PREVALENCE AND RISK FACTORS OF LEFT VENTRICULAR THROMBUS IN NONISCHEMIC CARDIOMYOPATHY PATIENTS WITH SEVERE LEFT VENTRICULAR SYSTOLIC DYSFUNCTION

Purpose We aimed to determine the prevalence of left ventricular systolic dysfunction (LVSD), including symptomatic (ie, heart failure [HF]) and asymptomatic LVSD in adult lymphoma survivors (LSs) after autologous hematopoietic stem-cell transplantation (auto-HCT) and to identify risk factors for LVSD in this population. Patients and Methods All LSs treated with auto-HCT as adults in Norway from 1987 to 2008 were eligible for this national cross-sectional study. Asymptomatic LVSD was defined as left ventricular ejection fraction less than 50% by echocardiography, and HF was defined according to current recommendations. The results in LSs were compared with those found in an age- and sex-matched (1:1) control group. Results We examined 274 LSs (69% of all eligible survivors); 62% were men, the mean (± standard deviation) age was 56 ± 12 years, and mean follow-up time from lymphoma diagnosis was 13 ± 6 years. The mean cumulative doxorubicin dose was 316 ± 111 mg/m2, and 35% of LSs had received additional radiation therapy involving the heart. We found LVSD in 15.7% of the LSs, of whom 5.1% were asymptomatic. HF patients were symptomatically mildly affected, with 8.8% of all LSs classified as New York Heart Association class II, whereas more severe HF was rare (1.8%). Compared with controls, LSs had a substantially increased LVSD risk (odds ratio, 6.6; 95% CI, 2.5 to 17.6; P < .001). A doxorubicin dose ≥ 300 mg/m2 and cardiac radiation therapy dose greater than 30 Gy were independent risk factors for LVSD. Conclusion LVSD was frequent and HF more prevalent than previously reported in LSs after auto-HCT. Our results may help to identify LSs at increased LVSD risk and can serve as a basis for targeted surveillance strategies.

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Left Ventricular Systolic Dysfunction and Nonischemic Cardiomyopathy

Critical Care Nursing Quarterly ◽

10.1097/00002727-200301000-00002 ◽

2003 ◽

Vol 26 (1) ◽

pp. 3-15 ◽

Cited By ~ 2

Author(s):

Karen A. Tarolli

Keyword(s):

Left Ventricular Systolic Dysfunction ◽

Systolic Dysfunction ◽

Left Ventricular ◽

Nonischemic Cardiomyopathy ◽

Ventricular Systolic Dysfunction

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Abstract 3108: Clinical Characteristics of Left Ventricular Systolic Dysfunction without Heart Failure in Community-Based Elderly Individuals: The Cardiovascular Health Study

Circulation ◽

10.1161/circ.118.suppl_18.s_1093 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Jay Pandhi ◽

Willem J Kop ◽

John S Gottdiener

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Clinical Characteristics ◽

Left Ventricular Systolic Dysfunction ◽

Systolic Dysfunction ◽

Left Ventricular ◽

Cardiovascular Health Study ◽

Ventricular Systolic Dysfunction

Left ventricular systolic dysfunction without heart failure (HF), also known as asymptomatic left ventricular systolic dysfunction (ALVSD), is at least as prevalent in the general population as left ventricular systolic dysfunction with heart failure (HF-LVSD). However, the clinical characteristics of ALVSD have not been well defined in an elderly population. Our aim is to evaluate the clinical features of elderly community-based individuals with ALVSD. The Cardiovascular Health Study is a multicenter cohort study designed to assess cardiovascular risk factors and outcomes in a population 65 years and older. This study quantifies baseline demographic variables and cardiovascular risk factors in participants with ALVSD. Comparisons were made with two reference groups: individuals with HF-LVSD, and those with normal left ventricular systolic function without HF (NL-LVSF). ALVSD was present in 385 of 5152 participants (7.5%) at baseline, whereas HF-LVSD was present in 84 participants (1.6%). Among those with ALVSD, 251 (65.2%) had borderline ejection fraction (EF) (45–54%), and 134 (34.8%) had impaired EF (< 45%). ALVSD was associated with elevated cardiovascular risk factors and comorbidities compared to NL-LVSF but lower than those in individuals with HF-LVSD (see table ). Among participants with ALVSD, impaired EF was associated with male sex and higher prevalence of coronary disease and LVH compared with borderline LV function. ALVSD is more common than HF-LVSD in community-dwelling elderly individuals. Furthermore, it is characterized by more cardiac risk factors and comorbidities than those with NL-LVSF, but less than those with HF-LVSD. The severity of systolic dysfunction is associated with comorbid cardiovascular risk factors. ALVSD may identify an important group of individuals at high risk for heart failure and cardiovascular mortality. Comparison of Clinical Characteristics Between ALVSD, NL-LVSF, and HF-LVSD

