1.Left ventricular thrombus routine screening with contrast echocardiography in patients with anterior ST‑elevation myocardial infarction:is it worth it?
Joana Laranjeira CORREIA ; Gonçalo R. M. FERREIRA ; João Gouveia FIUZA ; Mariana Duarte ALMEIDA ; Joana COELHO ; Emanuel CORREIA ; José Miguel CORREIA ; Davide MOREIRA ; Nuno CRAVEIRO ; Maria Luísa GONÇALVES ; Vanda Devesa NETO
Journal of Cardiovascular Imaging 2024;32(1):21-
Background:
Left ventricular (LV) thrombus has a higher incidence among patients with anterior ST-elevation myocardial infarction (STEMI) when compared to other types of acute myocardial infarction and is associated with worse prognosis. The management of LV thrombus diagnosis remains challenging. Contrast echocardiography (transthoracic echocardiography, TTE) has shown potential in improving the accuracy for its diagnosis, thereby influencing treatment strategies concerning antithrombotic/anticoagulation therapy. The aim of this study was to assess the effectiveness of contrast TTE as a routine screening method for detecting LV thrombus in the acute phase of anterior STEMI.
Methods:
A prospective, single center, randomized controlled trial was conducted among patients with anterior STEMI. The study group underwent contrast TTE, while the control group received a conventional approach. Demographical, clinical, and diagnostic data were collected. Thrombus detection rates were compared between groups.
Results:
A total of 68 patients were included (32 in the study group and 36 in the control group). No substantial baseline differences were observed between groups. Thrombus detection rate was 25.0% in the study group and 13.9% in the control group, however these results did not reach statistical significance (P = 0.24). The prevalence of anterior/ apical aneurysm was higher in the study group (46.9% vs. 22.2%, P = 0.03).
Conclusions
Conventional TTE may be adequate for diagnosing LV thrombus in the acute phase of anterior STEMI; however, further larger-scale and multicenter studies are necessary to obtain more robust and conclusive results. Ultrasound contrast may play a significant role in the detection of anterior/apical aneurysms, which are known risk factors for the subsequent development of thrombus.
2.Left ventricular thrombus routine screening with contrast echocardiography in patients with anterior ST‑elevation myocardial infarction:is it worth it?
Joana Laranjeira CORREIA ; Gonçalo R. M. FERREIRA ; João Gouveia FIUZA ; Mariana Duarte ALMEIDA ; Joana COELHO ; Emanuel CORREIA ; José Miguel CORREIA ; Davide MOREIRA ; Nuno CRAVEIRO ; Maria Luísa GONÇALVES ; Vanda Devesa NETO
Journal of Cardiovascular Imaging 2024;32(1):21-
Background:
Left ventricular (LV) thrombus has a higher incidence among patients with anterior ST-elevation myocardial infarction (STEMI) when compared to other types of acute myocardial infarction and is associated with worse prognosis. The management of LV thrombus diagnosis remains challenging. Contrast echocardiography (transthoracic echocardiography, TTE) has shown potential in improving the accuracy for its diagnosis, thereby influencing treatment strategies concerning antithrombotic/anticoagulation therapy. The aim of this study was to assess the effectiveness of contrast TTE as a routine screening method for detecting LV thrombus in the acute phase of anterior STEMI.
Methods:
A prospective, single center, randomized controlled trial was conducted among patients with anterior STEMI. The study group underwent contrast TTE, while the control group received a conventional approach. Demographical, clinical, and diagnostic data were collected. Thrombus detection rates were compared between groups.
Results:
A total of 68 patients were included (32 in the study group and 36 in the control group). No substantial baseline differences were observed between groups. Thrombus detection rate was 25.0% in the study group and 13.9% in the control group, however these results did not reach statistical significance (P = 0.24). The prevalence of anterior/ apical aneurysm was higher in the study group (46.9% vs. 22.2%, P = 0.03).
