scholarly journals The prevalence of left ventricular thrombus among patients with low ejection fraction by trans-thoracic echocardiography

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Nouradden Noman Aljaber ◽  
Zohoor Ali Mattash ◽  
Sultan Abdulwadoud Alshoabi ◽  
Fahad Hassan Alhazmi
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Heart Disease ◽  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Ventricular Thrombus ◽  
The Mean ◽  
Low Ejection Fraction

Background and objectives: Ejection fraction (EF) is a measurement of heart function that reflects the portion of pumped out blood from the filled left ventricle per each heartbeat. The current study aimed to investigate the prevalence of left ventricular thrombus in patients with EF lower than 35% by using Transthoracic Echocardiography (TTE). Methods: In this prospective study, 82 cardiac patients underwent TTE procedure in order to assess the presence of left ventricular thrombus (LVT) from January 1st to December 31st 2017 at the Military Cardiac Centre in Sana’a, Yemen. Results: Out of 82 patients enrolled in this study, the mean age was 49.13 ± 14.8 years and 87.8% were male. The mean of EF was 31.16% and LVT was found in 6.1%. The spontaneous contrast was seen in 25.6% of patients indicating strong relationship with low EF (p < 0.001). Among patients with low EF, ischemic heart disease (IHD) was identified in 50%, hypertension in 30.5%, diabetes mellitus (DM) type 2 in 23.2%, and hyperlipidemia 12.2%. Exactly 80% of LVT were detected in IHD patients with dilated cardiomyopathy (DCMP) and 80% of detected LVT were apical in site. Conclusion: Cardiac patients with low ejection fraction developed left ventricular thrombosis, and most of the affected patients were ischemic heart disease with dilated cardiomyopathy. Interestingly, spontaneous contrast was found high significantly in these patients, which may reflect the continuous process of thrombus formation. Abbreviations:EF: ejection fraction, ASE: American society of echocardiography, EACVI: European association of cardiovascular imaging, LV: left ventricle, LVEF: left ventricular ejection fraction, HFpEF: heart failure with preserved ejection fraction, HFrEF: heart failure with reduced ejection fraction, MI: myocardial infarction, DCMP: dilated cardiomyopathy, AF: atrial fibrillation, TTE: Transthoracic echocardiography, TEE: trans-esophageal echocardiography, RHD: rheumatic heart disease, HTN: hypertension, DM: diabetes mellitus, CHF: congestive heart failure, JVP: jugular venous pressure, CBC: complete blood count, LFT: liver function tests, RFT: renal function test, LVT: left ventricular thrombus, ECG: electrocardiography, LVT: left ventricular thrombus, EDV: end diastolic volume, ESV: end systolic volume, SPSS: statistical package for the social sciences, IBM: international business machines, SD: standard deviation. doi: https://doi.org/10.12669/pjms.36.4.1972 How to cite this:Aljaber NN, Mattash ZA, Alshoabi SA, Alhazmi FA. The prevalence of left ventricular thrombus among patients with low ejection fraction by trans-thoracic echocardiography. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1972 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals EPIDEMILOGICAL, CLINICAL AND ECHOCARDIOGRAPHIC FEATURES OF HEART FAILURE IN MOROCCO

2021 ◽  
Vol 9 (11) ◽  
pp. 521-526
Author(s):  
A. Maliki Alaoui ◽  
◽  
Y. Fihri ◽  
A. Ben El Mekki ◽  
H. Bouzelmat ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Heart Failure ◽  
Heart Disease ◽  
Ejection Fraction ◽  
Cross Sectional ◽  
Reduced Ejection Fraction ◽  
Cardiology Department ◽  
Common Risk Factors ◽  
The Mean

Heart failure (HF) is a major public issue taking an epidemic dimension globally. Its incidence is continuing to rise because of a growing and aging population. We held a cross-sectional retrospective studyin the cardiology department of Mohamed V military teaching hospital of Rabat in morocco fromSeptember 2019 toSeptember 2021, including 104 patients admitted with HF. The mean age was 68.5 ±10.3year. Hypertension and diabetes mellitus are the most common risk factors. HF with reduced ejection fraction represents about 49%. Forty-four percent had dilated cardiomyopathy. Ischemic heart disease is the first cause of HF.

scholarly journals Insights on the left ventricular thrombus in patients with ischemic dilated cardiomyopathy

