Objective: To analyze the characteristics of trans esophageal echocardiography(TEE) in patients with left ventricular thrombus, and to analyze the correlation between indexes detected by TEE and left ventricular thrombus formation, and to explore the feasibility of TEE to predict the risk of left ventricular thrombus formation.Methods:87 cases of left ventricular enlargement diagnosed by transthoracic echocardiographic guidance were included. TEE was taken as the gold standard for diagnosis of left ventricular thrombus formation, according to the diagnosis, 16 cases with left ventricular thrombus were included into the observation group, while the other 71 cases were included into the control group. left ventricular posterior wall(LVPM), interventricular septal thickness(IVS), left ventricular end diastolic diameter(LVIDd), left ventricular end systolic diameter(LVIDs), left ventricular ejection fraction(LVEF), peak filling velocity in early diastole(E), peak filling velocity in atrial contraction(A), max volume of left atrial appendage, minimum volume of left atrial appendage, left atrial volume change rate(LAA-EF), peak emptying velocity of left atrial appendage, peak filling velocity of left atrial appendage, mitral regurgitation area(RJA), left atrial area(LAA), changes on heart cavity configuration and basic clinical data in 2 groups were compared. The correlation between indexes above and left ventricular thrombus formation was analyzed. A risk assessment model for left ventricular thrombus formation was made according to Logistic regression analysis, and the value of the model was tested by ROC curve.Results: Patients with hypertensionin the observation group were more, LVIDd was higher, LVEF was lower, A was lower, max and minimum volume of left atrial appendage were bigger, LAA-EF was lower, peak emptying and filling velocity of left atrial appendage were slower, flow of mitral regurgitation was less than in the control group. The differences above were statistically significant(P<0.05). Logistic regression analysis showed that LVEF, LAA-EF and mitral regurgitation were the independent protective factors for left ventricular thrombosis(P<0.05). The model for predicting left ventricular thrombus formation was made as follow: Risk score = 100×[0.9×LVEF+1.1×LAA-EF+0.5×(RJA/LAA)]. ROC curve showed that the model has good reliability in predicting left ventricular thrombus formation(P<0.05), when the risk score was less than 88, patients had high risk for left ventricular thrombus formation.Conclusion: TEE is clear and reliable, and can be used in the prediction of left ventricular thrombus formation in patients with left ventricular enlargement. |
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