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Left ventricular thrombus formation after acute myocardial infarction as assessed by cardiovascular magnetic resonance imaging.
- Source :
-
European journal of radiology [Eur J Radiol] 2012 Dec; Vol. 81 (12), pp. 3900-4. Date of Electronic Publication: 2012 Sep 17. - Publication Year :
- 2012
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Abstract
- Introduction: Left ventricular (LV) thrombus formation is a feared complication of myocardial infarction (MI). We assessed the prevalence of LV thrombus in ST-segment elevated MI patients treated with percutaneous coronary intervention (PCI) and compared the diagnostic accuracy of transthoracic echocardiography (TTE) to cardiovascular magnetic resonance imaging (CMR). Also, we evaluated the course of LV thrombi in the modern era of primary PCI.<br />Methods: 200 patients with primary PCI underwent TTE and CMR, at baseline and at 4 months follow-up. Studies were analyzed by two blinded examiners. Patients were seen at 1, 4, 12, and 24 months for assessment of clinical status and adverse events.<br />Results: On CMR at baseline, a thrombus was found in 17 of 194 (8.8%) patients. LV thrombus resolution occurred in 15 patients. Two patients had persistence of LV thrombus on follow-up CMR. On CMR at four months, a thrombus was found in an additional 12 patients. In multivariate analysis, thrombus formation on baseline CMR was independently associated with, baseline infarct size (g) (B=0.02, SE=0.02, p<0.001). Routine TTE had a sensitivity of 21-24% and a specificity of 95-98% compared to CMR for the detection of LV thrombi. Intra- and interobserver variation for detection of LV thrombus were lower for CMR (κ=0.91 and κ=0.96) compared to TTE (κ=0.74 and κ=0.53).<br />Conclusion: LV thrombus still occurs in a substantial amount of patients after PCI-treated MI, especially in larger infarct sizes. Routine TTE had a low sensitivity for the detection of LV thrombi and the interobserver variation of TTE was large.<br /> (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)
- Subjects :
- Female
Humans
Male
Middle Aged
Myocardial Infarction surgery
Reproducibility of Results
Sensitivity and Specificity
Thrombosis prevention & control
Treatment Outcome
Ventricular Dysfunction, Left prevention & control
Magnetic Resonance Imaging, Cine methods
Myocardial Infarction complications
Myocardial Infarction pathology
Thrombosis etiology
Thrombosis pathology
Ventricular Dysfunction, Left etiology
Ventricular Dysfunction, Left pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1872-7727
- Volume :
- 81
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- European journal of radiology
- Publication Type :
- Academic Journal
- Accession number :
- 22995173
- Full Text :
- https://doi.org/10.1016/j.ejrad.2012.06.029