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The natural history of left ventricular spontaneous contrast
D N Doud1, W R Jacobs, J F Moran
1Department of Cardiology, Loyola University Medical Center, Maywood, IL 60153.
Insights
Spontaneous left ventricular contrast is rare but can indicate serious heart conditions. Its presence may be linked to thromboembolic events, though prognosis varies with underlying heart function.
Area of Science:
- Cardiology
- Echocardiography
- Cardiovascular Imaging
Background:
- Spontaneous contrast in the left ventricle is an uncommon finding on echocardiograms.
- This phenomenon may be associated with altered blood flow dynamics and potential embolic risk.
Purpose of the Study:
- To investigate the clinical characteristics, reproducibility, embolic potential, and prognostic implications of left ventricular spontaneous contrast.
- To analyze echocardiographic findings in patients with spontaneous left ventricular contrast.
Main Methods:
- Retrospective analysis of 16 patients with spontaneous contrast on two-dimensional echocardiograms.
- Evaluation of clinical data, including diagnoses, ejection fraction, and thromboembolic events.
- Assessment of contrast reproducibility and its correlation with clinical outcomes.
Main Results:
- Common diagnoses included ischemic heart disease (9 patients) and dilated cardiomyopathy (6 patients).
- Mean ejection fraction was significantly reduced at 17.6%.
- Six thromboembolic events occurred in four patients; contrast was reproducible up to 39 months.
Conclusions:
- Left ventricular spontaneous contrast is associated with severe cardiac dysfunction and carries an embolic risk.
- Disappearance of contrast correlated with improved ventricular function or aneurysmectomy.
- Prognosis in patients with reproducible spontaneous contrast did not appear worse than those with similar ventricular dysfunction, warranting further study.
Abstract:
Spontaneous contrast in the left ventricle is an unusual entity. We retrospectively studied 16 patients who were found to have spontaneous contrast present on two-dimensional echocardiograms, specifically noting their clinical characteristics, the reproducibility of this phenomenon, the presence of thrombi and embolic events, and prognostic implications. Diagnoses included ischemic heart disease in nine patients, dilated cardiomyopathy in six patients, and hypertensive cardiomyopathy in one patient. The mean ejection fraction was 17.6%. There were six thromboembolic events in four patients. The spontaneous contrast was reproducible for periods of time up to 39 months. Patients who had improvement in their left ventricular dysfunction or who underwent aneurysmectomy had disappearance of the spontaneous contrast. Those patients who had spontaneous contrast reproduced on subsequent echocardiograms did not seem to have a worse prognosis than patients with similarly depressed ventricular function, but a larger study is necessary to verify this.