Heart failure & cardiomyopathies
Resolution of left ventricular thrombus assessed by echocardiography: insights from a contemporary multicentre prospective registry
Authors' conclusion
The present longitudinal multicentre registry reveals that LVT persists in nearly one-third of patients after initial detection, even with anti-coagulation therapy, and is associated with a poorer prognosis. Additionally, it offers valuable insights into echocardiographic predictors of LVT persistence, which could inform personalized follow-up strategies and treatment approaches.
Study context
- Population
- Consecutive patients with left ventricular thrombus (LVT) detected and followed by echocardiographyconsecutive patients with LVT enrolled October 2020 to September 2022 (mean age 67 ± 11 years, 79% men)
- Participants
- 154 patients
- Exposure
- Patients with LVT resolution compared with those without resolution
- Outcome
- LVT resolution
- Follow-up
- Median 36 (IQR 15-74) days
Methodological detailsTen centres, consecutive patients
- Ten centres
- Consecutive patients
Main finding
As reported in the abstract
LVT resolution achieved
68%
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| Follow-up echocardiographic associates of LVT resolution · follow-up echocardiogramLVEF · per-unit association with LVT resolution · independently associated | OR 1.04 (95% CI 1.01–1.07) | P = 0.026 | |
| Follow-up echocardiographic associates of LVT resolution · follow-up echocardiogramApical wall motion score index · per-unit association with LVT resolution · independently associated | OR 0.94 (95% CI 0.89–0.99) | P = 0.025 | |
| Embolic events · median follow-up of 1.91 (IQR, 1.32-2.83) yearsLower risk with LVT resolution | adjusted HR 0.36 (95% CI 0.13–0.99) | P = 0.04 | |
| Death · median follow-up of 1.91 (IQR, 1.32-2.83) yearsLower risk with LVT resolution | adjusted HR 0.36 (95% CI 0.14–0.95) | P = 0.03 | |
| 0.10.31310Ratio (log scale) |
Baseline predictors of LVT resolution · baseline assessment
- Smaller LVT area and mobile LVT were independent predictors of LVT resolution
Anti-coagulation duration
- Median duration of anti-coagulation
- 6 (3-12) months
- Different anti-coagulant regimens were used
Safety
- LVT resolution was not associated with bleeding complications
Original publication
Resolution of left ventricular thrombus assessed by echocardiography: insights from a contemporary multicentre prospective registry. Eur Heart J Cardiovasc Imaging. Published 21 May 2025. doi:10.
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