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The value of non-contrast harmonic transthoracic echocardiography for the detection of left ventricular thrombi in patients with cardiomyopathy: comparison with contrast-enhanced magnetic resonance imaging

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Abstract

We sought to assess the value of non-contrast enhanced transthoracic harmonic echocardiography (TEE) for the visualization of left ventricular thrombi in 34 patients with cardiomyopathy. Results were compared to contrast-enhanced magnetic resonance imaging as reference standard. Maximal thrombus size was quantified with both modalities. Magnetic resonance imaging demonstrated thrombi in 15 patients. In these subjects echocardiography was negative in seven patients. Thrombi were excluded in 19 patients with magnetic resonance while echocardiography was deemed positive in 5 subjects. Thrombus size by ce-CMR was not different for clots visualized or not visualized by echocardiography (P = 0.71). Moreover, observer agreement was superior for ce-CMR (κ = 0.94) as compared to TTE (κ= 0.71). Non-contrast-enhanced harmonic TTE has limited value for the visualization of thrombi in patients with cardiomyopathy.

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Abbreviations

TTE:

transthoracic echocardiography

ce-CMR:

contrast-enhanced cardiovascular magnetic resonvance

LV:

left ventricular/left ventricle

References

  1. Chiarella F, Santoro E, Domenicucci S et al (1998) Predischarge two-dimensional echocardiographic evaluation of left ventricular thrombosis after acute myocardial infarction in the GISSI-3 study. Am J Cardiol 81:822–827

    Article  PubMed  CAS  Google Scholar 

  2. Vecchio C, Chiarella F, Lupi G et al (1991) Left ventricular thrombus in anterior acute myocardial infarction after thrombolysis. A GISSI-2 connected study. Circulation 84:512–519

    PubMed  CAS  Google Scholar 

  3. Dunkman WB, Johnson GR, Carson PE et al (1993) Incidence of thromboembolic events in congestive heart failure. The V-HeFT VA Cooperative Studies Group. Circulation 87(6 Suppl):VI94–V101

    Google Scholar 

  4. Vaitkus PT, Barnathan ES (1993) Embolic potential, prevention and management of mural thrombus complicating anterior myocardial infarction: a meta-analysis. J Am Coll Cardiol 22:1004–1009

    Article  PubMed  CAS  Google Scholar 

  5. Van de WF, Ardissino D, Betriu A et al (2003) Management of acute myocardial infarction in patients presenting with ST-segment elevation. The Task Force on the Management of Acute Myocardial Infarction of the European Society of Cardiology. Eur Heart J 24:28–66

    Google Scholar 

  6. Sandercock P, Mielke O, Liu M et al (2003) Anticoagulants for preventing recurrence following presumed non-cardioembolic ischaemic stroke or transient ischaemic attack. Cochrane Database Syst Rev :CD000248

  7. Stratton JR, Lighty GW Jr, Pearlman AS et al (1982) Detection of left ventricular thrombus by two-dimensional echocardiography: sensitivity, specificity, and causes of uncertainty. Circulation 66:156–166

    PubMed  CAS  Google Scholar 

  8. Visser CA, Kan G, David GK et al (1983) Two dimensional echocardiography in the diagnosis of left ventricular thrombus. A prospective study of 67 patients with anatomic validation. Chest 83:228–232

    PubMed  CAS  Google Scholar 

  9. Erbel R, Schweizer P, Lambertz H et al (1983) Echoventriculography – a simultaneous analysis of two-dimensional echocardiography and cineventriculography. Circulation 67:205–215

    PubMed  CAS  Google Scholar 

  10. Bruder O, Waltering KU, Hunold P et al (2005) Detection and characterization of left ventricular thrombi by MRI compared to transthoracic echocardiography. Rofo 177:344–349

    PubMed  CAS  Google Scholar 

  11. Mollet NR, Dymarkowski S, Volders W et al (2002) Visualization of ventricular thrombi with contrast-enhanced magnetic resonance imaging in patients with ischemic heart disease. Circulation 106:2873–2876

    Article  PubMed  Google Scholar 

  12. Barkhausen J, Hunold P, Eggebrecht H et al (2002) Detection and characterization of intracardiac thrombi on MR imaging. AJR Am J Roentgenol 179:1539–1544

    PubMed  Google Scholar 

  13. Korcyk D, Edwards CC, Armstrong G et al (2004) Contrast-enhanced cardiac magnetic resonance in a patient with familial isolated ventricular non-compaction. J Cardiovasc Magn Reson 6:569–576

    Article  PubMed  CAS  Google Scholar 

  14. Asinger RW, Mikell FL, Sharma B et al (1981) Observations on detecting left ventricular thrombus with two dimensional echocardiography: emphasis on avoidance of false positive diagnoses. Am J Cardiol 47:145–156

    Article  PubMed  CAS  Google Scholar 

  15. Franke A, Hoffmann R, Kuhl HP et al (2000) Non-contrast second harmonic imaging improves interobserver agreement and accuracy of dobutamine stress echocardiography in patients with impaired image quality. Heart 83:133–140

    Article  PubMed  CAS  Google Scholar 

  16. Ezekowitz MD, Wilson DA, Smith EO et al (1982) Comparison of Indium-111 platelet scintigraphy and two-dimensional echocardiography in the diagnosis of left ventricular thrombi. N Engl J Med 306:1509–1513

    Article  PubMed  CAS  Google Scholar 

  17. Senior R (2002) Left ventricular contrast echocardiography: role for evaluation of function and structure. Echocardiography 19:615–620

    PubMed  Google Scholar 

  18. Bednarz JE, Spencer KT, Weinert L et al (1999) Identification of cardiac masses and abnormal blood flow patterns with harmonic power Doppler contrast echocardiography. J Am Soc Echocardiogr 12:871–875

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Medical Clinic I, University Hospital of the RWTH Aachen, Pauwelsstrasse 30, 52057, Aachen, Germany

    Claudia Lipke, Andreas Franke & Harald P. Kühl

  2. Department of Radiology, University Hospital of the RWTH, Aachen, Germany

    Marcus Katoh, Gabriele Krombach & Arno Buecker

Authors
  1. Claudia Lipke
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  2. Marcus Katoh
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  3. Andreas Franke
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  4. Gabriele Krombach
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  5. Arno Buecker
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  6. Harald P. Kühl
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Correspondence to Harald P. Kühl.

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Lipke, C., Katoh, M., Franke, A. et al. The value of non-contrast harmonic transthoracic echocardiography for the detection of left ventricular thrombi in patients with cardiomyopathy: comparison with contrast-enhanced magnetic resonance imaging. Int J Cardiovasc Imaging 23, 479–487 (2007). https://doi.org/10.1007/s10554-006-9190-8

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  • DOI: https://doi.org/10.1007/s10554-006-9190-8

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