Conclusions
Conventional TTE may be adequate for diagnosing LV thrombus in the acute phase of anterior STEMI; however, further larger-scale and multicenter studies are necessary to obtain more robust and conclusive results. Ultrasound contrast may play a significant role in the detection of anterior/apical aneurysms, which are known risk factors for the subsequent development of thrombus.
3.Left ventricular thrombus routine screening with contrast echocardiography in patients with anterior ST‑elevation myocardial infarction:is it worth it?
Joana Laranjeira CORREIA ; Gonçalo R. M. FERREIRA ; João Gouveia FIUZA ; Mariana Duarte ALMEIDA ; Joana COELHO ; Emanuel CORREIA ; José Miguel CORREIA ; Davide MOREIRA ; Nuno CRAVEIRO ; Maria Luísa GONÇALVES ; Vanda Devesa NETO
Journal of Cardiovascular Imaging 2024;32(1):21-
Background:
Left ventricular (LV) thrombus has a higher incidence among patients with anterior ST-elevation myocardial infarction (STEMI) when compared to other types of acute myocardial infarction and is associated with worse prognosis. The management of LV thrombus diagnosis remains challenging. Contrast echocardiography (transthoracic echocardiography, TTE) has shown potential in improving the accuracy for its diagnosis, thereby influencing treatment strategies concerning antithrombotic/anticoagulation therapy. The aim of this study was to assess the effectiveness of contrast TTE as a routine screening method for detecting LV thrombus in the acute phase of anterior STEMI.
Methods:
A prospective, single center, randomized controlled trial was conducted among patients with anterior STEMI. The study group underwent contrast TTE, while the control group received a conventional approach. Demographical, clinical, and diagnostic data were collected. Thrombus detection rates were compared between groups.
Results:
A total of 68 patients were included (32 in the study group and 36 in the control group). No substantial baseline differences were observed between groups. Thrombus detection rate was 25.0% in the study group and 13.9% in the control group, however these results did not reach statistical significance (P = 0.24). The prevalence of anterior/ apical aneurysm was higher in the study group (46.9% vs. 22.2%, P = 0.03).
Conclusions
Conventional TTE may be adequate for diagnosing LV thrombus in the acute phase of anterior STEMI; however, further larger-scale and multicenter studies are necessary to obtain more robust and conclusive results. Ultrasound contrast may play a significant role in the detection of anterior/apical aneurysms, which are known risk factors for the subsequent development of thrombus.
4.Left ventricular thrombus routine screening with contrast echocardiography in patients with anterior ST‑elevation myocardial infarction:is it worth it?
Joana Laranjeira CORREIA ; Gonçalo R. M. FERREIRA ; João Gouveia FIUZA ; Mariana Duarte ALMEIDA ; Joana COELHO ; Emanuel CORREIA ; José Miguel CORREIA ; Davide MOREIRA ; Nuno CRAVEIRO ; Maria Luísa GONÇALVES ; Vanda Devesa NETO
Journal of Cardiovascular Imaging 2024;32(1):21-
Background:
Left ventricular (LV) thrombus has a higher incidence among patients with anterior ST-elevation myocardial infarction (STEMI) when compared to other types of acute myocardial infarction and is associated with worse prognosis. The management of LV thrombus diagnosis remains challenging. Contrast echocardiography (transthoracic echocardiography, TTE) has shown potential in improving the accuracy for its diagnosis, thereby influencing treatment strategies concerning antithrombotic/anticoagulation therapy. The aim of this study was to assess the effectiveness of contrast TTE as a routine screening method for detecting LV thrombus in the acute phase of anterior STEMI.
Methods:
A prospective, single center, randomized controlled trial was conducted among patients with anterior STEMI. The study group underwent contrast TTE, while the control group received a conventional approach. Demographical, clinical, and diagnostic data were collected. Thrombus detection rates were compared between groups.
Results:
A total of 68 patients were included (32 in the study group and 36 in the control group). No substantial baseline differences were observed between groups. Thrombus detection rate was 25.0% in the study group and 13.9% in the control group, however these results did not reach statistical significance (P = 0.24). The prevalence of anterior/ apical aneurysm was higher in the study group (46.9% vs. 22.2%, P = 0.03).
