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Published on: June 11, 2019
[Clinical characteristics of cardiomyopathies complicated with ventricular thrombosis]
1Center of Arrhythmia, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China.
Insights
Dilated cardiomyopathy is the most common cause of ventricular thrombosis, typically affecting the left ventricle. Female patients with ventricular thrombosis often experience more severe cardiac dysfunction and poorer outcomes.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Ventricular thrombosis is a serious complication of cardiomyopathy.
- Understanding its clinical characteristics is crucial for patient management.
Purpose of the Study:
- To summarize the clinical characteristics of cardiomyopathy complicated with ventricular thrombosis.
- To identify risk factors and outcomes associated with ventricular thrombosis in cardiomyopathy patients.
Main Methods:
- Retrospective analysis of 125 inpatients with cardiomyopathy and ventricular thrombosis.
- Data collected from Fuwai Hospital between January 2015 and May 2019.
- Analysis included patient demographics, cardiomyopathy type, thrombosis location, cardiac function, and laboratory findings.
Main Results:
- Dilated cardiomyopathy was the most frequent type (62.4%).
- Left ventricle thrombosis occurred in 74.4% of cases; right ventricle thrombosis was more common in arrhythmogenic right ventricular cardiomyopathy (ARVC).
- Most patients had moderate to severe cardiac dysfunction (NYHA Class III/IV); female patients showed higher rates of severe dysfunction and mortality.
Conclusions:
- Dilated cardiomyopathy is the primary associated condition with ventricular thrombosis.
- Left ventricular thrombosis is most prevalent, while ARVC is linked to higher rates of right ventricular thrombosis.
- Female patients with ventricular thrombosis face a higher risk of severe illness and adverse prognosis.
Abstract:
Objective: To summarize the clinical characteristics of cardiomyopathy complicated with ventricular thrombosis. Methods: The clinical data of inpatients suffered from cardiomyopathy complicated with ventricular thrombosis in Fuwai Hospital between January 2015 and May 2019 were analyzed retrospectively. Results: A total of 125 cases were reviewed, and 24.8% were female. Dilated cardiomyopathy was the most common disease (62.4%), followed by arrhythmogenic right ventricular cardiomyopathy (ARVC) (13.6%) and hypertrophic cardiomyopathy (11.2%). There were 74.4% thrombosis in left ventricle, 12.8% in right ventricle and 12.8% in biventricle. The proportions of right ventricle thrombosis were higher in ARVC than in other cardiomyopathies (52.9% vs 6.5%, P<0.01). The majority suffered from cardiac function New York Heart Association (NYHA) Class Ⅲ (45.6%) and class Ⅳ (39.2%). The ratio of NYHA Class Ⅳ was higher in female patients than in male ones (25.8% vs 10.6%, P<0.05). In lab detection, positive results of D-Dimer and N terminal-pro B type natriuretic peptide (NT-proBNP) accounted for 72.8% and 97.6%, respectively. There were 2.5% patients died in the hospital or discharged because of the worsening of illness, the chances were higher in female than male patients (9.7% vs 0, P<0.01). Among these patients, one succumbed to massive ischemic stroke caused by ventricular thrombus detachment under standard anticoagulation therapy. Conclusions: Dilated cardiomyopathy is the most common cardiomyopathy complicated with ventricular thrombosis. The most common location of thrombosis is left ventricle. Right ventricle thrombosis is more common in ARVC. The majority suffer from moderate or severe cardiac dysfunction. Higer proportion of female patients suffer from anemia, severe condition and poor prognosis.
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