Title:Distribution of Left Ventricular Thrombus among Patients with Significantly Impaired Systolic Function
Volume: 2
Author(s): Ibrahim Abdullah Alranini*, Hatim Kheirallah, Juan Jaime Alfonso and Ahmed R. Al Fagih
Affiliation:
- Department of Adult Cardiology, Prince Sultan Cardiac Center, Riyadh,Saudi Arabia
Keywords:
LV thrombus, Ejection fraction, Myocardial infarction, Mitral regurgitation, Transthoracic echocardiography.
Abstract: Background:
The prevalence of Left Ventricular (LV) thrombus as well as the distribution among patients with a variable degree of left ventricular systolic
function impairment due to various etiologies is not well known.
Objectives:
To describe the distribution of left ventricular thrombus in relation to the underlying pathology, i.e., ischemic versus non-ischemic cardiomyopathy
with Ejection Fraction (EF) below 45%.
Methods:
All echocardiography studies performed between January 2013 and September 2017 were reviewed, and only those with confirmed LV thrombus
were included. The patient’s demographic, clinical characteristics, cardiac history, and echocardiographic parameters were obtained. The cohort
was divided into 4 subgroups: 22 patients with EF of 36 - 45% (A), 114 with 26% - 35% (B), 99 with 16 - 25% (C) and 48 with 15% or less (D).
Results:
A total of 63,732 echocardiography study results were reviewed. Only 282 patients were proved to have LV thrombus with EF less than 45%. 217
(77%) patients had previous myocardial infarction, of which 212 (97.7%) were presented with anterior regional wall motion abnormality. 90
(32.7%) patients were found to have dilated left ventricle, and 41 (14.5%) with dilated cardiomyopathy (DCM). 37 (13.2%) patients had
moderately severe to severe mitral regurgitation. It was observed that the highest distribution of LV thrombus was seen in group B (40.3%).
Conclusion:
The majority of LV thrombus distribution was seen in patients with EF between 26% to 35% due to ischemic cardiomyopathy. Conversely, in the
cohort of non-ischemic cardiomyopathy, the majority were observed in those with severely impaired LV function.
