title: Left ventricular and left atrial thrombi in sinus rhythm patients with dilated ischemic cardiomyopathy.
abstract: BACKGROUND
  Ischemic dilated cardiomyopathy offers a favorable terrain for left ventricular (LV) thrombus formation; however, left artial appendage (LAA) may be an additional source of thrombi in patients with dilated heart. The main objectives of this study were to determine the prevalence of LV and LAA thrombi in patients with chronic ischemic dilated cardiomyopathy in sinus rhythm, as well as to reveal echocardiographic predictors for thrombus formation.
  
  
  METHODS
  The study included 57 patients with chronic dilated ischemic cardiomyopathy in sinus rhythm, who were not under oral anticoagulation therapy. Exclusion criteria included patients with: swallowing problems, acute myocardial infarction, idiopathic and/or non-ischemic dilated cardiomyopathy, atrial fibrillation/flatter, severe systolic dysfunction. Transthoracic echocardiography and transesophageal echocardiography were obtained for each patient.
  
  
  RESULTS
  Mean patient age was 62 +/- 10.5 years, mean LV end diastolic diameter was 67.2 +/- 5.8 mm, whereas mean LV ejection fraction (EF) was 37.1 +/- 4.3%. LV thrombus was detected in 11 (19.3%) patients; while 23 (40.3%) patients had LAA thrombus. In a multiple regression analysis LV size (p = 0.05) and lack of aspirin therapy (p = 0.02) showed to be independent LV thrombus predictors, whereas lower LV EF (p = 0.02) and larger LAA maximal area (p = 0.004) demonstrated to be independent predictors of LAA thrombus.
  
  
  CONCLUSIONS
  We consider that our study sheds light to the high possibility of LAA thrombi formation in addition to LV thrombi in patients with chronic dilated ischemic cardiomyopathy in sinus rhythm. LV size, LV EF, LAA maximal area and lack of aspirin therapy are shown to be independent predictors of left heart chamber thrombi in this patient category.
authors: Department of Cardiology, Clinic of Internal Medicine, University Clinical Center of Kosova, Prishtine, Kosovo. abakalli@hotmail.com
authors: Aurora
authors: A
authors: Bakalli
authors: Ljubica
authors: L
authors: Georgievska-Ismail
authors: Dardan
authors: D
authors: Koçinaj
authors: Nebi
authors: N
authors: Musliu
authors: Bedri
authors: B
authors: Zahiti
authors: Agim
authors: A
authors: Krasniqi
authors: Tefik
authors: T
authors: Bekteshi
authors: Basri
authors: B
authors: Sejdiu
mesh_terms: D002311:Cardiomyopathy, Dilated / Q000150:complications* / Q000503:physiopathology; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*