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Thromb Haemost
DOI: 10.1055/a-2536-8739
Atherosclerosis and Ischemic Disease

Identifying Risk Factors for Left Ventricular Thrombus in Patients with Ischemic Left Ventricular Aneurysm Using Cardiac MRI

Yanfang Wu‡   *
1   Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
,
Hui Wang‡   *
2   Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
,
Zhiyan Wang
1   Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
,
Chang Hua
1   Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
,
Ran Xiong
1   Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
,
Hao Fu
1   Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
,
Qiang Lv
1   Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
,
Lei Xu‡   **
2   Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
,
Xin Du‡   **
1   Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
3   Heart Health Research Center, Beijing, China
,
Jianzeng Dong
1   Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
4   Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Henan Province, China
› Institutsangaben Funding We gratefully acknowledge the support of Postdoctoral Fellowship Program of CPSF (GZC20231751).
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Abstract

Background

Ischemic left ventricular (LV) aneurysm is associated with LV thrombus and subsequent embolic events. However, there is currently no evidence-based recommendation for anticoagulation in these patients.

Objective

To determine the characteristics of LV aneurysms associated with a high risk of thrombus formation.

Methods

This retrospective study included all hospitalized patients with ischemic LV aneurysm who underwent cardiac magnetic resonance (CMR) from September 2015 to June 2023. Baseline characteristics and CMR parameters were compared between patients with and without LV thrombus. Factors associated with LV thrombus were identified using univariable and multivariable logistic regression analyses.

Results

Among the 317 patients included in this study, 88 (27.8%) had LV thrombus. Patients with LV thrombus demonstrated a higher prevalence of heart failure, lower left ventricular ejection fraction, and greater volume, mass, and global extent of late gadolinium enhancement (LGE). They also exhibited distinct LV aneurysm characteristics, such as a larger maximum transverse dimension (maximum width), a wider aneurysm neck, and a higher aneurysm shape index (ratio of maximum length to neck width). Multivariable logistic regression analyses identified aneurysm neck width (OR 1.33 per 5 mm, 95% CI 1.00–1.77, P = 0.047), shape index (OR 1.63 per 20%, 95% CI 1.23–2.16, P = 0.001), and LGE global extent of >50% (OR 6.58, 95% CI 3.04–14.27, P < 0.001) as significant predictors of LV thrombus.

Conclusion

A wider aneurysm neck, a higher aneurysm shape index, and LGE global extent >50% are associated with LV thrombus in patients with ischemic LV aneurysm.

Keywords

ischemic heart disease - left ventricular aneurysm - ventricular thrombus - cardiac magnetic resonance

* These authors have contributed equally to this work and share first authorship.


** These authors are joint senior authors who contributed equally.




Publikationsverlauf

Eingereicht: 07. August 2024

Angenommen: 10. Februar 2025

Accepted Manuscript online:
11. Februar 2025

Artikel online veröffentlicht:
24. März 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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