Keywords
dilated cardiomyopathy
treatment
Niamey
How to Cite
Abstract
Introduction :
Intracardiac thrombosis remains a prognostic turning point associated with a high risk of ischemic and embolic events and an increased risk of mortality, whatever the underlying heart disease or general illness. The aim of this study was to determine the diagnostic and therapeutic aspects of intracardiac thrombosis at the Hôpital National Amirou Boubacar Diallo (HNABD) in Niamey.
Patients and method :
This were a cross-sectional study with retrospective (January 1, 2016 to December 31, 2021) and prospective (January 1, 2022 to June 30, 2022) data collection, i.e. 78 months in the cardiology department of the HNABD in Niamey. Patients hospitalized with intracardiac thrombosis confirmed by imaging were included in the study.
Results :
Two hundred and fifty-two cases (252) of intracardiac thrombosis were recorded. Males accounted for 75% (n=174), i.e. a sex ratio of 2.23. The mean age of patients was 50.1± 19.8 years. The age range [55 to 64 years] was in the majority with 19.4% (n=49). Orthopnea and edema of the lower limbs were present in 81% (n=204) of cases, and cough in 72.6% (n=183). Dilated cardiomyopathy (DCM) was the underlying pathology in 53.1% of cases (n=134). The mean left ventricular systolic ejection fraction (LVEF) was 38.48± 15.13% (extremes: 15 and 77%). LV thrombi were present in 66.67% (n=54). Anti-vitamin K drugs (AVK) were prescribed for 61.9% (n=156) of our patients, and low-molecular-weight heparin (LMWH) for 33.3%. The outcome was marked by 31 deaths (12.30%), with the remainder of patients improving.
Conclusion :
Thrombotic pathologies remain frequent in Niger. The anticoagulant therapy is the mainstay of treatment. Their evolution is still marked by embolic complications, with a high mortality rate.
References
1. Société Française de Médecine Vasculaire, Collège des enseignants de médecine vasc, Collège Français de Pathologie Vasculaire. Traité de médecine vasculaire. Tome 1 : Principes de base, maladies artérielles. Elsevier, Masson ; 2012 Jan 30. ISBN : 978-2-294-70917-3
2. Lattuca B, Silvain J. Thrombus intraventriculaire : diagnostic et traitement. Réal Cardiol.2023 ;380 :28-34.
3. Lakhal Z, Zaimi A, Feliouni H, Mouine N, Asfalou I, Raissouni M, et al. Les Thrombi intra cardiaques : étude de 30 cas. Cardiologie Tunisienne. 2014 ; 10 (03) : 203-207.
4. Lattuca B, Bouziri N, Kerneis M et al. Antithrombotic therapy for patients with left ventricular mural thrombus. J Am Coll Cardiol, 2020; 75:1676-1685.
5. Mccarthy CP, Vaduganathan M, Mccarthy KJ et al. Left ventricular thrombus after acute myocardial infarction: screening, prevention, and treatment. JAMA Cardiol, 2018 ; 3:642.
6. Tagueniti J, .Samih A, .Raissouni M, Benyass A. Thrombus cardiaques : Diagnostic positif et étiologique Centre de cardiologie, Hôpital militaire d’instruction Mohammed V, Rabat. Maroc Journal de Radiologie diagnostique et interventionnelle. Volume 93, n°7-8 p611-619, Juillet 2012.
7. Baldé EY, Baldem D, Beavogui M, Barry I S, Kimso O, Touré S et al. Thrombus intracavitaire : aspects épidémiologique, clinique, échographique et évolutif au service de cardiologie de l’Hôpital National Ignace Deen de Conakry. Cardiol. Trop. N° 140, JanFév–Mar 2014.
8. Ralamboson SA, Miandrisoa R.M, Riel A., Ravaoavy H, Rakotomanga D, Rajomarison M et al. Aspects épidémio-cliniques et échographiques des thrombi intracavitaires cardiaques vus au Centre Hospitalier de Soavianandriana Rev Médicale Madag. 2011 ; 1(3) :58–62.
9. Zongo RWA. Les maladies thrombo-emboliques veineuses et les thromboses intra-cardiaques : Etude des aspects épidémiologiques, cliniques, thérapeutiques et évolutifs : A propos de 46 cas au service de Cardiologie du Centre Hospitalier National Yalgado Ouédraogo (CHN-YO). Thèse Méd. UFR/SDSOuagadougou- Burkina Faso, 2001, n˚40 du 20/12/2001, 161p.
10. Kane A, Mbaye M, Ndiaye M. Evolution et complications thromboemboliques de la myocardiopathie idiopathique du péripartum au CHU de Dakar : étude prospective à propos de 33 cas. J Gynécologie Obstétrique Biol Reprod. 2010; 39:484–9.
11. Sharma N, McCullough P. Left Ventricular Thrombus and Subsequent Thromboembolism in Patients with Severe Systolic Dysfunction. 2000 Feb; 117(2):314-20.
12. Govindan SC, Kamra A, Vellani H. Incidence, predictors and course of left ventricular thrombus in indian patients surviving to discharge after anterior wall myocardial infarction. JEBMH. 15 avr 2019 ; 6(15) : 1213 7.
13. Gellen B, Biere L, Logeart D et al. Timing of cardiac magnetic resonance imaging impacts on the detection rate of left ventricular thrombus after myocardial infarction. JACC Cardiovasc Imaging, 2017 ; 10 :1404-1405.
14. Meurin P, Brandao Carreira V, Dumaine R et al. Incidence, diagnostic methods, and evolution of left ventricular thrombus in patients with anterior myocardial infarction and low left ventricular ejection fraction: a prospective multicenter study. Am Heart J, 2015; 170:256-262.
15. Robinson AA, Jain A, Gentry M et al. Left ventricular thrombi after STEMI in the primary PCI era: a systematic review and meta-analysis. Int J Cardiol, 2016; 221:554-559.
16. Mao TF, Bajwa A, MUSKULA P et al. Incidence of left ventricular thrombus in patients with acute st-segment elevation myocardial infarction treated with percutaneous coronary intervention. Am J Cardiol, 2018; 121:27-31.
17. Maniwa N, Fujino M, Nakai M et al. Anticoagulation combined with antiplatelet therapy in patients with left ventricular thrombus after first acute myocardial infarction. Eur Heart J, 2018; 39:201-208.
18. Vikhe V, Gupta A, Shende P. A case of chronic left ventricular thrombus with ischemic cardiomyopathy. Med J DY Patil Univ. 2013; 6(4): 459-461.
19. Jiang YX, Jing LD, Jia YH. Clinical characteristics and risk factors of left ventricular thrombus after acute myocardial infarction: a matched case-control study. Chin Med J (Engl) 2015 ; 128 :2415–2419.
20. Nishi I, Ishimutsu T, Ishizu T, Ueno Y, Suzuki A, Seo Y, et al. Peripartum cardiomyopathy and biventricular thrombi. Circ J. 2002; 66(9): 863-5.
21. Abdelnabi M, Saleh Y, Fareed A et al. Comparative study of oral anticoagulation in left ventricular thrombi (No-LVT Trial). J Am Coll Cardiol, 2021 ; 77 :1590-2159.
Metrics
Downloads
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2026 B Dodo, H Saley, A Bonkano, A Maliki, I Garba, H Idrissa, K Souley, M Mossi, H Harouna, R Arab, S Brah, I Toure