Abnormal Left Ventricular Vortex Flow Patterns in Association With Left Ventricular Apical Thrombus Formation in Patients With Anterior Myocardial Infarction - A Quantitative Analysis by Contrast Echocardiography

Title
Abnormal Left Ventricular Vortex Flow Patterns in Association With Left Ventricular Apical Thrombus Formation in Patients With Anterior Myocardial Infarction - A Quantitative Analysis by Contrast Echocardiography
Author(s)
손장원박원종최정현[최정현]홍그루[홍그루]정남식[정남식]Helene Houle[Helene Houle]Mani A. Vannan[Mani A. Vannan]
Keywords
NATURAL-HISTORY; ANTICOAGULATION; QUANTIFICATION; VELOCIMETRY; DOPPLER
Issue Date
201210
Publisher
JAPANESE CIRCULATION SOC
Citation
CIRCULATION JOURNAL, v.76, no.11, pp.2640 - 2646
Abstract
Background: The current study was designed to investigate the correlation between the left ventricular (LV) vortex flow pattern and LV apical thrombus formation in patients with acute anterior wall myocardial infarction (MI). Methods and Results: Fifty-seven patients with acute anterior wall MI were enrolled in this study. Eighteen patients with apical thrombus (thrombus group) and 39 patients without apical thrombus (non-thrombus group) underwent 2-dimensional contrast echocardiography (CE). Morphology and pulsatility parameters of the LV vortex were measured using Omega flow and compared between the 2 groups. In the thrombus group, the vortex was located more centrally and did not extend to the apex. In the thrombus group, quantitative vortex parameters of vortex depth (0.409 +/- 0.101 vs. 0.505 +/- 0.092, respectively; P=0.002) and relative strength (1.574 +/- 0.310 vs. 1.808 +/- 0.376, respectively, P=0.034) were significantly lower than the non-thrombus group. Following multivariate analysis, the vortex depth below 0.45 remained a significant independent parameter for formation of the LV apical thrombus (odds ratio 9.714, 95% confidence interval 1.674-56.381, P=0.011). Conclusions: These findings suggest that the location and pulsatility power of the LV vortex are strongly associated with the LV thrombus formation in patients with anterior MI. Therefore, LV vortex flow analysis using CE can be clinically useful for characterizing and quantifying the risk of LV apical thrombus in patients with anterior MI. (Circ J 2012; 76: 2640-2646)
URI
http://hdl.handle.net/YU.REPOSITORY/27112http://dx.doi.org/10.1253/circj.CJ-12-0360
ISSN
1346-9843
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의과대학 > 내과학교실 > Articles
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