Conclusions
Conventional TTE may be adequate for diagnosing LV thrombus in the acute phase of anterior STEMI; however, further larger-scale and multicenter studies are necessary to obtain more robust and conclusive results. Ultrasound contrast may play a significant role in the detection of anterior/apical aneurysms, which are known risk factors for the subsequent development of thrombus.
5.Reasons influencing the preferences of prospective patients and orthodontists for different orthodontic appliances
Guido Artemio MARAÑÓN-VÁSQUEZ ; Luísa Schubach da COSTA BARRETO ; Matheus Melo PITHON ; Lincoln Issamu NOJIMA ; Matilde da Cunha GONÇALVES NOJIMA ; Mônica Tirre de SOUZA ARAÚJO ; Margareth Maria GOMES DE SOUZA
The Korean Journal of Orthodontics 2021;51(2):115-125
Objective:
To evaluate the reasons influencing the preferences for a certain type of orthodontic appliance over another among prospective patients (PP) and orthodontists.
Methods:
A total of 49 PP and 51 orthodontists were asked about their preferences for the following appliances: clear aligners (CA), lingual metallic brackets (LMB), polycrystalline and monocrystalline ceramic brackets, and buccal metallic brackets (BMB). The participants rated the importance of 17 potential reasons that would explain their choices. The reasons that contributed most to these preferences were identified. Non-parametric tests (Fisher’s exact, χ2 and Mann–Whitney tests) and multivariate analyses (regression and discriminant analysis) were used to assess the data (α = 0.05).
Results:
CA and BMB were the most chosen appliances by PP and orthodontists, respectively.LMB was the most rejected option among both groups of participants (p < 0.001). Rates of the importance of pain/discomfort, smile esthetics, finishing details, and feeding/speech impairment showed the highest differences between PP and orthodontists (p < 0.0005). Discriminant analyses showed that individuals who considered treatment time and smile esthetics as more important were more likely to prefer CA, while those who prioritized finishing details and cost were more likely to choose BMB (p < 0.05).
Conclusions
Reasons related to comfort and quality of life during use were considered as more important by PP, while those related to the results and clinical performance of the appliances were considered as more relevant by orthodontists.
6.Reasons influencing the preferences of prospective patients and orthodontists for different orthodontic appliances
Guido Artemio MARAÑÓN-VÁSQUEZ ; Luísa Schubach da COSTA BARRETO ; Matheus Melo PITHON ; Lincoln Issamu NOJIMA ; Matilde da Cunha GONÇALVES NOJIMA ; Mônica Tirre de SOUZA ARAÚJO ; Margareth Maria GOMES DE SOUZA
The Korean Journal of Orthodontics 2021;51(2):115-125
Objective:
To evaluate the reasons influencing the preferences for a certain type of orthodontic appliance over another among prospective patients (PP) and orthodontists.
Methods:
A total of 49 PP and 51 orthodontists were asked about their preferences for the following appliances: clear aligners (CA), lingual metallic brackets (LMB), polycrystalline and monocrystalline ceramic brackets, and buccal metallic brackets (BMB). The participants rated the importance of 17 potential reasons that would explain their choices. The reasons that contributed most to these preferences were identified. Non-parametric tests (Fisher’s exact, χ2 and Mann–Whitney tests) and multivariate analyses (regression and discriminant analysis) were used to assess the data (α = 0.05).
Results:
CA and BMB were the most chosen appliances by PP and orthodontists, respectively.LMB was the most rejected option among both groups of participants (p < 0.001). Rates of the importance of pain/discomfort, smile esthetics, finishing details, and feeding/speech impairment showed the highest differences between PP and orthodontists (p < 0.0005). Discriminant analyses showed that individuals who considered treatment time and smile esthetics as more important were more likely to prefer CA, while those who prioritized finishing details and cost were more likely to choose BMB (p < 0.05).
Conclusions
Reasons related to comfort and quality of life during use were considered as more important by PP, while those related to the results and clinical performance of the appliances were considered as more relevant by orthodontists.