title: Cardiac magnetic resonance detection of left ventricular thrombus in acute myocardial infarction.
abstract: BACKGROUND
  Left ventricular thrombosis (LVT) is a possible complication of acute myocardial infarction. Aim of our study was to evaluate incidence and clinical characteristics of patients with LVT after ST elevation myocardial infarction (STEMI) using contrast- enhanced magnetic resonance (CMR).
  
  
  RESULTS
  In a prospective cohort of 36 consecutive patients with STEMI acutely reperfused with primary percutaneous coronary intervention, CMR was performed within one week. LVT was found in 7 patients (19%), and was located in left ventricle apex or adherent to antero-septum. Compared to the rest of population patients with LVT have lower ejection fraction (38 ± 7% versus 51 ± 6%, P = 0.009), larger left ventricle end systolic volume (95.8 ± 19 ml versus 68.9 ± 19 ml, P = 0.02), higher time to reperfusion (9.3 ± 7.2 versus 5 ± 3.6, P = 0.03) and left anterior descending artery was constantly involved (100% versus 41 %, P = 0.06). In 5 cases the LVT was also detected by echocardiography, however, in 2 cases it was missed.
  
  
  CONCLUSIONS
  The incidence of LVT after STEMI is not negligible and was accurately detected by CMR. Localization of myocardial infarction, time to reperfusion, ejection fraction and left ventricle end systolic volume are the most important predictors of left ventricle thrombus formation.
authors: Cardiology Department, Policlinico Casilino, Rome, Italy. chiaralanzilllo@hotmail.com
authors: Chiara
authors: C
authors: Lanzillo
authors: Mauro
authors: M
authors: Di Roma
authors: Alessandro
authors: A
authors: Sciahbasi
authors: Monia
authors: M
authors: Minati
authors: Luciano
authors: L
authors: Maresca
authors: Gianluca
authors: G
authors: Pendenza
authors: Enrico
authors: E
authors: Romagnoli
authors: Francesco
authors: F
authors: Summaria
authors: Roberto
authors: R
authors: Patrizi
authors: Marco
authors: M
authors: Di Luozzo
authors: Paolo
authors: P
authors: Preziosi
authors: Ernesto
authors: E
authors: Lioy
authors: Francesco
authors: F
authors: Romeo
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D000077144:Clopidogrel; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D004452:Echocardiography; D005260:Female; D006801:Humans; D015994:Incidence; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D013318:Stroke Volume; D013927:Thrombosis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin