EMBOLIC POTENTIAL OF LEFT-VENTRICULAR THROMBI DETECTED BY TWO-DIMENSIONAL ECHOCARDIOGRAPHY
EMBOLIC POTENTIAL OF LEFT-VENTRICULAR THROMBI DETECTED BY TWO-DIMENSIONAL ECHOCARDIOGRAPHY
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DOI：
10.1161/01.cir.70.4.588
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发表时间：
1984-01-01
期刊：
影响因子：
37.8
通讯作者：
HODGES, M
中科院分区：
文献类型：
--
作者：
HAUGLAND, JM;ASINGER, RW;HODGES, M
确定左心室血栓的超声心动图表现与全身性栓塞之间是否存在关联。对 60 名因左心室血栓接受诊断性二维超声心动图的患者的临床和超声心动图特征进行了回顾。在这 60 名患者 (27%) 中，16 名有全身栓塞的证据。分析了左心室血栓的多种超声心动图特征，包括活动性、形状、异质性、回声密度、分层、中心回声透明度、动脉瘤内的存在以及与低密度旋转回声的关联。血栓可移动或伸入左心室腔的患者的栓塞发生率显着较高（分别为 P < 0.002 和 P < 0.05）。贝叶斯分析表明，栓塞的预测可能性为 27%，并且在存在活动性、中心回声透明度和突出的情况下分别增加到 60%、50% 和 40%。逐步回归表明，在识别栓塞现象患者时，流动性是第一个最有帮助的超声心动图特征，突出是第二个最有用的超声心动图特征。临床特征对于识别左心室血栓患者的栓塞风险帮助不大。 31 名近期发生心肌梗死（< 3 周）的患者中有 9 名（29%）有栓塞，而 26 名远期心肌梗死（> 3 周）患者中有 5 名（19%）存在栓塞（P = NS）。 3 例无梗塞的患者患有充血性心肌病，2 例有栓塞。
Whether an association existed between the echocardiographic appearance of left ventricular thrombi and systemic embolization was determined. The clinical and echocardiographic characteristics of 60 patients who underwent diagnostic 2-dimensional echocardiography for left ventricular thrombi were reviewed. Of these 60 patients (27%), 16 had evidence of systemic embolization. Multiple echocardiographic characteristics of left ventricular thrombi were analyzed, including mobility, shape, heterogeneity, echo density, layering, central echo lucency, presence within an aneurysm, and association with low density swirling echoes. Incidence of embolization was significantly higher in patients with thrombi that were mobile or protruded into the left ventricular cavity (P < 0.002 and P < 0.05, respectively). Bayesian analysis indicated that the pretest likelihood for embolization was 27% and increased in the presence of mobility, central echo lucency, and protrusion to 60, 50 and 40%, respectively. A stepwise regression indicated that mobility was the 1st and protrusion the 2nd most helpful echocardiographic characteristic in identifying patients with embolic phenomena. Clinical features were of less help in identifying the risk for embolization of patients with left ventricular thrombi. Nine of 31 patients (29%) with recent myocardial infarction (< 3 wk) had emboli in contrast to 5 of 26 patients (19%) with remote myocardial infarction (> 3 wk) (P = NS). The 3 patients without infarction had congestive cardiomyopathy and 2 had emboli.