Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Association between the E-wave propagation index and left ventricular thrombus formation after ST-elevation myocardial infarction

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Clopidogrel, prasugrel, and ticagrelor for all-comers with ST-segment elevation myocardial infarction

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Prolonged QT-interval in cirrhosis: is it reversible?

    Research output: Contribution to journalEditorialResearchpeer-review

  3. Electrocardiographic T-wave morphology and risk of mortality

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Right atrial strain: Tapping into a new reservoir of hemodynamic information

    Research output: Contribution to journalEditorialResearchpeer-review

View graph of relations

OBJECTIVE: To explore the association between E-wave propagation index (EPI) as a marker of apical washout and the risk of left ventricular thrombus (LVT) formation in patients with ST-elevation myocardial infarction (STEMI).

METHODS: We performed a post-hoc analysis on 364 prospectively enrolled STEMI patients from a single-center. Non-contrast transthoracic echocardiographic examinations were performed a median of 2 days (IQR:1-3 days) after PCI. The endpoint was LVT formation, identified retrospectively. Univariable and multivariable logistic regression was applied to assess the association between EPI and LVT formation. Multivariable adjustments included LVEF, LAD culprit, prior myocardial infarction, heart rate, and early myocardial relaxation velocity. Area under receiver operating characteristic curves (AUC) was used to assess the diagnostic ability.

RESULTS AND CONCLUSIONS: Among 364 patients, 31 (8.5%) developed LVT. The mean age was 62 years, 75% were men, and mean LVEF was 46%. Patients developing LVT had increased heart rate, lower LVEF, impaired GLS, and more frequently had prior myocardial infarction. Variables associated with low values of EPI included, among others, LVEF, LV aneurysm, and GLS. EPI and LVT formation were significantly associated in the univariable model (OR = 1.87 (1.53-2.28), p < 0.001), and EPI showed an AUC of 0.90. After multivariable adjustments, EPI and LVT formation remained significantly associated (OR = 1.79 (1.42-2.27), p < 0.001). Patients with an EPI < 1.0 had a 23 times higher likelihood of LVT formation (OR = 23.41 (10.06-54.49), p < 0.001). EPI and LVT formation are strongly associated in patients with STEMI, with low values of EPI indicating a markedly increased probability of LVT formation.

Original languageEnglish
JournalInternational Journal of Cardiology
Volume326
Pages (from-to)213-219
Number of pages7
ISSN0167-5273
DOIs
Publication statusPublished - 1 Mar 2021

Bibliographical note

Publisher Copyright:
© 2020 Elsevier B.V.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

    Research areas

  • E-wave propagation index, Echocardiography, Left ventricular thrombus, ST-elevation myocardial infarction

ID: 61894406