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Abnormal left ventricular vortex flow patterns in association with left ventricular apical thrombus formation in
Jang-Won Son1, Won-Jong Park, Jung-Hyun Choi
1Division of Cardiology, Yeungnam University, Daegu, Republic of Korea.
Insights
Left ventricular (LV) vortex flow patterns are linked to LV apical thrombus formation in acute myocardial infarction (MI) patients. Reduced vortex depth and strength indicate a higher risk of thrombus development.
Area of Science:
- Cardiology
- Medical Imaging
- Fluid Dynamics
Background:
- Acute anterior wall myocardial infarction (MI) poses a risk for left ventricular (LV) apical thrombus formation.
- Understanding the factors contributing to thrombus development is crucial for patient management.
Purpose of the Study:
- To investigate the correlation between LV vortex flow patterns and LV apical thrombus formation in patients with acute anterior wall MI.
- To identify specific vortex characteristics associated with thrombus presence.
Main Methods:
- Fifty-seven patients with acute anterior wall MI were analyzed.
- Two-dimensional contrast echocardiography (CE) was used to assess LV vortex morphology and pulsatility.
- Quantitative vortex parameters were measured using Omega flow® and compared between patients with and without apical thrombus.
Main Results:
- Patients with LV apical thrombus exhibited a more central vortex that did not extend to the apex.
- Vortex depth (P=0.002) and relative strength (P=0.034) were significantly lower in the thrombus group.
- Vortex depth below 0.45 was an independent predictor of LV apical thrombus formation (OR 9.714, P=0.011).
Conclusions:
- LV vortex location and pulsatility are strongly associated with LV apical thrombus formation in anterior MI.
- LV vortex flow analysis via CE can aid in risk stratification for LV apical thrombus in these patients.
Background:
The current study was designed to investigate the correlation between the left ventricular (LV) vortex flow pattern and LV apical thrombus formation in patients with acute anterior wall myocardial infarction (MI).
Methods And Results:
Fifty-seven patients with acute anterior wall MI were enrolled in this study. Eighteen patients with apical thrombus (thrombus group) and 39 patients without apical thrombus (non-thrombus group) underwent 2-dimensional contrast echocardiography (CE). Morphology and pulsatility parameters of the LV vortex were measured using Omega flow(®) and compared between the 2 groups. In the thrombus group, the vortex was located more centrally and did not extend to the apex. In the thrombus group, quantitative vortex parameters of vortex depth (0.409±0.101 vs. 0.505±0.092, respectively; P=0.002) and relative strength (1.574±0.310 vs. 1.808±0.376, respectively, P=0.034) were significantly lower than the non-thrombus group. Following multivariate analysis, the vortex depth below 0.45 remained a significant independent parameter for formation of the LV apical thrombus (odds ratio 9.714, 95% confidence interval 1.674-56.381, P=0.011).
Conclusions:
These findings suggest that the location and pulsatility power of the LV vortex are strongly associated with the LV thrombus formation in patients with anterior MI. Therefore, LV vortex flow analysis using CE can be clinically useful for characterizing and quantifying the risk of LV apical thrombus in patients with anterior MI.
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