TY - JOUR
T1 - Left ventricular thrombus formation in myocardial infarction is associated with altered left ventricular blood flow energetics
AU - Garg, Pankaj
AU - van der Geest, Rob J.
AU - Swoboda, Peter P.
AU - Crandon, Saul
AU - Fent, Graham J.
AU - Foley, James R. J.
AU - Dobson, Laura E.
AU - Al Musa, Tarique
AU - Onciul, Sebastian
AU - Vijayan, Sethumadhavan
AU - Chew, Pei G.
AU - Brown, Louise A. E.
AU - Bissell, Malenka
AU - Hassell, Mariëlla E. C. J.
AU - Nijveldt, Robin
AU - Elbaz, Mohammed S. M.
AU - Westenberg, Jos J. M.
AU - Dall'Armellina, Erica
AU - Greenwood, John P.
AU - Plein, Sven
N1 - A correction has been published: European Heart Journal - Cardiovascular Imaging, Volume 20, Issue 1, January 2019, Page 117, https://doi.org/10.1093/ehjci/jey148
There were three errors in the originally published version:
1. Affiliation 3 was incorrect in the original version and should have read ‘Radboudumc, Department of Cardiology, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands.’
2. Under the heading ‘CMR examination’, the abbreviation ‘MR’ has been spelt out as ‘mitral regurgitation’ but should have read ‘magnetic resonance’.
3. Under the heading ‘Haemodynamic analysis’, the abbreviation ‘MR’ stands for ‘mitral regurgitation’.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Aims
The main aim of this study was to characterize changes in the left ventricular (LV) blood flow kinetic energy (KE) using four-dimensional (4D) flow cardiovascular magnetic resonance imaging (CMR) in patients with myocardial infarction (MI) with/without LV thrombus (LVT).
Methods and results
This is a prospective cohort study of 108 subjects [controls = 40, MI patients without LVT (LVT− = 36), and MI patients with LVT (LVT+ = 32)]. All underwent CMR including whole-heart 4D flow. LV blood flow KE wall calculated using the formula: KE=12 ρblood . Vvoxel . v2, where ρ = density, V = volume, v = velocity, and was indexed to LV end-diastolic volume. Patient with MI had significantly lower LV KE components than controls (P < 0.05). LVT+ and LVT− patients had comparable infarct size and apical regional wall motion score (P > 0.05). The relative drop in A-wave KE from mid-ventricle to apex and the proportion of in-plane KE were higher in patients with LVT+ compared with LVT− (87 ± 9% vs. 78 ± 14%, P = 0.02; 40 ± 5% vs. 36 ± 7%, P = 0.04, respectively). The time difference of peak E-wave KE demonstrated a significant rise between the two groups (LVT−: 38 ± 38 ms vs. LVT+: 62 ± 56 ms, P = 0.04). In logistic-regression, the relative drop in A-wave KE (beta = 11.5, P = 0.002) demonstrated the strongest association with LVT.
Conclusion
Patients with MI have reduced global LV flow KE. Additionally, MI patients with LVT have significantly reduced and delayed wash-in of the LV. The relative drop of distal intra-ventricular A-wave KE, which represents the distal late-diastolic wash-in of the LV, is most strongly associated with the presence of LVT.
AB - Aims
The main aim of this study was to characterize changes in the left ventricular (LV) blood flow kinetic energy (KE) using four-dimensional (4D) flow cardiovascular magnetic resonance imaging (CMR) in patients with myocardial infarction (MI) with/without LV thrombus (LVT).
Methods and results
This is a prospective cohort study of 108 subjects [controls = 40, MI patients without LVT (LVT− = 36), and MI patients with LVT (LVT+ = 32)]. All underwent CMR including whole-heart 4D flow. LV blood flow KE wall calculated using the formula: KE=12 ρblood . Vvoxel . v2, where ρ = density, V = volume, v = velocity, and was indexed to LV end-diastolic volume. Patient with MI had significantly lower LV KE components than controls (P < 0.05). LVT+ and LVT− patients had comparable infarct size and apical regional wall motion score (P > 0.05). The relative drop in A-wave KE from mid-ventricle to apex and the proportion of in-plane KE were higher in patients with LVT+ compared with LVT− (87 ± 9% vs. 78 ± 14%, P = 0.02; 40 ± 5% vs. 36 ± 7%, P = 0.04, respectively). The time difference of peak E-wave KE demonstrated a significant rise between the two groups (LVT−: 38 ± 38 ms vs. LVT+: 62 ± 56 ms, P = 0.04). In logistic-regression, the relative drop in A-wave KE (beta = 11.5, P = 0.002) demonstrated the strongest association with LVT.
Conclusion
Patients with MI have reduced global LV flow KE. Additionally, MI patients with LVT have significantly reduced and delayed wash-in of the LV. The relative drop of distal intra-ventricular A-wave KE, which represents the distal late-diastolic wash-in of the LV, is most strongly associated with the presence of LVT.
U2 - 10.1093/ehjci/jey121
DO - 10.1093/ehjci/jey121
M3 - Article
VL - 20
SP - 108
EP - 117
JO - European Heart Journal-Cardiovascular Imaging
JF - European Heart Journal-Cardiovascular Imaging
SN - 2047-2404
IS - 1
ER -