Related Experiment Videos
Frequency and embolic potential of left ventricular thrombus in dilated cardiomyopathy: assessment by 2-dimensional
Insights
Left ventricular thrombus is common in dilated cardiomyopathy, but does not increase embolism risk. Echocardiography can detect thrombus, but it doesn't predict systemic emboli in these patients.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Left ventricular (LV) thrombus and systemic emboli are frequent in dilated cardiomyopathy.
- Anticoagulation carries risks, necessitating noninvasive methods to identify high-risk patients.
Purpose of the Study:
- To analyze wide-angle 2-D echocardiograms for LV thrombus in dilated cardiomyopathy patients.
- To compare thrombus presence with clinical outcomes, specifically systemic emboli.
Main Methods:
- 123 patients with chronic dilated cardiomyopathy underwent 2-D echocardiography.
- LV thrombus presence was assessed and compared with clinical course in 96 patients.
Main Results:
- LV thrombus was detected in 36% of patients via 2-D echocardiography.
- Systemic emboli occurred in 11% of patients and were not more frequent in those with LV thrombus.
- Thrombus presence and emboli frequency were similar in patients with and without coronary artery disease.
Conclusions:
- 2-D echocardiography reveals a high prevalence of LV thrombus in dilated cardiomyopathy, regardless of coronary artery disease.
- LV thrombus in dilated cardiomyopathy does not appear to increase the risk of clinical systemic emboli.
Abstract:
Left ventricular (LV) thrombus at autopsy and systemic emboli during life have been frequent findings in patients with dilated cardiomyopathy. Since anticoagulation has substantial risk, noninvasive identification of those patients likely to have emboli is important. Therefore, wide-angle 2-dimensional (2-D) echocardiograms in 123 patients (average age 56 +/- 6 years) with chronic dilated cardiomyopathy were analyzed for the presence of LV thrombus; these findings were compared with the clinical course in 96 patients. On 2-D echocardiography, thrombus was present in 44 patients (36%). Events compatible with systemic emboli occurred in 11 patients (11%), and were not more frequent in those patients with than in those without LV thrombus. In addition, neither the presence of thrombus nor the frequency of systemic emboli differed between patients with and those without associated coronary artery disease. Thus, although 2-D echocardiography shows a high frequency of LV thrombus in patients with dilated cardiomyopathy irrespective of the presence of coronary artery disease, clinical events compatible with systemic emboli are not more frequent in those with than those without LV thrombus.