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Left ventricular and left atrial thrombi in sinus rhythm patients with dilated ischemic cardiomyopathy

Aurora Bakalli1, Ljubica Georgievska-Ismail, Dardan Koçinaj

  • 1Department of Cardiology, Clinic of Internal Medicine, University Clinical Center of Kosova, Prishtine, Kosovo. abakalli@hotmail.com

Medical Archives (Sarajevo, Bosnia and Herzegovina)
|July 25, 2012
PubMed

Insights

In patients with ischemic cardiomyopathy, left atrial appendage thrombi are common, occurring in 40.3%. Larger left ventricular size and lack of aspirin therapy predict left ventricular thrombi.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Thrombosis Research

Background:

  • Ischemic dilated cardiomyopathy creates conditions favorable for left ventricular (LV) thrombus formation.
  • The left atrial appendage (LAA) can also be a source of thrombi in patients with heart disease.

Purpose of the Study:

  • To determine the prevalence of LV and LAA thrombi in patients with chronic ischemic dilated cardiomyopathy in sinus rhythm.
  • To identify echocardiographic predictors of thrombus formation in these patients.

Main Methods:

  • The study included 57 patients with chronic dilated ischemic cardiomyopathy in sinus rhythm, excluding those on anticoagulation or with specific comorbidities.
  • Transthoracic echocardiography and transesophageal echocardiography were performed for all participants.

Main Results:

  • Left ventricular (LV) thrombus was found in 19.3% of patients, and left atrial appendage (LAA) thrombus in 40.3%.
  • Independent predictors for LV thrombus included larger LV size (p=0.05) and lack of aspirin therapy (p=0.02).
  • Lower LV ejection fraction (EF) (p=0.02) and larger LAA maximal area (p=0.004) predicted LAA thrombus.

Conclusions:

  • This study highlights the significant possibility of LAA thrombi in addition to LV thrombi in patients with chronic ischemic cardiomyopathy and sinus rhythm.
  • LV size, LV EF, LAA maximal area, and aspirin use are independent predictors of left heart chamber thrombi in this population.
Abstract

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