Echocardiographic measures associated with the presence of left ventricular thrombus in patients with chemotherapy-related cardiac dysfunction
Danai Kitkungvan MD
Division of Cardiovascular Medicine, The University of Texas Health and Science Center at Houston, Houston, TX, USA
Search for more papers by this authorSyed W. Yusuf MBBS
Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorRohit Moudgil MD, PhD
Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorNicolas Palaskas MD
Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorMichele Guindani PhD
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorSong Juhee PhD
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorSaamir Hassan MD
Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorLiza Sanchez RCS
Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorCorresponding Author
Jose Banchs MD
Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Correspondence
Jose Banchs, Echocardiography, Medicine, Department of Cardiology, University of Texas - MD Anderson Cancer Center, Houston, TX, USA.
Email: [email protected]
Search for more papers by this authorDanai Kitkungvan MD
Division of Cardiovascular Medicine, The University of Texas Health and Science Center at Houston, Houston, TX, USA
Search for more papers by this authorSyed W. Yusuf MBBS
Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorRohit Moudgil MD, PhD
Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorNicolas Palaskas MD
Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorMichele Guindani PhD
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorSong Juhee PhD
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorSaamir Hassan MD
Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorLiza Sanchez RCS
Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorCorresponding Author
Jose Banchs MD
Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Correspondence
Jose Banchs, Echocardiography, Medicine, Department of Cardiology, University of Texas - MD Anderson Cancer Center, Houston, TX, USA.
Email: [email protected]
Search for more papers by this authorAbstract
Background
Previous studies have not evaluated the prevalence and specific risk factors for the development of left ventricular (LV) thrombus in patients with severely reduced left ventricular dysfunction due to chemotherapy-related cardiomyopathy. We sought to evaluate the prevalence and potential markers of LV thrombus in this patient population.
Methods
From January 2009 to December 2013, patients with chemotherapy-related severe LV dysfunction (LV ejection fraction [LVEF] ≤ 30%) identified from MD Anderson Cancer Center database were reviewed. Patient characteristics and echocardiographic parameters were analyzed to determine potential risk factors for LV thrombus.
Results
A total of 121 patients met inclusion criteria (age 54.8 ± 15.2 years; female 63.6%; LVEF 26.3 ± 4%). LV thrombus was present in 9 patients (7.4%). Patients with LV thrombus have significantly lower LVEF compared to those without (18.7 ± 3.8% vs 26.9 ± 3.4%, P < .0001). Prevalence of LV thrombus increased as LVEF decreased and was the highest in patients with LVEF < 20%. By univariate analysis, decreased LVEF, particularly LVEF < 20% (OR 36.30, 95% CI 7.35–179.25, P < .0001) and restrictive LV filling pattern (OR 18.13, 95% CI 4.17–78.89, P = .0001) were associated with presence of LV thrombus.
Conclusion
In patients with severely reduced LV systolic function due to chemotherapy-induced cardiomyopathy, LV thrombus was found in 7.4% of subjects. Severely decreased LVEF (<20%) and restrictive LV filling pattern were associated with the presence of LV thrombus.
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