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.
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* 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: firstname.lastname@example.org
Abdullah Shehab Emirates Cardiac Society Emirates Medical Association Dubai (United Arab Emirates) Biography
Biography of Abdullah Shehab
Dr. Abdullah Shehab has 22 years of experience in Internal medicine, cardiology and interventional cardiology and medical education. Currently, he serves as the General Secretary of Emirates Cardiac Society and Vice President of Gulf Intervention Society. He is a Fellow of royal college of physicians UK, American college of physician, European society of cardiology, American college of cardiology, American society of cardiac intervention and fellow of the American heart association. Professor Shehab is the Chief Editor of Emirates Medical Journal and also serves as Editor in many other regional and international journals. Dr. Shehab has published 149 paper in Medline. His research interest includes: Heart failure, Coronary artery disease, Dyslipidaemia, Hypertension, Arrhythmias, Cardiac intervention, Cardiac imaging, Screening for cardiac disease in sport players, cardiovascular disease in pregnancy.