Related Experiment Video
Updated: May 20, 2026
09:05
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Differentiation between fresh and old left ventricular thrombi by deformation imaging
Markus Niemann1, Philipp Daniel Gaudron, Bart Bijnens
1Comprehensive Heart Failure Center, Department of Internal Medicine I, Institute of Radiology, University of Wuerzburg, Oberdürrbacher Strasse 6, Würzburg, Germany.
Circulation. Cardiovascular Imaging
|July 7, 2012
Summary
Echocardiography can now differentiate fresh from old left ventricular thrombi using strain-rate imaging. Fresh thrombi, identified by specific strain-rate patterns, often resolve with anticoagulation therapy.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Differentiating fresh from old left ventricular thrombi post-myocardial infarction is crucial for assessing embolization risk and guiding anticoagulation therapy.
- Current noninvasive methods lack definitive accuracy in distinguishing thrombus age.
Purpose of the Study:
- To evaluate the efficacy of echocardiographic strain-rate (SR) imaging in differentiating fresh from old left ventricular thrombi.
- To assess the impact of anticoagulation on fresh thrombi identified by SR imaging.
Main Methods:
- A two-part study involving 52 patients with post-myocardial infarction thrombi.
- Substudy-I: 20 patients with known fresh or old thrombi analyzed using SR imaging.
- Substudy-II: 32 patients with incident thrombi treated with phenprocoumon and followed for 6 months, assessed with SR imaging, standard echocardiography, and MRI.
Main Results:
- Peak SR during isovolumetric relaxation period effectively discriminated between fresh (5-27 days) and old (4-26 months) thrombi (cutoff: 1 s(-1)).
- In prospective substudy-II, 17 thrombi classified as fresh showed 94% resolution after 6 months of phenprocoumon.
- Conversely, 14 of 15 old thrombi remained unchanged, with only one resolving.
Conclusions:
- Echocardiographic deformation imaging, specifically peak SR during isovolumetric relaxation, reliably differentiates fresh from old intracavitary thrombi.
- Anticoagulation with phenprocoumon promotes significant resolution of fresh left ventricular thrombi.
