BACKGROUND: Left atrial appendage (LAA) may be a source of thrombi in patients with dilated cardiomyopathy at sinus rhythm. The objectives of our study were to assess the prevalence of intracardiac left chamber thrombus and/or spontaneous echo contrast and to identify clinical and echocardiographic predictors for left ventricle (LV), left atrium (LA), and/or LAA thrombus formation, particularly as regard to LV, LA, and LAA size, in heart failure patients at sinus rhythm. METHODS: We included 45 patients with dilated cardiomyopathy of ischemic or idiopathic origin with mild to moderate systolic dysfunction, who were at sinus rhythm and without anticoagulation therapy. RESULTS: Mean left ventricular end diastolic diameter was 64.9 ± 6.1 mm, and mean LV ejection fraction was 39.9 ± 7.3%. LV thrombus was found in 13.3% of patients and LAA thrombus in 68. 9%. Left ventricular end diastolic diameter was correlated with LA volume (r = 0.59, p < 0.0001) and LV thrombus (r = 0.38, p = 0.005). LA volume was correlated with LAA maximal area (r = 0.34, p = 0.01), which was an independent predictor for LAA thrombus formation (p = 0.003). CONCLUSIONS: Dilation of left cardiac chambers offers a suitable terrain for thrombus formation. The high probability of LAA thrombosis should be kept in mind when designing the treatment strategy for patients with dilated cardiomyopathy at sinus rhythm.
BACKGROUND: Left atrial appendage (LAA) may be a source of thrombi in patients with dilated cardiomyopathy at sinus rhythm. The objectives of our study were to assess the prevalence of intracardiac left chamber thrombus and/or spontaneous echo contrast and to identify clinical and echocardiographic predictors for left ventricle (LV), left atrium (LA), and/or LAA thrombus formation, particularly as regard to LV, LA, and LAA size, in heart failurepatients at sinus rhythm. METHODS: We included 45 patients with dilated cardiomyopathy of ischemic or idiopathic origin with mild to moderate systolic dysfunction, who were at sinus rhythm and without anticoagulation therapy. RESULTS: Mean left ventricular end diastolic diameter was 64.9 ± 6.1 mm, and mean LV ejection fraction was 39.9 ± 7.3%. LV thrombus was found in 13.3% of patients and LAA thrombus in 68. 9%. Left ventricular end diastolic diameter was correlated with LA volume (r = 0.59, p < 0.0001) and LV thrombus (r = 0.38, p = 0.005). LA volume was correlated with LAA maximal area (r = 0.34, p = 0.01), which was an independent predictor for LAA thrombus formation (p = 0.003). CONCLUSIONS: Dilation of left cardiac chambers offers a suitable terrain for thrombus formation. The high probability of LAA thrombosis should be kept in mind when designing the treatment strategy for patients with dilated cardiomyopathy at sinus rhythm.
Authors: Lorenzo Rossini; Pablo Martinez-Legazpi; Vi Vu; Leticia Fernández-Friera; Candelas Pérez Del Villar; Sara Rodríguez-López; Yolanda Benito; María-Guadalupe Borja; David Pastor-Escuredo; Raquel Yotti; María J Ledesma-Carbayo; Andrew M Kahn; Borja Ibáñez; Francisco Fernández-Avilés; Karen May-Newman; Javier Bermejo; Juan C Del Álamo Journal: J Biomech Date: 2015-11-30 Impact factor: 2.712
Authors: Mikko Taina; Petri Sipola; Antti Muuronen; Marja Hedman; Pirjo Mustonen; Anne-Mari Kantanen; Pekka Jäkälä; Ritva Vanninen Journal: PLoS One Date: 2014-03-04 Impact factor: 3.240
Authors: Ibrahim El-Battrawy; Michael Behnes; Dennis Hillenbrand; Darius Haghi; Ursula Hoffmann; Theano Papavassiliu; Siegfried Lang; Christian Fastner; Tobias Becher; Stefan Baumann; Felix Heggemann; Jürgen Kuschyk; Martin Borggrefe; Ibrahim Akin Journal: Clin Med Insights Cardiol Date: 2016-07-12