Association between Mitral Regurgitation and Left Ventricular Mural Thrombi following Anterior ST Segment Elevation Myocardial Infarction | ||
| Zagazig University Medical Journal | ||
| Article 4, Volume 30, Issue 8.1, November 2024, Pages 3784-3794 PDF (469.56 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2024.269236.3170 | ||
| Authors | ||
| Mohamed Abdelwahed Abdelhamid Ibrahim* 1; Nader Talat Kandil2; Ahmed El Zayat1; Mohamed Saad El-Shetry3 | ||
| 1Cardiology Department, Faculty of Medicine, Zagazig University, Egypt | ||
| 2cardiovascular department ,faculty of medicine,zagazig university | ||
| 3Cardiology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt | ||
| Abstract | ||
| Background: Acute myocardial infarction patients may be protected against left ventricular thrombus development by mitral regurgitation (MR). This study aimed to assess incidence of left ventricular thrombosis in patients suffering from acute anterior myocardial infarction and determine if mitral regurgitation prevents development of left ventricular mural thrombus. Methods: Seventy patients with anterior STEMI were enrolled in this prospective cohort study, they were divided into a non-LV thrombus group (n=55) and LV thrombus group (n=15), 2-dimensional and color Doppler echocardiography were done to all cases. Results: LV thrombus formation was significantly higher among patients presented with passed time anterior STEMI than those presented within 48 hours of chest pain onset (P value < 0.001). LV EDV and LV ESV were significantly higher among LV thrombus group than non-LV thrombus group (P value =0.032). severity of MR was significantly lower in LV thrombus group compared to non-LV thrombus group (P value =0.039). Pain to door time was able to significantly predict LV apical thrombus formation (P <0.001 AUC = 0.875) at cut-off >32 hours with 80% sensitivity, 80% specificity, 52.2% PPV 93.6% NPV. In Multivariate regression, pain to door, and severity of MR were independent predictors of LV thrombus formation (P value < 0.05). Conclusion: Pain to door, and severity of MR were independent predictors of development of LV thrombus while ECG, passed time PCI and Conservative, LV EDV and LV ESV were not. associated mitral regurgitation could have a protective role against development of left ventricular mural thrombus following anterior STEMI | ||
| Keywords | ||
| Mitral Regurgitation; Left Ventricular Mural Thrombi; Anterior ST Segment Elevation Myocardial Infarction | ||
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