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New Emirates Medical Journal

Volume 3, 2 Issues, 2022
ISSN: 0250-6882 (Online)
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Open Access Article

Distribution of Left Ventricular Thrombus among Patients with Significantly Impaired Systolic Function

Ibrahim Abdullah Alranini1, *, Hatim Kheirallah1, Juan Jaime Alfonso1, Ahmed R. Al Fagih1
1 Department of Adult Cardiology, Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia



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.


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%.


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).


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%).


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.

Keywords: LV thrombus, Ejection fraction, Myocardial infarction, Mitral regurgitation, Transthoracic echocardiography.

Article Information

Identifiers and Pagination:

Year: 2021
Volume: 2
Issue: 2
First Page: 91
Last Page: 96
Publisher Id: nemj-2-91
DOI: 10.2174/0250688202666210519153051

Article History:

Received Date: 10/10/2020
Revision Received Date: 18/1/2021
Acceptance Date: 24/3/2021
Electronic publication date: 27/7/2021
Collection year: 2021

© 2021 Alranini et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Adult Cardiology, Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia; Tel: +96614777714 Ext: 8765; Fax: +96614778771; E-mail:


Abdullah Shehab
Emirates Cardiac Society
Emirates Medical Association
(United Arab Emirates)
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Acceptance rate = 40%

Average review speed: 45 days average

18 days from acceptance to publication