High Prevalence of Intracardiac Thrombi in Cardiac Amyloidosis

Cardiac magnetic resonance (CMR) is a sensitive noninvasive method for detecting intracardiac thrombi, offering a comparable and equally specific alternative to TEE for evaluation of thrombus in the left atrial appendage (LAA) (2). The presence of intracardiac thrombi was significantly higher in patients with more severe biventricular systolic dysfunction (stroke volume p < 0.01; ejection fraction p < 0.05; mitral annular plane systolic excursion p < 0.01; tricuspid annular plane systolic excursion p < 0.01; and global longitudinal strain p < 0.01), atrial dilatation (left atrium p < 0.05; right atrium p < 0.01), and more severe degree of amyloid infiltration (ECV p < 0.01). Intracardiac thrombi were also found in a significant number of patients in sinus rhythm, meriting further research to determine whether these patients benefit from prophylactic anticoagulation.