Doppler-derived mitral deceleration time as an early predictor of left ventricular thrombus rafter first anterior acute myocardial infarction

Background The relation between left ventricular (LV) diastolic function an d IV thrombus has not yet been fully investigated. The aim of this study wa s to determine whether early assessment of Doppler-derived mitral decelerat ion time (DT), a measure of IV compliance and filling, may predict LV throm bus formation after acute myocardial infarction. Methods and Results Two-dimensional and Doppler echocardiographic examinati ons were performed in 98 consecutive patients (aged 57 +/- 12 years; 8 wome n) with first acute myocardial infarction. The patients were studied within 24 hours and at days 3, 7 15, and 30 after arrival to the coronary care un it. Mitral flow velocities were obtained from the apical 4-chamber view wit h pulsed Doppler. IV thrombus was detected in 20 of 98. patients. Patients were divided into 2 groups according to LV thrombus formation: group 1 (n = 20) with thrombus and group 2 (n = 78) without thrombus. Mitral E-wave DT was significantly shorter in group 1 than group 2 (134 ms vs 175 ms; P < .0 01). Patients in group 1 had significantly larger LV end-diastolic and end- systolic volumes and a higher wall motion score index than patients in grou p 2 (133 +/- 39 mL vs 112 +/- 41 mL, P = .03; 83 +/- 34 mL vs 59 +/- 30 mL, P = .003; and 1.8 +/- 0.3 mL vs 1.5 +/- 0.3 mL, P = .007, respectively). T he LV election fraction was significantly lower in group 1 than in group 2 (39% +/- 13% vs 48% +/- 12%, P = .004). In a multivariate regression analys is, mitral E-wave DT was identified as an independent variable related to d evelopment of LV thrombus (P = .04). Conclusions Doppler-derived mitral DT is superior to conventional clinical and 2-dimensional echocardiographic assessment in estimating the risk of le ft ventricular thrombosis after myocardial infarction.