Improved detection of echocardiographically occult left ventricular thrombi following ST-elevation myocardial infarction
Performance · TTE-occult LVTResult — go to the resultOdds ratio 1.68 95% CI 1.43–1.97Authors' conclusion
After acute STEMI, AWMS16Seg served as a simple and very robust predictor of TTE-occult LVT.
Study context
- Population
- Patients with acute STEMI undergoing TTE and cardiac magnetic resonance (CMR) 3 days after infarction
- Participants
- 870 patients
- Comparison
- TTE vs CMR for LVT detection; AWMS16Seg as predictor of TTE-occult LVT
- Outcome
- Presence of TTE-occult LVT identified by CMR
- Follow-up
- 3 days after infarction
Performance
TTE-occult LVT
Odds ratio
1.68
95% CI 1.43–1.97
P < 0.001
By group
AWMS16Seg
- AUC
- 0.91 (95% CI 0.89-0.93); P < 0.001
- Sensitivity (AWMS16Seg ≥ 8)
- 100%
- Specificity (AWMS16Seg ≥ 8)
- 77%
AWMS16Seg
AUC0.91 (95% CI 0.89-0.93); P < 0.001
Sensitivity (AWMS16Seg ≥ 8)100%
Specificity (AWMS16Seg ≥ 8)77%
AWMS16Seg
OR 1.68 (95% CI 1.43–1.97); P < 0.001
As reported in the abstract
- LVT by CMR
- 37 (4%)
- LVT not identified by TTE (TTE-occult)
- 25 (68%)
- AWMS16Seg ≥ 8
- n = 260, 30%
Further findings
Thrombus characteristics, TTE-occult vs TTE-apparent LVT
- No significant difference in volume (1.4 vs. 2.74 cm³), diameter (19.0 vs. 23.3 mm), number of fragments or shape
- all P > 0.05
Original publication
Improved detection of echocardiographically occult left ventricular thrombi following ST-elevation myocardial infarction. Eur Heart J Acute Cardiovasc Care. Published 22 June 2023. doi:10.
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