Long-term Embolic Outcomes after Detection of Left Ventricular Thrombus by Late Gadolinium Enhancement Cardiovascular Magnetic Resonance Imaging: A Matched Cohort Study

Abstract

Late gadolinium enhancement cardiovascular magnetic resonance imaging (LGE CMR) is more sensitive than echocardiography for the detection of intracardiac thrombus. The long-term prognostic significance of left ventricular (LV) thrombus detected by LGE CMR is unknown. We performed a large matched cohort study of consecutive adult patients with LV thrombus detected by LGE CMR. First, we investigated the long-term incidence of a composite of embolic events. We found that patients with LV thrombus detected by LGE CMR have a significantly higher long-term incidence of embolism compared with matched non-LV thrombus patients. Next, we compared outcomes among patients with LV thrombus detected by LGE CMR stratified by whether the LV thrombus was also detected by echocardiography or not. We also found that patients with LV thrombus detected by LGE CMR but not by echocardiography have a similar rate of embolism as those with LV thrombus detected by both LGE CMR and echocardiography.