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Abstract 17132: Risk Factors for Anthracycline And/or Herceptin-induced Left Ventricular Systolic Dysfunction

Circulation ◽

10.1161/circ.130.suppl_2.17132 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Yasmin S Hamirani ◽

Ali El Sayed ◽

Patrick Dillon ◽

Andrew Wong ◽

Pooja Mehra ◽

...

Keyword(s):

Risk Factors ◽

Left Ventricular Systolic Dysfunction ◽

Systolic Dysfunction ◽

Left Ventricular ◽

Lv Function ◽

Fisher Exact Test ◽

Ventricular Systolic Dysfunction ◽

Exact Test ◽

The Difference

Introduction: Anthracyclines (ANT) and Herceptin (HER) are known to cause left ventricular (LV) systolic dysfunction and congestive heart failure (CHF). We aimed to identify the clinical risk factors associated with reduced LV function caused by one or both agents. Methods: We retrospectively examined our electronic records for patients that received ANT and/or HER from 2000-2013 and identified 3253 patients. 2704 were excluded for lack of a follow-up EF assessment (2699) or development of CAD (5) after the start of chemotherapy. Of the remaining 216 patients, 27 (12.5%) had a drop in EF after chemotherapy of >10% to below 50% and 185 (86.6%) did not. Kruskal Wallis test and Fisher exact test were utilized to estimate the difference between groups, and logistic regression model was used to predict a fall in EF. Results: More patients with a fall in EF had hypertension (HTN), hyperlipidemia (HL) and CAD (Table). A higher % of patients with a fall in EF received both HER and ANT as compared to ANT alone (36% vs 9.5% p=0.001). Higher use of liposomal doxorubicin was seen in the group with no reduction in EF. The median (IQR) time difference (days) between start of chemotherapy and reduced EF was 213 (76-761) and the doxorubicin dose in this group was 240 (128.5-254) mg/m2. On multivariate analysis hypertension and use of Herceptin remained independent predictors of EF fall. Conclusion: HTN, HL, CAD and concomitant HER use were univariate predictors of EF decline, while only HTN and HER were independent multivariate predictors. Given the prevalence of reduced EF at follow-up, late assessment of EF is indicated to avoid missing chemotherapy-induced cardiotoxicity.

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Successful Medical Management of a Left Ventricular Thrombus and Aneurysm following Failed Thrombolysis in Myocardial Infarction

Clinical Medicine Insights Cardiology ◽

10.4137/cmc.s10929 ◽

2013 ◽

Vol 7 ◽

pp. CMC.S10929 ◽

Cited By ~ 3

Author(s):

Adebayo T Oyedeji ◽

Christopher Lee ◽

Olukolade O Owojori ◽

Olabanji J Ajegbomogun ◽

Adeseye A Akintunde

Keyword(s):

Myocardial Infarction ◽

Left Ventricular Systolic Dysfunction ◽

Systolic Dysfunction ◽

Left Ventricular ◽

Left Ventricular Aneurysm ◽

Ventricular Systolic Dysfunction ◽

Anterior Myocardial Infarction ◽

Short Intervals ◽

Ventricular Thrombus

We report the case of a patient with an extensive anterior myocardial infarction complicated by left ventricular systolic dysfunction, left ventricular apical thrombus and an apical left ventricular aneurysm following failed thrombolysis. We obtained serial two-dimensional echocardiograms at short intervals in the acute phase and also during the months of recovery and follow up. The patient was successfully and exclusively medically managed.

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