Abstract 16451: Left Ventricular Sphericity Predicts Left Ventricular Thrombus Formation After Acute Anterior Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention
Introduction: The aim of this study is to investigate whether left ventricular sphericity index (LVSI) is associated with left ventricular thrombus (LVT) formation in patients with acute anterior myocardial infarction (AaMI).
Methods: The study population consisting of 205 AaMI patients (161 males, mean age 64.7±11.6 years) who were treated by primary PCI were retrospectively studied. LVT was detected within 14 days from admission.
LV function and LVSI were estimated by echocardiography. LVSI was calculated by dividing LV volume by the volume of a sphere whose diameter was the LV longitudinal axis (%).
Results: LVT was diagnosed in 17 patients (8.3%).
Patients with LVT had more TIMI flow grade =< 1 before primary PCI (94.1% vs. 66.5%, p=0.019) and higher maximum CK-MB (621±446 vs. 209±289 U/L, p<0.001) compared to those without LVT. Patients with LVT had larger LV end-diastolic volume index (LVEDVI) (58.9±22.5 vs. 42.4±15.0 mL/m2, p<0.001), LV end-systolic volume index (LVESVI) (34.4±22.0 vs. 21.9±11.4 mL/m2, p=0.033), diastolic LVSI (LVSId, 30.3±7.5 vs. 26.0±8.0 %, p=0.034) and systolic LVSI (LVSIs, 26.2±6.8 vs. 18.0±5.6 %, p<0.001) and lower LV ejection fraction (LVEF) (42.5±12.4 vs. 50.5±10.2 %, p=0.003) than those without LVT. Patients with worse quartile of LVEF (<43%), LVSId (>30.0%) or LVSIs (>22.1%) had higher incidence of LVT than the rest population (Figure). In both groups of lower (<43%) and higher LVEF (>43%), patients with larger LVSIs (>22.1%) had higher incidence of LVT than the rest population (Figure). ROC analysis showed LVSIs as useful to predict LVT (AUC 0.846 [95%CI 0.750 - 0.942], p<0001). Multivariate regression analysis showed that LVSId and LVSIs were independent predictors of LVT (odds ratio 1.497 [1.157-1.934], p=0.002 and 1.646 [1.257-2.155], p<0.001, respectively).
Conclusion: LVSIs was a predictor of LVT formation after AaMI.
- © 2013 by American Heart Association, Inc.