{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T20:37:07Z","timestamp":1783024627739,"version":"3.54.6"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1790,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T00:00:00Z","timestamp":1611532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Medical Health Science and Technology Projects of Zhejiang Province","award":["2021RC091"],"award-info":[{"award-number":["2021RC091"]}]},{"name":"Wenzhou Science Technology Bureau Foundation","award":["Y20190616"],"award-info":[{"award-number":["Y20190616"]}]},{"DOI":"10.13039\/501100004731","name":"Natural Science Foundation of Zhejiang Province","doi-asserted-by":"publisher","award":["LQ15H020005"],"award-info":[{"award-number":["LQ15H020005"]}],"id":[{"id":"10.13039\/501100004731","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81600341"],"award-info":[{"award-number":["81600341"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017594","name":"Medical Science and Technology Project of Zhejiang Province","doi-asserted-by":"publisher","award":["2021RC091"],"award-info":[{"award-number":["2021RC091"]}],"id":[{"id":"10.13039\/501100017594","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004731","name":"Natural Science Foundation of Zhejiang Province","doi-asserted-by":"publisher","award":["LQ15H020005"],"award-info":[{"award-number":["LQ15H020005"]}],"id":[{"id":"10.13039\/501100004731","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81600341"],"award-info":[{"award-number":["81600341"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to determine prevalence, predictors, and association with ischaemic stroke risk of spontaneous echocardiographic contrast (SEC) or left ventricular thrombus (LVT) in patients with heart failure with reduced ejection fraction (HFrEF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Clinical, echocardiographic, and follow-up data from January 2009 through February 2019 were retrospectively extracted from electronic medical records of patients with heart failure with left ventricular ejection fraction &amp;lt; 40% by echocardiography on admission, with follow-up to February 2020. Of 9485 consecutive patients with HFrEF, 123 (1.3%) presented LVT and 331 (3.5%) presented SEC. Patients with vs. those without SEC\/LVT had larger left ventricular end-diastolic volume (199.5 \u00b1 77.7 vs. 165.8 \u00b1 61.3 mL, P &amp;lt; 0.001), lower left ventricular ejection fractions (29.5 \u00b1 7.0% vs. 33.7 \u00b1 5.5%, P &amp;lt; 0.001), and more often ischaemic cardiomyopathy, apical aneurysm, chronic kidney diseases, and smoking habit. In Cox regression analysis, SEC and LVT were independent predictors for ischaemic stroke occurrence [hazard ratio (HR) = 2.40, 95% confidence interval (CI): 1.74\u20133.31; HR = 4.52, 95% CI: 2.77\u20137.40, both P &amp;lt; 0.001]. In patients with those without SEC or LVT, stroke risk was higher among those not on anticoagulants (HR = 2.55, 95% CI: 1.85\u20133.53; HR = 4.71, 95% CI: 2.84\u20137.81, both P &amp;lt; 0.001), but similar among those on anticoagulants (P &amp;gt; 0.05). In patients with sinus rhythm, the associations between SEC\/LVT and ischaemic stroke persist with HRs of 2.57 (95% CI: 1.69\u20133.92) and 5.74 (95% CI: 3.38\u20139.75).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with HFrEF, SEC was not uncommon and increased risk of ischaemic stroke as well as LVT. Anticoagulants could play a role in the reduction of stroke risk, suggesting that patients with SEC\/LVT, even those in sinus rhythm, would benefit from systemic anticoagulation treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13196","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T21:46:00Z","timestamp":1611611160000},"page":"1284-1294","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["The Prevalence, Predictors, and Outcomes of Spontaneous Echocardiographic Contrast or Left Ventricular Thrombus in Patients with HFrEF"],"prefix":"10.1093","volume":"8","author":[{"given":"Xiaodong","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Nanbaixiang, Wenzhou, Zhejiang, 325000 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruiyu","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Nanbaixiang, Wenzhou, Zhejiang, 325000 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaojun","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Nanbaixiang, Wenzhou, Zhejiang, 325000 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianli","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Nanbaixiang, Wenzhou, Zhejiang, 325000 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changzuan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Nanbaixiang, Wenzhou, Zhejiang, 325000 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liangguo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Nanbaixiang, Wenzhou, Zhejiang, 325000 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenglong","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Longgang City People's Hospital , Longgang, Zhejiang ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Nanbaixiang, Wenzhou, Zhejiang, 325000 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueli","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Nanbaixiang, Wenzhou, Zhejiang, 325000 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weijian","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Nanbaixiang, Wenzhou, Zhejiang, 325000 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peiren","family":"Shan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University , Nanbaixiang, Wenzhou, Zhejiang, 325000 ,","place":["China"]},{"name":"Department of Cardiology, Longgang City People's Hospital , Longgang, Zhejiang ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,1,25]]},"reference":[{"key":"2026012115081363300_ehf213196-bib-0001","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.ahj.2005.08.021","article-title":"Clinical, imaging, and pathological characteristics of left ventricular thrombus: a comparison of contrast-enhanced magnetic resonance imaging, transthoracic echocardiography, and transesophageal echocardiography with 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