The E-wave propagation index (EPI): A novel echocardiographic parameter for prediction of left ventricular thrombus. Derivation from computational fluid dynamic modeling and validation on human subjects.
Int J Cardiol
; 227: 662-667, 2017 Jan 15.
Article
em En
| MEDLINE
| ID: mdl-27838120
ABSTRACT
BACKGROUND:
To describe the derivation and validation of a novel echocardiographic metric for prediction of left ventricle thrombus (LVT).METHODS:
Computational fluid dynamic modeling using cardiac CT images was used to derive a novel echocardiography-based metric to predict the presence of LVT. We retrospectively reviewed 25 transthoracic echocardiograms showing definite LVT (LVT group). We then randomly selected 25 patients with LVEF ≥55% (Normal EF group) and 25 patients with severe cardiomyopathy (CMP) with LVEF ≤40% without evidence of LVT (CMP group). The E-wave Propagation Index (EPI) was measured as the E-wave velocity time-integral divided by the LV length. An EPI>1 indicates penetration of the mitral jet into the apex whereas an EPI<1 is indicative of incomplete apical washout. The mean EPI was compared between the three groups. Crude and adjusted odd ratios of EPI and LVT association were also measured.RESULTS:
Mean EPI was highest for the normal EF group and lowest in the LVT group (1.7 vs. 0.8; p<0.0001). Mean EPI also differed significantly between LVT and CMP groups (0.8 vs. 1.2; p<0.0001). 88% of the LVT group had EPI <1.0 compared to only 20% of the CMP group (p<0.0001). Among the LVT and CMP groups, an EPI <1 increased the odd ratio of LVT by 53.7 times (95% CI 6.9-416) controlling for LVEF and LV volume.CONCLUSIONS:
The E-wave propagation index is a novel, easily-obtainable, echocardiographic metric to evaluate apical LV flow. An EPI of less than 1 is an independent predictor of LVT formation.Palavras-chave
Texto completo:
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Trombose
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Ecocardiografia
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Biologia Computacional
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Hidrodinâmica
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Cardiopatias
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Ventrículos do Coração
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Int J Cardiol
Ano de publicação:
2017
Tipo de documento:
Article