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논문 기본 정보

자료유형
학술저널
저자정보
Jin Kyung Oh (Chungnam National University Hospital) Jae-Hyeong Park (Chungnam National University Hospital) Jae-Hwan Lee (Chungnam National University Hospital) Jeongai Kim (Chungnam National University Hospital) In Whan Seong (Chungnam National University Hospital)
저널정보
대한심장학회 Korean Circulation Journal Korean Circulation Journal Vol.49 No.9
발행연도
2019.1
수록면
829 - 837 (9page)

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Background and Objectives: Left ventricular (LV) apical thrombi are usually present with LV dilatation, and oral anticoagulants reduce embolic risk in these patients. However, echocardiographic data regarding thrombus resolution remain limited. We studied its echocardiographic features that were associated with early resolution (within 1 month). Methods: We performed a retrospective observational study by reviewing baseline and follow-up echocardiographic images and medical records in patients with LV apical thrombi. Results: Between January 2005 and December 2017, 77 patients (59 males, mean 61±12 years old) were enrolled. Patients were classified into 2 groups based on duration of thrombus resolution: group 1 showing resolution within 1 month (n=23) and group 2 with persistence after 1 month (n=54). Thrombus size was significantly smaller in group 1 (10.7±4.2 vs. 12.1±5.5 mm, p=0.046). Grade 1 mobility (partially mobile; odds ratio [OR], 7.800; p=0.012) and grade 2 mobility (highly mobile; OR, 14.625; p=0.002) were significantly associated with the early resolution. Round thrombi were associated with early resolution than mural form (OR, 3.187; p=0.026). Multivariate analysis showed that the mobility was the most important parameter, and a highly mobile (grade 2 mobility) LV apical thrombi showed earlier resolution (OR, 12.525; p=0.013). During the follow-up over 62±44 months, 25 patients (32.5%) had ≥1 adverse clinical events. The late resolution of thrombi was associated with poor long-term clinical outcomes (hazard ratio, 5.727; p=0.020). Conclusions: Mobility of LV apical thrombi was the most important parameter associated with early thrombus resolution. Late resolution of LV apical thrombi was associated with poor long-term clinical outcomes.
#Thrombus #Left ventricle #Anticoagulants #Embolism

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참고문헌 (16)

참고문헌 신청
Delewi R / 2012 / Left ventricular thrombus formation after acute myocardial infarction / Heart 98:1743~1749 google schola Friedman MJ / 1982 / Clinical correlations in patients with acute myocardial infarction and left ventricular thrombus detected by two-dimensional echocardiography / Am J Med 72:894~898 google schola Weinreich DJ / 1984 / Left ventricular mural thrombi complicating acute myocardial infarction. Long-term follow-up with serial echocardiography / Ann Intern Med 100:789~794 google schola Ibanez B / 2018 / 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation : the task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology(ESC) / Eur Heart J 39:119~177 google schola Maniwa N / 2018 / Anticoagulation combined with antiplatelet therapy in patients with left ventricular thrombus after first acute myocardial infarction / Eur Heart J 39:201~208 google schola

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