Journal of cardiology · 2025
Clinical and speckle tracking echocardiographic predictors of left ventricular thrombus following primary percutaneous coronary intervention for anterior ST-elevation myocardial infarction.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
El-Naggar Heba M, Abdel-Gaber Alaa A, Kishk Yehia T, Ahmed Tarek A N
Аннотация
BACKGROUND: Left ventricular thrombus (LVT) remains a serious complication of acute ST-elevation myocardial infarction (STEMI), mandating timely detection and proper antithrombotic therapy. This study aimed to assess the incidence and possible clinical and echocardiographic predictors of LVT development.
METHODS: This study prospectively included 300 patients with acute anterior STEMI who underwent primary percutaneous coronary intervention (PPCI). Serial echocardiographic examinations were performed at three time-points post-PPCI: in-hospital, 2-weeks, and 3-months to assess LVT development. LV global (GLS) and regional longitudinal strain (LS) and radial strain were determined. The occurrence of major adverse cardiovascular events (MACE) at three months post-PPCI was reported.
RESULTS: The incidence of LVT development was 16.3 %, most of which (51 %) were detected early at the post-PPCI in-hospital echocardiography examination, whereas 22.4 % were detected at 2 weeks and 26.5 % after 3 months post-PPCI. Prior infarction, longer total ischemic time, no or partial ST-segment resolution, and high coronary thrombus grade were significant independent predictors of LVT development. On receiver operating characteristic analysis, baseline GLS ≥ -11.08 % [area under the curve (AUC) = 0.73, 95 % confidence interval (CI) = 0.65-0.81, p < 0.001] and apical LS ≥ -4.9 % (AUC = 0.75, 95 % CI = 0.69-0.82, p < 0.001) showed significant discrimination for LVT. Adjusted for other covariates, impaired baseline apical LS was the only echocardiographic independent predictor of later LVT development at 2 weeks and 3 months post-PPCI. MACE were significantly higher among patients who developed LVT. LVT resolution was achieved in 93.3 % after three months of anticoagulation.
CONCLUSION: Serial echocardiographic studies after acute anterior STEMI improved LVT detection. The occurrence of LVT within three months following PPCI was associated with impaired GLS and apical LS obtained after PPCI.
METHODS: This study prospectively included 300 patients with acute anterior STEMI who underwent primary percutaneous coronary intervention (PPCI). Serial echocardiographic examinations were performed at three time-points post-PPCI: in-hospital, 2-weeks, and 3-months to assess LVT development. LV global (GLS) and regional longitudinal strain (LS) and radial strain were determined. The occurrence of major adverse cardiovascular events (MACE) at three months post-PPCI was reported.
RESULTS: The incidence of LVT development was 16.3 %, most of which (51 %) were detected early at the post-PPCI in-hospital echocardiography examination, whereas 22.4 % were detected at 2 weeks and 26.5 % after 3 months post-PPCI. Prior infarction, longer total ischemic time, no or partial ST-segment resolution, and high coronary thrombus grade were significant independent predictors of LVT development. On receiver operating characteristic analysis, baseline GLS ≥ -11.08 % [area under the curve (AUC) = 0.73, 95 % confidence interval (CI) = 0.65-0.81, p < 0.001] and apical LS ≥ -4.9 % (AUC = 0.75, 95 % CI = 0.69-0.82, p < 0.001) showed significant discrimination for LVT. Adjusted for other covariates, impaired baseline apical LS was the only echocardiographic independent predictor of later LVT development at 2 weeks and 3 months post-PPCI. MACE were significantly higher among patients who developed LVT. LVT resolution was achieved in 93.3 % after three months of anticoagulation.
CONCLUSION: Serial echocardiographic studies after acute anterior STEMI improved LVT detection. The occurrence of LVT within three months following PPCI was associated with impaired GLS and apical LS obtained after PPCI.