Alhassan Donya A, Waheed Khawaja Bilal, Sharif Muhammad N, Ul Hassan Muhammad Z, Ghaffar Fazal, Salem Khaled S, Said Emad F M, Altalaq Bayan M, Qarmash Ahmad O, Arulanantham Zechariah J
Department of Radiology, King Fahad Military Medical Complex, Dhahran, Saudi Arabia.
Department of Cardiology, King Fahad Military Medical Complex, Dhahran, Saudi Arabia.
J Saudi Heart Assoc. 2020 Aug 17;32(3):368-376. doi: 10.37616/2212-5043.1042. eCollection 2020.
To highlight detection of left ventricular thrombi on cardiac magnetic resonance (CMR) viability studies.
This retrospective observational study was conducted in the Radiology Department at our Hospital in Dhahran, from April 2015-2019. All recently re-perfused (post-percutaneous coronary intervention/PCI) patients with ST-segment elevation myocardial infarctions (STEMI), having low ejection fractions (<40%), impaired LV functions or abnormal wall motions on transthoracic echocardiographies (TTEs), who underwent cardiac magnetic resonance (CMR) imaging viability studies were included. Patients with incomplete or limited studies (due to artifacts), previous coronary artery bypass graft (CABG), those who lost follow-ups, and those who were contraindicated or unfit for MRIs were excluded. An area of low signal intensity with no late gadolinium enhancement (LGE) was defined as thrombus on MR imaging, and two radiologists reached consensus report for the diagnoses. Patients with anterior or non-anterior wall MI were documented, and their ejection fractions were recorded. Percentage estimation of LV thrombi as detected on CMR studies was made. Any complications (like MI, stroke or death) that occurred within one year of diagnoses were documented. A Chi-square was used to determine association.
Of the 125 patients, most were men (71.2%) with a mean age of 56.78 years. Eleven patients had left ventricular thrombi (8.8%), and most of these were anterior wall infarctions with low ejection fractions (<40%). Three out of 11 patients with LV thrombi developed complications versus 3 out of 114 without LV thrombi (P- value, .0005).
Left ventricular thrombi can be detected on cardiac viability studies in recently re-perfused STEMI patients and may possibly predict the risk of complications.
强调在心脏磁共振（CMR）心肌存活研究中对左心室血栓的检测。
本回顾性观察性研究于2015年4月至2019年在达兰我们医院的放射科进行。纳入所有近期再灌注（经皮冠状动脉介入治疗/PCI术后）的ST段抬高型心肌梗死（STEMI）患者，这些患者射血分数低（<40%）、左心室功能受损或经胸超声心动图（TTE）显示室壁运动异常，并接受了心脏磁共振（CMR）成像心肌存活研究。排除研究不完整或受限（由于伪影）的患者、既往有冠状动脉旁路移植术（CABG）的患者、失访患者以及禁忌或不适合进行MRI检查的患者。在磁共振成像上，无延迟钆增强（LGE）的低信号强度区域被定义为血栓，两名放射科医生对诊断达成共识报告。记录前壁或非前壁心肌梗死患者，并记录其射血分数。对CMR研究中检测到的左心室血栓进行百分比估计。记录诊断后一年内发生的任何并发症（如心肌梗死、中风或死亡）。采用卡方检验确定相关性。
125例患者中，大多数为男性（71.2%），平均年龄56.78岁。1男患者有左心室血栓（8.8%），其中大多数为前壁梗死且射血分数低（<40%）。11例有左心室血栓的患者中有3例发生并发症，而114例无左心室血栓的患者中有3例发生并发症（P值，0.0005）。
在近期再灌注的STEMI患者的心脏存活研究中可检测到左心室血栓，并且可能预测并发症风险。
