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Article Abstract
Rationale And Objectives: Ischemic left ventricular aneurysm (LVA) is associated with left ventricular thrombus (LVT), which poses a significant risk of systemic embolism. This retrospective study aimed to identify clinical and cardiac magnetic resonance (CMR)-related risk factors for LVT in patients with ischemic LVA.
Materials And Methods: This study included consecutive hospitalized patients who underwent CMR for ischemic LVA between September 2015 and June 2024. Univariate and multivariate logistic regression analyses were conducted to identify risk factors for LVT in the overall cohort and in two subgroups: acute (AMI) and chronic myocardial infarction (CMI).
Results: Among 384 patients, 108 (28.1%) had LVT. Multivariate logistic regression identified high-sensitivity C reactive protein (hs-CRP) levels (Odds Ratio (OR) 1.05, 95%Confidence Interval (CI) 1.01-1.08, P =0.013), apical aneurysm(OR 4.23, 95%CI 1.15-1.08, P=0.030), infarcted zone peak circumferential strain (PCS) (OR 1.14, 95%CI 1.09-1.21, P<0.001) and extent of late gadolinium enhancement (LGE) (OR 1.35 per 5% increase, 95%CI 1.21-1.50, P <0.001) as significant risk factors for LVT. In patients with AMI, hs-CRP levels, infarcted zone PCS, and extent of LGE were independent predictors of LVT. In patients with CMI, D-dimer, infarcted zone PCS, and extent of LGE emerged as significant predictors.
Conclusion: Elevated hs-CRP levels, higher infarcted zone PCS, greater extent of LGE and apical aneurysm are independent risk factors for LVT in patients with ischemic LVA. Both infarcted zone PCS and extent of LGE are significant predictors of LVT in patients with either AMI or CMI complicated with LVA.
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| http://dx.doi.org/10.1016/j.acra.2025.04.041 | DOI Listing |
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