiac thrombi. The main aetiologies of CE have changed in recent decades. Currently, atrial fibrillation is the most common cause. Most studies on CE infarcts are case reports with small numbers of patients. There are still no clear guidelines for the management in embolic myocardial infarction. Depending on the aetiology, the treatment needs to be tailored individually. As long-term outcomes indicate, patients with CE causing AMI are at high-risk and therefore require close follow-up. StreszczenieZator tętnicy wieńcowej należy podejrzewać w przypadku ostrego zespołu wieńcowego u pacjentów bez choroby miażdży-cowej, ale z czynnikami ryzyka sprzyjającymi powstawaniu skrzeplin wewnątrzsercowych. Najważniejsze etiologie zatoru tętnic wieńcowych zmieniały się w ciągu ostatnich dekad. Obecnie za najczęstszą przyczynę uznaje się migotanie przedsionków. Większość prac na temat zawałów spowodowanych zatorem tętnicy wieńcowej to opisy przypadków z niewielką liczbą przedstawionych pacjentów. Niestety nadal nie ma jasnych wytycznych co do diagnostyki oraz leczenia zatoru tętnic wieńcowych. W zależności od etiologii leczenie powinno być dopasowane indywidualnie. Jak wskazują wyniki długoter-minowych obserwacji, pacjenci z zawałem w wyniku zatoru tętnicy wieńcowej stanowią grupę wysokiego ryzyka, która wymaga dokładnej obserwacji.Approximately 5% of all patients with acute myocardial infarction (AMI) do not have atherosclerotic coronary artery disease [1]. Coronary artery embolism (CE) should be suspected in patients with factors or comorbidities predisposing to embolic events, who develop severe chest pain with elevated cardiac enzymes. Large diversity of aetiologies makes the precise diagnosis challenging. Most studies on coronary artery embolic infarcts are case reports with a small number of patients. There are still no clear guidelines for diagnostic criteria and the management of such cases. The approach of this paper is to provide a literature review of the CE causing AMI.Results from research by Prizel et al. revealed the incidence of coronary artery embolic infarcts in 55 out of 419 patients, which comprised 13% of autopsy-studied infarcts [2]. In another recent mechanistic study, based on analysis of 1776 patients with de novo AMI, the prevalence of CE was 2.9% [3]. The growing importance of invasive diagnostic and therapeutic methods provides a wealth of information about CE and its aetiology. There are a number of causes of coronary artery embolism. Analysis of the four main autopsy studies reported in the literature [4][5][6] with additional recently published mechanistic study [3], shows how the aetiology of CE has varied over the last half-century. Initially infective endocarditis accounted for more than half of all cases, then with the widespread use of antibiotics non-infected valvular heart disease became more ...

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Prevalence of left chamber cardiac thrombi in patients with dilated left ventricle at sinus rhythm: The role of transesophageal echocardiography

Abstract: Dilation of left cardiac chambers offers a suitable terrain for thrombus formation. The high probability of LAA thrombosis should be kept in mind when designing the treatment strategy for patients with dilated cardiomyopathy at sinus rhythm.

Cited by 45 publications

References 32 publications

Renin–angiotensin system inhibition is associated with reduced risk of left atrial appendage thrombosis formation in patients with atrial fibrillation

Renin–angiotensin system inhibition is associated with reduced risk of left atrial appendage thrombosis formation in patients with atrial fibrillation

Left ventricular mural thrombus despite treatment with dabigatran and clopidogrel

Coronary embolism causing acute myocardial infarction. Review of the literature

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