Abstract 19523: Clinical Usefulness of Left Ventricular Vortex Flow Analysis for Predicting Apical Thrombus Formation in Patient with Cardiomyopathy by Contrast Echocardiography
Background: Prediction of the left ventricular (LV) apical thrombus formation in patients with dilated cardiomyopathy (DCMP) is important for long-term mortality and morbidity. However, conventional echo-Doppler parameters including EF could not predict LV thrombus formation well. The LV vortex flow may play a key role in thrombus formation in LV the apex. The aim of this study was to assess clinical usefulness of the LV vortex flow analysis for predicting apical thrombus in patients with DCMP.
Methods: 25 DCMP (LVEF < 40%) patients were enrolled for this study. Of the study population, 12 patients with apical thrombus(thrombus group) and 13 patients without apical thrombus (non-thrombus group) underwent 2D contrast echocardiography (CE) with intravenous infusion of Definity. Morphology and pulsatility parameters of LV vortex were measured using Omega flow® (Siemens Medical Solution, Mountain View, CA) and compared between two groups.
Results: LVEF, LV volume index, and sphericity index of the LV were not significantly different between two groups. In non-thrombus group, a coherent vortex was placed near the LV apex. However, in thrombus group, major vortex was located in the center of the LV, and did not extend to the LV apex. Vortex depth (0.618 ± 0.257 vs. 0.301 ± 0.135, p = 0.05) is significantly decreased in thrombus group, but relative strength (1.884 ± 0.470 vs. 1.540 ± 0.305, p = 0.177) was not significantly different between groups, but it tended to be lower in the thrombus group.
Conclusions: LV vortex flow analysis is clinically useful for predicting apical thrombus in patients with DCMP, which offers a new method to application for anticoagulation treatment in DCMP.
- © 2010 by American Heart Association, Inc.