| Value of contrast echocardiography for left ventricular thrombus detection postinfarction and impact on antithrombotic therapy. | |
| | |
MedLine Citation:
|
PMID: 19877307 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
INTRODUCTION: Conventional echocardiography is often inconclusive for the presence or the absence of left ventricular (LV) thrombus. Contrast echocardiography could have additional diagnostic and therapeutic significance. This analysis investigated the value of contrast echocardiography for LV thrombus detection in patients postinfarction and the impact on choice of antithrombotic therapy. METHODS: From a cohort of 991 patients undergoing routine echocardiography postinfarction, 156 patients who underwent additional contrast echocardiography formed the study population. Changes in antithrombotic therapy were noted. RESULTS: Characteristics of the 156 analyzed patients were: age 62+/-12 years, 88% male, 85% anterior infarction. Conventional echocardiography was inconclusive for LV thrombus in 123 patients and in 33 patients LV thrombus was suspected. With the use of contrast agent, all 123 echocardiographic studies turned conclusive: 14 patients had LV thrombus and in 109 patients LV thrombus was absent. In 33 patients with suspected LV thrombus, thrombus was ruled out in 13 (39%) patients, whereas thrombus was confirmed in 20 patients. In total, 34 patients had LV thrombus confirmed with contrast echocardiography. As a consequence, in 23 of 34 (68%) patients, antithrombotic therapy was upgraded from antiplatelet aggregation to oral anticoagulants. Moreover, unnecessary anticoagulation therapy was avoided in the 13 of 33 (39%) patients ruled out for LV thrombus with contrast echocardiography. CONCLUSION: Contrast echocardiography in post-infarction patients can detect LV thrombus when conventional echocardiography is inconclusive and can unmask artifacts or myocardial structures initially suspect for LV thrombus. Contrast echocardiography changed antithrombotic therapy in 68% of patients with confirmed LV thrombus. |
| | |
Authors:
|
Hans-Marc J Siebelink; Arthur J H A Scholte; Nico R Van de Veire; Eduard R Holman; Gaetano Nucifora; Ernst E van der Wall; Jeroen J Bax |
Related Documents
:
|
6225587 - Echocardiographic evaluation of cardiac size and function in dialysis patients. 138357 - Echocardiographic observations in patients with systemic infiltrative disease involving... 18678207 - Substantial systolic improvement and reverse cardiac remodeling in elderly-onset idiopa... 10424507 - Successful treatment of right heart thromboemboli with iv recombinant tissue-type plasm... 8464317 - Distinguishing post-kala-azar dermal leishmaniasis from leprosy: experience in the sudan. 8566577 - Risk and natural history of colonic neoplasia in patients with primary sclerosing chola... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Coronary artery disease Volume: 20 ISSN: 1473-5830 ISO Abbreviation: Coron. Artery Dis. Publication Date: 2009 Nov |
Date Detail:
|
Created Date: 2009-10-29 Completed Date: 2010-01-07 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9011445 Medline TA: Coron Artery Dis Country: England |
Other Details:
|
Languages: eng Pagination: 462-6 Citation Subset: IM |
Affiliation:
|
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. h.j.siebelink@lumc.nl |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Aged, 80 and over Anterior Wall Myocardial Infarction / complications*, drug therapy, ultrasonography Anticoagulants / therapeutic use* Artifacts Contrast Media / diagnostic use* Female Fibrinolytic Agents / therapeutic use* Heart Ventricles / ultrasonography Humans Male Middle Aged Patient Selection Phospholipids / diagnostic use* Platelet Aggregation Inhibitors / therapeutic use* Predictive Value of Tests Retrospective Studies Sulfur Hexafluoride / diagnostic use* Thrombosis / drug therapy, etiology, ultrasonography* |
| Chemical | |
Reg. No./Substance:
|
0/Anticoagulants; 0/Contrast Media; 0/Fibrinolytic Agents; 0/Phospholipids; 0/Platelet Aggregation Inhibitors; 0/contrast agent BR1; 2551-62-4/Sulfur Hexafluoride |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: No relationship between neutrophil granulocyte activation and the myeloperoxidase gene - 129 G>A...
Next Document: Metabolism and pharmacokinetics of anthraquinones in Rheum palmatum in rats and ex vivo antioxidant ...