Document Detail

Left ventricular apical thrombus and myocardial viability: a dobutamine stress echocardiographic study.
MedLine Citation:
PMID:  11000589     Owner:  NLM     Status:  MEDLINE    
The objective of this article was to determine whether the presence of left ventricular apical thrombus is a marker of nonviable myocardium. Reduced coronary blood flow secondary to atherosclerosis may result in chronic reversible left ventricular wall-motion abnormalities. Severe regional abnormalities also predispose to formation of left ventricular thrombus. The relationship between left ventricular apical thrombus and myocardial viability has not been previously described. Eighty patients with coronary artery disease and chronic left ventricular dysfunction were studied by dobutamine stress echocardiography. Left ventricular apical thrombus was identified using echocardiographic criteria. Wall-motion analysis was performed using a standard 16-segment model and ejection fraction was calculated. As a result, 48 patients (60%) had definite or highly suspicious findings for left ventricular thrombus (group 1), and 32 patients (40%) had no thrombus (group 2). Group 1 had significantly higher composite (54.0 +/- 5.8 vs 43.3 +/- 6.4) and apical (6.0 +/- 2.7 vs 12.4 +/- 3.4) wall-motion scores compared to those in group 2 (P = 0.01). Thirty-two patients (67%) in group 1 demonstrated no contractile reserve in the apical segments, consistent with lack of viability, versus eight patients (25%) in group 2 (P = 0.0003). The number of viable apical segments per patient was significantly less in group 1 (0.7 +/- 1.2) versus group 2 (1.8 +/- 1.3) (P = 0.01). Left ventricular apical thrombus is more likely to be present when there is absence of myocardial viability in the corresponding segments.
D A Cusick; R O Bonow; F A Chaudhry
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  17     ISSN:  0742-2822     ISO Abbreviation:  Echocardiography     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2000-11-29     Completed Date:  2000-11-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  547-54     Citation Subset:  IM    
Division of Cardiology, Department of Medicine, Northwestern University Medical School, Chicago, Illinois, USA.
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MeSH Terms
Aged, 80 and over
Chi-Square Distribution
Coronary Disease / complications
Dobutamine / diagnostic use
Exercise Test
Heart Diseases / etiology,  ultrasonography*
Heart Ventricles / ultrasonography
Middle Aged
Myocardial Contraction
Risk Assessment
Stroke Volume
Thrombosis / etiology,  ultrasonography*
Ventricular Dysfunction, Left / etiology,  ultrasonography*
Reg. No./Substance:

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