Detection of Left Ventricular Thrombus by Delayed-Enhancement Cardiovascular Magnetic Resonance

• Published in: Journal of the American College of Cardiology 2008-07, Vol.52 (2), p.148-157
• Main Authors: Weinsaft, Jonathan W., MD, Kim, Han W., MD, Shah, Dipan J., MD, Klem, Igor, MD, Crowley, Anna Lisa, MD, Brosnan, Rhoda, MD, James, Olga G., MD, Patel, Manesh R., MD, Heitner, John, MD, Parker, Michele, MS, RN, Velazquez, Eric J., MD, Steenbergen, Charles, MD, PhD, Judd, Robert M., PhD, Kim, Raymond J., MD
• Format: Article
• Language: English
• Subjects: Cardiovascular; cardiovascular magnetic resonance; delayed enhancement imaging; Internal Medicine; thrombus
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2008.03.041

Detection of Left Ventricular Thrombus by Delayed-Enhancement Cardiovascular Magnetic Resonance: Prevalence and Markers in Patients With Systolic Dysfunction Jonathan W. Weinsaft, Han W. Kim, Dipan J. Shah, Igor Klem, Anna Lisa Crowley, Rhoda Brosnan, Olga G. James, Manesh R. Patel, John Heitner, Michele Parker, Eric J. Velazquez, Charles Steenbergen, Robert M. Judd, Raymond J. Kim Among a broad population of 784 patients with systolic dysfunction that underwent cardiovascular magnetic resonance (CMR) for left ventricular thrombus evaluation at 2 institutions, delayed-enhancement cardiovascular magnetic resonance (DE-CMR) detected thrombus in 7% (55 patients) and cine-CMR in 4.7% (37 patients, p < 0.005). Follow-up was consistent with DE-CMR as a better reference standard than cine-CMR based on pathology verification of thrombus and follow-up end points (p < 0.005). Cine-CMR generally missed small intracavitary and small or large mural thrombus detected by DE-CMR. In addition to traditional indices such as low left ventricular ejection fraction and ischemic cardiomyopathy, multivariable analysis showed that increased myocardial scarring, an additional parameter available from DE-CMR, was an independent risk factor for thrombus.