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Elsayed M. Mehana ◽  
Abeer M. Shawky ◽  
Heba S. Abdelrahman
Keyword(s):  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Left Ventricular Ejection ◽  
Myocardial Scarring ◽  
Ventricular Thrombus ◽  
Group A ◽  
Study Population ◽  
Group B

Abstract Background Left ventricular thrombus (LVT) formation represents a common complication of dilated cardiomyopathy (DCM). LVT is usually underestimated with transthoracic echocardiography (TTE) while cardiac magnetic resonance imaging (CMRI) is promising as an alternative imaging modality for cardiac thrombus detection. The study aims to compare TTE and CMRI in their ability to detect LVT, also, to assess the clinical and imaging parameters to determine variables that may predispose for thrombus formation. The study population includes seventy-six patients with ischemic DCM. They were divided into 2 groups based on the presence of LVT as detected by delayed-enhancement CMRI (DE-CMRI) [Group A included 20 patients with a LVT and Group B included 56 patients without]. Results All of the current study population had ischemic DCM with left ventricular ejection fraction (LVEF) < 50%. DE-CMR detected thrombus in 20 cases of the studied population that represented group A. From group A, conventional TTE detected LVT only in 8 and cine-CMR detected 13 cases out of the out of 20 cases. The ejection fraction of the left ventricle as measured by functional CMRI was significantly lower in group A (P = 0.045). Interestingly, the myocardial scarring in group A was seen significantly more extensive than in group B (the P value is < 0.00001), paralleling the increased prevalence of thrombus. Conclusions DE-CMRI provides superiority for the detection of LVT compared with standard TTE or cine-CMRI and the amount of myocardial scarring detected by DE-CMRI can be considered an independent marker for thrombus presence.

scholarly journals Arterial thromboembolism in a young woman with occult dilated cardiomyopathy

2016 ◽  
Vol 3 (3) ◽  
pp. 12
Author(s):  
Alicia Topoll ◽  
Jordan Owens ◽  
Jorge Cheirif ◽  
J. Mark Pool ◽  
Mark Feldman
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Systolic Heart Failure ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Caucasian Woman ◽  
Prothrombotic State ◽  
Vascular Intervention ◽  
Arterial Thromboembolism ◽  
Ventricular Thrombus

An acute dilated cardiomyopathy may present with vague symptoms including fatigue and malaise, which may delay the diagnosis until signs and symptoms of systolic heart failure develop. Left ventricular thrombus and arterial thromboembolism are rare complications of acute dilated cardiomyopathy. We present a case of a young Caucasian woman presenting with acute leg ischemia secondary to femoral artery thromboembolism associated with a previously undiagnosed acute dilated cardiomyopathy with severe systolic heart failure and a large left ventricular thrombus. Her prothrombotic state was refractory to heparin therapy and surgical vascular intervention. She eventually required leg amputation for recurrent limb ischemia with gangrene and thrombus extraction from the left ventricle. Risk factors for her prothrombotic state included the acute, dilated cardiomyopathy, use of a hormonal contraceptive agent, obesity, smoking, and a heterozygous Factor II (Prothrombin) G20110A mutation.

459Direct oral anticoagulants are an effective therapy for left ventricular thrombus formation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
F Gama ◽  
P Freitas ◽  
M Trabulo ◽  
A Ferreira ◽  
M J Andrade ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Antiplatelet Therapy ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
P Value ◽  
Warfarin Group ◽  
Ventricular Thrombus

Abstract Background and aim Left ventricular thrombus is a frequent complication of myocardial infarction (MI) and heart failure with severely depressed ejection fraction. Once diagnosed, anticoagulation for up to 6-months is recommended, but clinical experience with direct oral anticoagulation (DOAC) is limited to a few case reports. Our aim is to test DOAC LV thrombus resolution efficacy against warfarin. Methods Single-centre retrospective cohort study of consecutive patients with recently diagnosed LV thrombus, either after acute myocardial infarction or heart failure with reduced ejection fraction, from January 2009 till December 2018. Thrombus diagnosis and subsequent assessments were performed with echocardiography and complemented with cardiac magnetic resonance, when appropriate. Decisions regarding the type, dose and duration of anticoagulation and any concomitant antiplatelet therapy were left to physician's judgement. Results In a population of 66 patients (51 male, mean age 69±12 years), 13 received DOAC therapy, with the remainder receiving vit. K antagonists. One from each group was lost to follow up. The DOAC subgroup had higher prevalence of atrial fibrillation, higher left ventricular end-diastolic volumes and worse wall motion severity score index (WMSI). The duration of anticoagulant therapy, concomitant single or dual antiplatelet therapy and overall follow up were similar between strategies. Thrombus remission was observed in 91.7% (n=11) and 59.6% (n=31) patients within DOAC and warfarin group, respectively. Risk of unsuccessful resolution was reduced by 35% relative to the warfarin group (RR 0.65; 95% CI [0.491–0.862]; p-value 0.035) (figure). figure Conclusion DOAC seems to be an effective alternative to vitamin-K antagonists in patients with LV thrombus.

