Impaired left ventricular diastolic function is related to the formation of left ventricular apical thrombus in patients with acute anterior myocardial infarction

被引：21

作者：

Choi, Ung Lim ^{[1
]}

Park, Jae-Hyeong ^{[1
,2
]}

Sun, Byung Joo ^{[1
]}

Oh, Jin Kyung ^{[1
]}

Seong, Seok Woo ^{[1
]}

Lee, Jae-Hwan ^{[1
]}

Choi, Si Wan ^{[1
]}

Jeong, Jin-Ok ^{[1
]}

Kwon, In Sun ^{[2
]}

Seong, In-Whan ^{[1
]}

机构：

[1] Chungnam Natl Univ, Sch Med, Chungnam Natl Univ Hosp, Div Cardiol,Dept Internal Med, Daejeon 35015, South Korea

[2] Chungnam Natl Univ Hosp, Clin Trial Ctr, Daejeon, South Korea

来源：

HEART AND VESSELS | 2018年 / 33卷 / 05期

关键词：

Acute myocardial infarction; Thrombus; Diastolic dysfunction; PERCUTANEOUS CORONARY INTERVENTION; ECHOCARDIOGRAPHIC EVALUATION; CONTRAST ECHOCARDIOGRAPHY; VORTEX FLOW; FREQUENCY;

D O I：

10.1007/s00380-017-1079-z

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Left ventricular (LV) apical thrombus is a clinically important complication which can cause systemic embolization in patients with anterior acute myocardial infarction (AMI). Systolic dysfunction has been a risk factor for developing LV apical thrombus in AMI patients. However, the role of diastolic dysfunction in the development of LV apical thrombus in these patients is still unknown. We performed this study to evaluate whether diastolic dysfunction can influence the development of LV apical thrombus in anterior AMI patients. We retrospectively analyzed all consecutive anterior AMI patients with available echocardiographic images within 1 month from January 2005 to April 2016. After gathering clinical characteristics from their medical records, systolic and diastolic functions were analyzed from digitally stored echocardiographic images. We included a total of 1045 patients (748 males, mean age 64 +/- 12 years) with anterior AMI, and 494 (47%) were diagnosed as STEMI. The incidence of LV apical thrombus was 3.3% (34/1045). The LV apical thrombus group had larger LV diastolic dimension, larger LV diastolic and systolic volumes, and lower LVEF than the no LV thrombus group. The LV apical thrombus group showed higher mitral E velocity over mitral annular E' velocity ratio, an indicator of LV end-diastolic pressure (P < 0.001). In the LV apical thrombus group, the incidence of grade 2 diastolic dysfunction (32 vs 12%, P = 0.001) and grade 3 diastolic dysfunction (26 vs 2%, P < 0.001) were significantly higher than in the no LV apical thrombus group. The presence of more than grade 2 diastolic dysfunction, LVEF and presence of LV apical aneurysm were statistically significant factors associated with LV apical thrombus after the multivariate analysis. In conclusion, along with LV systolic dysfunction and LV apical aneurysm, LV diastolic dysfunction was also related with the presence of LV apical thrombus in patients with anterior AMI.

引用

页码：447 / 452

页数：6

共 17 条

[11] Frequency and Correlates of Early Left Ventricular Thrombus Formation Following Anterior Wall Acute Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention [J].