Domenicucci S, Bellotti P, Chiarella F, Lupi G, Vecchio C
Circulation. 1987 Apr;75(4):737-43. doi: 10.1161/01.cir.75.4.737.
Previous retrospective echocardiographic studies have reported a higher embolic potential of left ventricular thrombi with protruding configuration and patterns of mobility. The present study was performed to prospectively assess the shape and mobility patterns of left ventricular thrombi and their spontaneous changes with time. Two-dimensional echocardiograms were obtained in 109 consecutive patients with acute anterior myocardial infarction within 24 hr of the onset of symptoms, every 24 hr until day 5, every 48 hr until day 15, and then every month for a follow-up of 1 to 29 (mean 14 +/- 8) months in the survivors. None of the patients were treated with anticoagulants or platelet inhibitors during the study period. Left ventricular thrombi, detected in 59 patients (54%), appeared from 1 to 362 (mean 12 +/- 47) days after myocardial infarction. At first detection, the shape was mural in 21 patients and protruding in 38; patterns of mobility were present in eight patients. During follow-up, changes in the shape of the thrombi were noted in 24 patients (41%; from mural to protruding in nine, from protruding to mural in 15). These variations were encountered between 2 and 490 (mean 64 +/- 117) days after the first observation of the thrombus. Patterns of mobility, previously detected in eight patients, disappeared in five of eight within 2 to 28 (mean 14 +/- 11) days.(ABSTRACT TRUNCATED AT 250 WORDS)
既往回顾性超声心动图研究报告称，具有突出形态和活动模式的左心室血栓具有更高的栓塞风险。本研究旨在前瞻性评估左心室血栓的形状和活动模式及其随时间的自发变化。对109例症状发作后24小时内连续就诊的急性前壁心肌梗死患者进行二维超声心动图检查，在症状发作后第1天至第5天每24小时检查1次，第5天至第15天每48小时检查1次，之后对存活患者每月检查1次，随访1至29个月（平均14±8个月）。研究期间，所有患者均未接受抗凝剂或血小板抑制剂治疗。59例患者（54%）检测到左心室血栓，血栓出现在心肌梗死后1至362天（平均12±47天）。首次检测时，21例患者血栓呈壁性，38例呈突出性；8例患者存在活动模式。随访期间，24例患者（41%）血栓形状发生变化（9例从壁性变为突出性，15例从突出性变为壁性）。这些变化发生在首次发现血栓后2至490天（平均64±117天）。先前在8例患者中检测到的活动模式，在8例中有5例在2至28天（平均14±11天）内消失。（摘要截短于250字）
