Key result
Cardioscopy detected left ventricular thrombi in 30.2% of patients, demonstrating significantly higher sensitivity than left ventriculography (2.7%), non-contrast (1.9%), and contrast echocardiography (7.0%).
Why the study?
Does cardioscopy improve the detection rate of left ventricular thrombi compared to left ventriculography and echocardiography in patients with heart diseases?
Cross-Sectional (n=258)
Yes
Does cardioscopy improve the detection rate of left ventricular thrombi compared to left ventriculography and echocardiography in patients with heart diseases?
Absolute Event Rate: 30.2% vs 7%
p-value: p=<0.0001
Cardioscopy is significantly more sensitive than standard echocardiography and ventriculography for detecting left ventricular thrombi, revealing a high prevalence of mural thrombi across various heart diseases.
May enhance LV thrombus detection over echocardiography; hypothesis-generating, prospective trials needed before clinical adoption.
BACKGROUND: Thrombosis occurs in the left ventricle and causes ischemic cerebral attacks. However, differences in the incidence of left ventricular thrombi (LVT) among various categories of heart diseases are not known. METHODS AND RESULTS: From April 2000 to 31 March 2008, 258 patients (104 females and 154 males; age 63 ± 6 years) with a heart disease underwent cardioscopy of the left ventricle. LVT were detected by cardioscopy in 78 of 258 patients; 12.5% of 57 patients with stable angina, 0% of 9 with unstable angina, 45.2% of 42 with acute myocardial infarction, 23.2% of 43 with old myocardial infarction, 61.9% of 21 with idiopathic acute myocarditis, 44.3% of 68 with idiopathic chronic myocarditis, 33.3% of 6 with rheumatic valvular disease, 25.7% of 31 with idiopathic dilated cardiomyopathy and in 8.0% of 12 with idiopathic hypertrophic cardiomyopathy. Nine of 78 thrombi were globular and 69 were mural. The detection rate of LVT by cardioscopy, left venticulography, non-contrast and contrast echocardiography was 30.2%, 2.7%, 1.9% and 7.0%, respectively. CONCLUSIONS: LVT were frequently detected by cardioscopy in patients with heart diseases. Although invasive, cardioscopy was more sensitive in detecting LVT than left ventriculography, and non-contrast and contrast echocardiography.
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Uchida et al. (2011) conducted a cross-sectional in Heart diseases (including myocardial infarction, myocarditis, cardiomyopathy, and angina) (n=258). Cardioscopy vs. Left ventriculography, non-contrast echocardiography, and contrast echocardiography was evaluated on Detection rate of left ventricular thrombi (p=<0.0001). Cardioscopy detected left ventricular thrombi in 30.2% of patients, demonstrating significantly higher sensitivity than left ventriculography (2.7%), non-contrast (1.9%), and contrast echocardiography (7.0%).
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