Coronary disease & ACSCohort study
Peak apical rotation independently predicts left ventricular thrombus following anterior myocardial infarction
- multicentre prospective observational study
- peak apical rotation quantified post-hoc
- speckle tracking echocardiography
Authors' conclusion
Impaired peak apical rotation independently predicts and discriminates LV thrombus following anterior MI, outperforming global systolic parameters. Prospective validation is required to establish apical rotation as a tool for risk stratification.
Study context
- Population
- Patients presenting with anterior MIpatients presenting with anterior MI
- Participants
- 270 patients
- Exposure
- Peak apical rotation vs LVEF for discrimination of LV thrombus
Main finding
As reported in the abstract
LV thrombus · index admission or follow-up
LV thrombus identified in eligible patients
33%
Observational data: associations, not effects.
Further findings
°
| Outcome | patients with thrombus | patients without thrombus | Estimate | P value |
|---|---|---|---|---|
| Peak apical rotation · significantly lower in patients with thrombus | 5.0 | 9.8 | ||
| LV thrombus, per higher apical rotation (multivariate adjusted) · After multivariate adjustment | OR 0.45 | P < 0.001 | ||
| Delayed thrombus development, by admission apical rotation · independently predicted | 0.46 | P < 0.001 |
- Peak apical rotation: p < 0.001
- LV thrombus, per higher apical rotation (multivariate adjusted): approximately 2-fold increase in thrombus odds for every 1° reduction in rotation
- Discrimination for thrombus (AUC): Apical rotation AUC 0.91 · AUC, LVEF ≤40% subgroup 0.89
- Discrimination for thrombus (AUC): LVEF AUC 0.62 · AUC, LVEF ≤40% subgroup 0.48
- Discrimination for thrombus (AUC): overall p < 0.001
- Discrimination for thrombus (AUC): LVEF ≤40% subgroup p < 0.001
Original publication
Peak apical rotation independently predicts left ventricular thrombus following anterior myocardial infarction. Eur Heart J Cardiovasc Imaging. Published 29 September 2026. doi:10.1093/ehjci/jeag272
Summarised from the published abstract; every number is checked against it