title: Contrast echocardiography for the diagnosis of left ventricular thrombus in anterior myocardial infarction.
abstract: Although detecting left ventricular thrombus in anterior myocardial infarction is important for the prevention of embolic events, imaging of apical thrombus is often difficult using conventional echocardiography. We examined whether contrast echocardiography improves sensitivity and specificity in detecting thrombus in the left ventricle in comparison with conventional echocardiography alone in patients with anterior myocardial infarction. Participants in this single-center prospective study comprised 392 patients with anterior myocardial infarction admitted between 2000 and 2006. After conventional echocardiography, all patients underwent contrast echocardiography (left ventricular opacification and myocardial contrast echocardiography) during intravenous drip infusion of contrast media at rest. Left ventricular thrombus was diagnosed based on left ventriculography or multidetector-row computed tomography (MDCT). Mural left ventricular thrombus was confirmed by left ventriculography and/or MDCT in 32 of 393 patients (8 %). Sensitivity and specificity of conventional echocardiography alone were 88 % and 96 %, respectively, compared with 100 % each with contrast echocardiography. Among the 32 patients with left ventricular thrombus, 25 patients (78 %) showed no perfusion in the anterior wall on myocardial contrast echocardiography, even with a four-beat interval. In conclusion, contrast echocardiography offers a clinically feasible and useful method for noninvasively evaluating left ventricular thrombus in anterior myocardial infarction.
authors.affiliation: First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, Saitama, 330-8503, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wada
authors.forename: Takanori
authors.initials: T
authors.lastname: Yasu
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sakakura
authors.forename: Yuki
authors.initials: Y
authors.lastname: Hayakawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ishida
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Norifumi
authors.initials: N
authors.lastname: Kubo
authors.forename: Junya
authors.initials: J
authors.lastname: Ako
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Momomura
mesh_terms: D000368:Aged; D056988:Anterior Wall Myocardial Infarction / Q000150:complications*; D003287:Contrast Media / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D007262:Infusions, Intravenous; D007564:Japan; D008297:Male; D061330:Multidetector Computed Tomography; D011134:Polysaccharides / Q000008:administration & dosage; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508