Cancer-associated left ventricular thrombus with preserved ejection fraction: A multicenter descriptive study

Area of Science:

• Cardiology
• Oncology
• Hematology

Background:

• Left ventricular thrombus (LVT) is typically linked to reduced left ventricular ejection fraction (LVEF).
• Malignancy-associated hypercoagulability can paradoxically lead to LVT despite preserved systolic function.

Purpose of the Study:

• To investigate the characteristics and outcomes of patients with LVT and active malignancy despite preserved LVEF.
• To identify the clinical phenotype and risk associated with cancer-related LVT in patients with preserved systolic function.

Main Methods:

• Retrospective descriptive cohort study across three tertiary care centers.
• Inclusion criteria: adults with confirmed LVT, active malignancy, and LVEF ≥50% at diagnosis.
• Outcomes assessed: mortality, stroke/TIA, bleeding, LVT resolution, and anticoagulation strategy.

Main Results:

• Twenty-three patients (mean age 66 years, 17 men) with a mean LVEF of 57.3% were included.
• High all-cause mortality (14/23) and bleeding events (5/23) were observed.
• No ischemic stroke or transient ischemic attack events occurred; LVT resolved in 20 patients.

Conclusions:

• Cancer-associated LVT can occur in patients with preserved LVEF.
• This condition represents a high-risk phenotype warranting further investigation and tailored management strategies.