After acute myocardial infarction (AMI), left ventricular thrombosis is not reduced, and may even be increased, by mitral regurgitation occurring within 48 hours of the infarct. Left ventricular thrombus formation is also significantly related to the extent of wall motion abnormality.
These are the main findings of a GISSI-3 substudy in which 757 patients with a first AMI underwent echocardiography within 48 hours after symptom onset and again at discharge, 6 weeks and 6 months. “Few data from prospective studies are available on the effect of mitral regurgitation on left ventricular thrombus formation in patients with acute MI,” Dr. Luigi Ascione of Naples, Italy and the GISSI-3 investigators note in the August issue of the journal Heart.
They detected left ventricular thrombosis on one or more occasions in 64 of the 757 patients (8%). Compared with the 693 patients without evidence of left ventricular thrombosis, those with this finding were older and had larger infarcts, greater depression of left ventricular ejection fraction at first echo study, and greater left ventricular volumes early after MI.
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