VENTRICULAR THROMBI AND THROMBOEMBOLISM IN DILATED CARDIOMYOPATHY - A PROSPECTIVE FOLLOW-UP-STUDY
VENTRICULAR THROMBI AND THROMBOEMBOLISM IN DILATED CARDIOMYOPATHY - A PROSPECTIVE FOLLOW-UP-STUDY
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DOI：
10.1016/0002-8703(92)90757-m
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发表时间：
1992-01-01
影响因子：
4.8
通讯作者：
COATS, MH
中科院分区：
文献类型：
--
作者：
FALK, RH;FOSTER, E;COATS, MH
为了确定扩张型心肌病左心室血栓的患病率和自然史，我们前瞻性地对25例未接受抗凝治疗的非缺血性扩张型心肌病患者进行了二维超声心动图检查。在9至30个月期间连续进行了85次超声心动图检查（平均随访21.5个月）。11例（44%）患者在初始超声心动图上出现左心室血栓，另外4例在随访期间出现，2例消失。短缩分数小于或等于10%的患者（15例中的12例）血栓发生率明显高于短缩分数为11%至25%的患者（10例中的3例）（p < 0.02）。在随访期间发生了5起栓塞事件（4起脑栓塞），其中4起与先前可见的左心室血栓相关。3/5的血栓突出到左心室腔，随后栓塞。我们的结论是，在扩张型心肌病的非抗凝患者中，左心室血栓和血栓栓塞是常见的。超声心动图可能有助于预测哪些患者有血栓栓塞的风险。
To determine the prevalence and natural history of left ventricular thrombus in dilated cardiomyopathy, we prospectively performed two-dimensional echocardiograms in 25 patients with nonischemic dilated cardiomyopathy who were not receiving anticoagulation. Eighty-five echocardiograms were performed serially over a 9- to 30-month period (mean follow-up 21.5 months). A left ventricular thrombus was present on initial echocardiogram in 11 (44%) patients, became present during follow-up in an additional four, and disappeared in two. Thrombus was significantly more common in patients with fractional shortening of less-than-or-equal-to 10% (12 of 15) than in those with a fractional shortening 11% to 25% (3 of 10) (p < 0.02). Five embolic events (four cerebral) occurred over the follow-up period, four of which were associated with a previously visualized left ventricular thrombus. Three of five thrombi that protruded into the left ventricular cavity subsequently embolized. We conclude that in nonanticoagulated patients with dilated cardiomyopathy left ventricular thrombus and thromboembolism are common. Echocardiography may be helpful in predicting which patients are at risk of thromboembolism.