scholarly journals The Prevalence of Left Ventricular Thrombus among Heart Failure Patients Admitted to Kuwait Teaching Hospital in Sana’a City between January 2014 -2017

2019 ◽  
pp. 30-35
Author(s):  
Alaghbari Khaled ◽  
Askar Faiza
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Teaching Hospital ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Ischemic Heart ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Ventricular Thrombus

Background: Heart failure is a major Public Health problem due to its high morbidity and mortality rates .The Left Ventricular Thrombus (LVT) is more frequently seen in acute heart failure as a complication of Left Ventricular (LV) systolic dysfunction. Objectives: The objective of this study was to determine the prevalence of LVT and its outcome among Yemeni patients presented with heart failure to Kuwait teaching hospital in Sana’a. This cross sectional retrospective study made during the period of January 2014-January 2017 study for all patients admitted to the hospital with Heart Failure (HF). Results: During study period 1856 patients with cardiac diseases were admitted to the hospital. Of this 217 were in (F. Among patient which 61(28.1%) had LVT. The mean age of patient presented with LVT was 51 years ± 8.1 Most cases were male (90%) while only (10%), were females. Ischemic Heart Disease (IHD), Dilated Cardiac Myopathy (DCMP) and Hypertension, found to be an associated risk factors of LVT represented (51%, 34.2% and 34.2%) respectively. However 8 (13%) of patients with LVT had embolic complications. The mortality rate during hospitalization was 4 (6.6%). Conclusion: The Ischemic heart disease was the leading cause of left ventricular thrombus.

scholarly journals Etiological spectrum of Heart Failure in a tertiary health care facility of Central Nepal

2019 ◽  
Vol 16 (2) ◽  
pp. 23-28
Author(s):  
Mahesh Bhattarai ◽  
Rakesh Kumar Shah ◽  
Nayan Kamal Sainju ◽  
Buna Bhandari ◽  
Sumir Keshari ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Valvular Heart Disease ◽  
Heart Diseases ◽  
Left Ventricular ◽  
Reduced Ejection Fraction ◽  
Etiological Spectrum ◽  
Study Participants

Background and Aims: High-income countries have reported common causes of heart failure as ischaemic heart diseases, hypertension, valvular heart diseases, and cardiomyopathies. There are limited data available about epidemiology of heart failure in low-income countries like Nepal. The main objective of this study is to explore etiological spectrum of heart failure in Nepal. Methods: This cross-sectional study was conducted at the cardiology department of Kathmandu Medical College from April 15, 2019, to July 15, 2019. Data were collected from patients diagnosed as heart failure following the European Society of Cardiology criteria and having left ventricular ejection fraction less than 50% and classified into Heart failure with midrange or reduced ejection fraction. Diastolic heart failure, Cor-pulmonale, and stroke were excluded. The data were entered and analyzed in Statistical Package for Social Sciences 20.0 using descriptive and inferential statistics. Results: Among 132 heart failure patients (mean age: 63.9±13.9 years), around two-thirds (65.2%) had heart failure with reduced ejection fraction (ejection fraction of less than 40%) and one third (34.8%) had heart failure with mid-range ejection fraction (40 to 49%). Dilated cardiomyopathy was the leading cause of heart failure among nearly half (47.7%) of study participants, followed by valvular heart disease (19.7%), hypertensive heart disease (14.4%) and ischaemic heart disease (13.6%). Almost half of the study participants with dilated cardiomyopathy had severe left ventricular systolic dysfunction. (p<0.05). Conclusion: Dilated cardiomyopathy was the most prevalent cause of heart failure, followed by valvular heart disease in our study.

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