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Category: Volume 08 Issue 02 February 2020
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Title: Thrombotic Complications in Dilated Cardiomyopathy Patients-Comparative Study Using Echocardiography and Cardiac MRI

Authors: Dr Imtiyaz Ahmad Khan, Dr Manjeet Singh, Dr Rameez Mohiudin

 DOI: https://dx.doi.org/10.18535/jmscr/v8i2.46

Abstract

Objectives: Comparison between Echocardiography and Cardiac MRI in detection of intraventricular thrombi in Dilated cardiomyopathy patients.

Methods: Sixty Patients of DCM with reduced LV EF (<50%) were enrolled in this study.

All echocardiographic studies were performed on Aloka USG by an experienced cardiologist.

All Cardiac MR Studies were performed on 1.5 Tesla MRI .Obtained data was analyzed on Siemens Workstation.

Data was analyzed using Analysis of variance technique (ANOVA), Pearson’s correlational coefficient and Students t-test. A P-value of <0.05 was taken as significant. Bland-Altman method was used for comparison between EF values and ventricular volumes.

Observations: MRI showed ventricular thrombi in 9 out of 60 patients with average size of 1 to 9 cm3. Of the detected thrombi 6 were localized at ventricular apex and three were visualized at anteroseptal wall.

Trans-thoracic Echocardiography showed ventricular thrombus in 2 patients located in LV apex with average size of 4 cm3.

Taking MRI as gold standard for detection of intra-ventricular thrombi; Sensitivity of Echo For Thrombi Detection=33.4%.

Difference in EF on MRI between patients with and without ventricular thrombi was 8.96 (P=0.020).

Presence of intraventricular thrombi correlated with an increased left ventricular end diastolic volume.(P=0.010)

Conclusion

  • CARDIAC MRI is a better modality in identification of LV thrombi in DCM patients.

Presence of intra-ventricular thrombi correlates with lower EF and increased Left ventricular end diastolic volumes.

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Corresponding Author

Dr Imtiyaz Ahmad Khan

Fellow Thoracic Radiology, AIIMS