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Abnormal left ventricular vortex flow patterns in association with left ventricular apical thrombus formation in patients with anterior myocardial infarction: a quantitative analysis by contrast echocardiography.

Authors
 Jang-Won Son  ;  Won-Jong Park  ;  Jung-Hyun Choi  ;  Helene Houle  ;  Mani A. Vannan  ;  Geu-Ru Hong  ;  Namsik Chung 
Citation
 CIRCULATION JOURNAL, Vol.76(11) : 2640-2646, 2012 
Journal Title
CIRCULATION JOURNAL
ISSN
 1346-9843 
Issue Date
2012
MeSH
Aged ; Anterior Wall Myocardial Infarction*/diagnostic imaging ; Anterior Wall Myocardial Infarction*/physiopathology ; Blood Flow Velocity ; Echocardiography* ; Female ; Heart Ventricles*/diagnostic imaging ; Heart Ventricles*/physiopathology ; Humans ; Male ; Middle Aged ; Pulsatile Flow ; Thrombosis*/diagnostic imaging ; Thrombosis*/physiopathology
Keywords
Contrast echocardiography ; Left ventricle ; Thrombus ; Vortex
Abstract
BACKGROUND: The current study was designed to investigate the correlation between the left ventricular (LV) vortex flow pattern and LV apical thrombus formation in patients with acute anterior wall myocardial infarction (MI).

METHODS AND RESULTS: Fifty-seven patients with acute anterior wall MI were enrolled in this study. Eighteen patients with apical thrombus (thrombus group) and 39 patients without apical thrombus (non-thrombus group) underwent 2-dimensional contrast echocardiography (CE). Morphology and pulsatility parameters of the LV vortex were measured using Omega flow(®) and compared between the 2 groups. In the thrombus group, the vortex was located more centrally and did not extend to the apex. In the thrombus group, quantitative vortex parameters of vortex depth (0.409±0.101 vs. 0.505±0.092, respectively; P=0.002) and relative strength (1.574±0.310 vs. 1.808±0.376, respectively, P=0.034) were significantly lower than the non-thrombus group. Following multivariate analysis, the vortex depth below 0.45 remained a significant independent parameter for formation of the LV apical thrombus (odds ratio 9.714, 95% confidence interval 1.674-56.381, P=0.011).

CONCLUSIONS: These findings suggest that the location and pulsatility power of the LV vortex are strongly associated with the LV thrombus formation in patients with anterior MI. Therefore, LV vortex flow analysis using CE can be clinically useful for characterizing and quantifying the risk of LV apical thrombus in patients with anterior MI.
Files in This Item:
T201203936.pdf Download
DOI
22878352
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Chung, Nam Sik(정남식)
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89966
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