Identifying Risk Factors for Left Ventricular Thrombus in Patients with Ischemic Left Ventricular Aneurysm Using...

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Medical Research

Background:

• Ischemic left ventricular (LV) aneurysm is linked to LV thrombus and embolic events.
• Current guidelines lack evidence-based recommendations for anticoagulation in these patients.

Purpose of the Study:

• To identify characteristics of LV aneurysms associated with a high risk of thrombus formation.
• To inform risk stratification and potential therapeutic strategies for patients with ischemic LV aneurysm.

Main Methods:

• Retrospective study of 317 hospitalized patients with ischemic LV aneurysm undergoing cardiac magnetic resonance (CMR).
• Comparison of baseline characteristics and CMR parameters between patients with and without LV thrombus.
• Logistic regression analysis to identify significant predictors of LV thrombus.

Main Results:

• 88 (27.8%) patients had LV thrombus, associated with heart failure and reduced ejection fraction.
• Significant predictors of LV thrombus included wider aneurysm neck width (OR 1.33), higher shape index (OR 1.63), and LGE global extent >50% (OR 6.58).
• Patients with LV thrombus showed greater LV volume, mass, and LGE extent.

Conclusions:

• Wider aneurysm neck, higher aneurysm shape index, and extensive LGE (>50%) are key predictors of LV thrombus in ischemic LV aneurysm.
• These imaging markers can help identify patients at higher risk for embolic events.
• Further research is warranted to establish anticoagulation guidelines for this patient group.