Echocardiography vs Cardiac Magnetic Resonance Imaging for the Diagnosis of Left Ventricular Thrombus: A Systematic Review

2015 ◽  
Vol 31 (6) ◽  
pp. 785-791 ◽  
Author(s):  
Idan Roifman ◽  
Kim A. Connelly ◽  
Graham A. Wright ◽  
Harindra C. Wijeysundera
Keyword(s):  
Magnetic Resonance Imaging ◽  
Systematic Review ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Magnetic Resonance Imaging ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Resonance Imaging ◽  
Ventricular Thrombus

Abstract 1975: Detection Of Left Ventricular Thrombus With Cardiac Magnetic Resonance Imaging In Patients With Acute St-segment Elevation Myocardial Infarction (stemi)

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Ingo Eitel ◽  
Kathrin Schindler ◽  
Josef Friedenberger ◽  
Georg Fuernau ◽  
Gerhard Schuler ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Myocardial Infarction ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Magnetic Resonance Imaging ◽  
Late Enhancement ◽  
Left Ventricular ◽  
Resonance Imaging ◽  
Ventricular Thrombus ◽  
Left Ventricular Thrombi

Introduction Previously published studies showed differences regarding the prevalence of intraventricular thrombi in patients with acute myocardial infarction (MI) (4–56%). Until now there are no exact results about the occurrence of left ventricular thrombi in acute STEMI. Recognition of LV thrombus is important because the related risk of systemic embolization is high. Methods To investigate the extent of myocardial infarction we examined 225 consecutive patients undergoing primary percutaneous coronar intervention (PCI) in acute STEMI within 12 h after symptom onset by cardiac magnetic resonance imaging within 2– 4 days. Routinely all patients were examined with transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE). All images were analyzed for the presence of intraventricular thrombi. Results In 18 patients (8.0%) we detected left ventricular thrombi, but none of these were seen in TTE or TEE. In two cases an intraventricular thrombus was detected by TEE and TTE, but in the subsequently performed MRI no thrombus was found. In all cases the left ventricular thrombi could be detected in the late enhancement sequence, 8 (44.4%) of them were missed in the cine SSFP sequences. Left ventricular thrombi were more frequently diagnosed in patients with moderate to severe impairment of the left ventricular systolic function (13/18 [72,2%]). Remarkable was also that 14 (77.8%) of the 18 patients with left ventricular thrombus in MRI had an anterior MI, whereas only 2 (11.1%) had an inferior MI, 1 (5,6%) a septal MI and 1 patient (5,6%) a lateral MI. Conclusion In our study TEE and TTE missed left ventricular thrombi in all 18 patients as compared to MRI. There were two false-positive results in TEE and TTE as compared to MRI. Patients with impaired left ventricular function and acute anterior MI have a higher risk of developing left ventricular thrombi than in other infarct-locations. Therefore it could be potentially important to screen in particular high-risk patients (with anterior MI and impaired left ventricular function) with cardiac magnetic resonance imaging to exclude left ventricular thrombi and to lower the risk of embolic events. In particular late enhancement sequences are suitable to detect intraventricular thrombi.

Abstract MP31: Left Ventricular Hypertrophy by Electrocardiogram versus Cardiac Magnetic Resonance Imaging as a Predictor for Heart Failure: The MESA Study

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Abdullahi O Oseni ◽  
Waqas T Qureshi ◽  
Mohammed F Almahmoud ◽  
Alain Bertoni ◽  
David A Bluemke ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Heart Failure ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Ventricular Hypertrophy ◽  
Cardiac Magnetic Resonance Imaging ◽  
Ventricular Hypertrophy ◽  
Predictive Ability ◽  
Left Ventricular ◽  
Resonance Imaging

Background: Left ventricular hypertrophy (LVH) is an established risk factor for heart failure (HF). However, it is unknown whether LVH detected by electrocardiogram (ECG-LVH) is equivalent to LVH ascertained by cardiac magnetic resonance imaging (MRI-LVH) in terms of prediction of incident HF using risk prediction models like the Framingham Heart Failure Risk Score (FHFRS). Methods: This analysis included 4745 (mean age 61+10 years, 53.5% women, 61.7% non-whites) from the Multi-Ethnic Study of Atherosclerosis who were free of cardiovascular disease at the time of enrollment. ECG-LVH was defined using Cornell’s criteria while MRI-LVH was derived from left ventricular (LV) mass measured by cardiac MRI. Cox proportional hazard regression was used to examine the association between ECG-LVH and MRI-LVH with incident HF. Harrell’s concordance C-index was used to estimate the predictive ability of the FHFRS when either ECG-LVH or MRI-LVH were included as one of its components. The added predictive ability of ECG-LVH and MRI-LVH were investigated using integrated discrimination improvement (IDI) index and relative IDI. Results: ECG-LVH was present in 291(6.1%) while MRI-LVH was present in 499 (10.5%) of the participants. Over a median follow up of 10.4 years, 140 participants developed HF. Both ECG-LVH [HR (95% CI): 2.25(1.38-3.69)] and MRI-LVH [HR (95% CI): 3.80(1.56-5.63)] were associated with an increased risk of HF in multivariable adjusted models (Table 1). The ability of FHFRS to predict HF was improved with MRI-LVH (C-index 0.871, 95% CI: 0.842-0.899) when compared with ECG-LVH (C-index 0.860, 95% CI: 0.833-0.888) (p < 0.0001). To assess the potential clinical utility of using LVH-MRI instead of ECG-LVH, we calculated several measures of reclassification (Table 1), which were consistent with the statistically significantly improved C-statistic with MRI-LVH. Conclusion: Both ECG-LVH and MRI-LVH are predictive of HF when used in the FHFRS. Substituting MRI-LVH for ECG-LVH improves the predictive ability of the FHFRS.

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