{"id":"9ab832c60eaf","type":"article","url":"https://hartvaat.nl/2026/05/26/recidief-linkerventrikel-trombus-12-recidief-actieve-eerdere-maligniteit-verzesv/","title":"Recidief linkerventrikel-trombus: 12% recidief — actieve/eerdere maligniteit verzesvoudigt het risico","title_en":"","category":"algemeen","category_label":"Algemeen","professions":["cardioloog","internist"],"tags":[],"journal":"Heart","doi":"http://heart.bmj.com/cgi/content/short/112/12/684?rss=1","source_url":"https://doi.org/http://heart.bmj.com/cgi/content/short/112/12/684?rss=1","authors":["Leow","A. S.-T.","Low","C. J.","Goh","F.-Q.","Seah","A. W.-J.","Tan","B. Y.-Q.","Kong","W. K. F.","Poh","K.-K.","Chan","M. Y.","Yeo","L. L. L.","Chai","P.","Yeo","T.-C.","Zhou","X.","Lip","G. Y. H.","Sia","C.-H."],"significance":6,"published":"2026-07-03","source_date":"2026-05-26","image":"https://hartvaat.nl/global/img/737cbe5a1f5d.webp","kennis":["https://hartvaat.nl/kennis/farmacologie/betablokkers-cardiale-indicaties/","https://hartvaat.nl/kennis/cardiometabool/bloedsuikerdoelen-cardiovasculair/"],"congress":"","summary_en":"Retrospective cohort of 346 patients with resolved left ventricular thrombus (LVT) at a tertiary centre (2011-2021; mean age 59.9 years, 86.4% male, median follow-up 4.4 years). LVT recurrence occurred in 11.8% (41/346) of all cases and 12.0% (23/192) after post-AMI LVT. In multivariable analysis with competing risks, active or previous malignancy was a strong predictor of recurrence — both overall (aSHR 5.59; 95% CI 2.02-15.5) and in post-AMI LVT (aSHR 13.9; 95% CI 4.05-47.7). Initial LVT characteristics also predicted recurrence: thrombus size (per cm; aSHR 1.42) and protrusion into the LV lumen (aSHR 5.46). LVT recurrence was associated with more composite outcomes (MI, ischaemic stroke, acute HF, mortality; aHR 3.04 overall; aHR 2.77 post-AMI). Active malignancy warrants extra screening and prevention strategy in patients with prior LVT.","created":"2026-07-03T10:33:09Z","updated":"2026-07-03T13:32:04Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Retrospectieve cohortstudie van 346 patiënten met opgeloste linkerventrikel-trombus (LVT) in een tertiair centrum (2011-2021; gemiddelde leeftijd 59,9 jaar, 86,4% man, mediane follow-up 4,4 jaar). LVT-recidief trad op bij 11,8% (41/346) van alle gevallen en 12,0% (23/192) na post-AMI-LVT. In multivariate analyse met concurrente risico's was actieve of voorgaande maligniteit een sterke voorspeller van recidief — zowel overall (aSHR 5,59; 95%-BI 2,02-15,5) als bij post-AMI-LVT (aSHR 13,9; 95%-BI 4,05-47,7). Initiële LVT-kenmerken voorspelden ook recidief: trombusgrootte (per cm; aSHR 1,42) en uitsteken in het LV-lumen (aSHR 5,46). LVT-recidief was geassocieerd met meer samengestelde uitkomsten (infarct, ischemisch CVA, acuut HF, sterfte; aHR 3,04 algemeen; aHR 2,77 post-AMI). Actieve maligniteit verdient extra screening en preventiestrategie bij patiënten met eerdere LVT.","abstract_original":"<sec><st>Background</st>\n<p>There is limited contemporary data available on the subject of left ventricular thrombus (LVT) recurrence. This study aimed to evaluate the incidence, outcomes and predictors of patients with LVT recurrence after resolution.</p>\n</sec>\n<sec><st>Methods</st>\n<p>This was a retrospective cohort study involving 346 patients with resolved LVT at baseline, derived from an echocardiography database at a tertiary medical centre, from March 2011 to January 2021. Patients were stratified based on the presence of LVT recurrence during follow-up, with subgroup analysis performed for patients who developed LVT post-acute myocardial infarction (AMI) over a median follow-up duration of 4.4 years.</p>\n</sec>\n<sec><st>Results</st>\n<p>The incidence of LVT recurrence was 11.8% (n=41/346) among all resolved LVT (mean age of 59.9&plusmn;11.6 years, 86.4% male), and 12.0% (n=23/192) in patients with post-AMI resolved LVT. On multivariable regression analyses accounting for competing risks (all-cause mortality), active or previous malignancy was associated with LVT recurrence in both all (adjusted subdistribution HR (aSHR) 5.59, 95% CI 2.02 to 15.5, p&lt;0.001) and patients with post-AMI (aSHR 13.9, 95% CI 4.05 to 47.7, p&lt;0.001) resolved LVT. Initial LVT characteristics such as size (per cm) (aSHR 1.42, 95% CI 1.02 to 1.96, p=0.036) and protrusion (aSHR 5.46, 95% CI 1.38 to 21.6, p=0.016) were associated with recurrence in all and patients with post-AMI, respectively. On multivariable Cox regression analyses, LVT recurrence was associated with increased composite outcomes (comprising AMI, acute ischaemic stroke, acute decompensated heart failure, all-cause mortality) in all patients with resolved LVT (adjusted HR (aHR) 3.04, 95% CI 1.70 to 5.44, p&lt;0.001), and in the post-AMI subgroup (aHR 2.77, 95% CI 1.21 to 6.32, p=0.016).</p>\n</sec>\n<sec><st>Conclusions</st>\n<p>Active or previous malignancy, and initial LVT imaging characteristics were associated with recurrent LVT. LVT recurrence was a marker of poor prognosis in terms of adverse composite outcomes in patients with resolved LVT.</p>\n</sec>"}