Diagnostic Utility of Contrast Echocardiography for Detection of LV Thrombi Post ST Elevation Myocardial Infarction
| Status: | Completed |
|---|---|
| Conditions: | Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 2/16/2018 |
| Start Date: | March 2007 |
| End Date: | January 2015 |
Diagnostic Utility of Contrast Echocardiography for Detection of Left Ventricular Thrombi Post ST Elevation Myocardial Infarction
This is a cross-sectional study of post myocardial infarction patients which is designed to
determine the prevalence of left ventricular thrombi (blood clots) using non-contrast
echocardiography and to compare this with the prevalence of left ventricular thrombi using
contrast echocardiography. Secondary aims of this study are (1) to identify clinical and
imaging correlates of left ventricular thrombi, and (2) to compare quantitative measurements
of left ventricular chamber size, function, and myocardial mass using contrast and
non-contrast echocardiography.
determine the prevalence of left ventricular thrombi (blood clots) using non-contrast
echocardiography and to compare this with the prevalence of left ventricular thrombi using
contrast echocardiography. Secondary aims of this study are (1) to identify clinical and
imaging correlates of left ventricular thrombi, and (2) to compare quantitative measurements
of left ventricular chamber size, function, and myocardial mass using contrast and
non-contrast echocardiography.
People that experience heart attacks ("myocardial infarctions") are at increased risk for
stroke, possibly due to formation of blood clots ("left ventricular thrombi"), which may
break loose from the heart and travel to other organs. While echocardiography is a test
commonly employed for thrombus detection, prior studies have yielded heterogeneous findings
regarding prevalence and predictors. Echocardiographic contrast ("perflutren lipid
microspheres") are FDA approved imaging agents that have been shown to improve thrombus
detection in selected populations. However, the decision to use contrast is often predicated
upon results of non-contrast echocardiography, a diagnostic strategy that hasn't been well
studied. This study is designed to test whether echocardiographic contrast improves thrombus
detection following myocardial infarction. Participants will undergo non-contrast and
contrast echocardiography. These will be compared for identification of thrombi and
assessment of cardiac size and function. Clinical features and results of other diagnostic
tests will also be reviewed in order to study whether these predict thrombus risk.
Participants will be contacted at regular intervals by study investigators to determine
whether thrombi identified by contrast or non-contrast echocardiography predict risk for
stroke or cardiac events. Findings from this study may improve detection of thrombi, thereby
improving treatment for patients following myocardial infarction.
stroke, possibly due to formation of blood clots ("left ventricular thrombi"), which may
break loose from the heart and travel to other organs. While echocardiography is a test
commonly employed for thrombus detection, prior studies have yielded heterogeneous findings
regarding prevalence and predictors. Echocardiographic contrast ("perflutren lipid
microspheres") are FDA approved imaging agents that have been shown to improve thrombus
detection in selected populations. However, the decision to use contrast is often predicated
upon results of non-contrast echocardiography, a diagnostic strategy that hasn't been well
studied. This study is designed to test whether echocardiographic contrast improves thrombus
detection following myocardial infarction. Participants will undergo non-contrast and
contrast echocardiography. These will be compared for identification of thrombi and
assessment of cardiac size and function. Clinical features and results of other diagnostic
tests will also be reviewed in order to study whether these predict thrombus risk.
Participants will be contacted at regular intervals by study investigators to determine
whether thrombi identified by contrast or non-contrast echocardiography predict risk for
stroke or cardiac events. Findings from this study may improve detection of thrombi, thereby
improving treatment for patients following myocardial infarction.
Inclusion Criteria:
- all patients who are admitted to The New York Presbyterian Hospital-Weill Medical
College of Cornell University (NYP-WMC) with ST elevation myocardial infarctions
Exclusion Criteria:
- contraindications to MRI at time of planned imaging (e.g. metallic contra-indication,
pacemaker, implantable cardiac defibrillator, cochlear implants, aneurysm clips
intolerance of the imaging protocol due to NYHA IV heart failure or CCS class IV
angina)
- known allergy/contra-indications to gadolinium or echo contrast agents (i.e. known
intracardiac shunt, severe reactive airway disease)
- known pregnancy
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