Peak apical rotation independently predicts left ventricular thrombus following anterior myocardial infarction
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 MI, peak apical rotation quantified by speckle tracking echocardiographypatients presenting with anterior MI
- Participants
- 270 patients
- Exposure
- Peak apical rotation in relation to LV thrombus (identified by echocardiography or CMR during index admission or follow-up); discrimination compared with LVEF
- Outcome
- LV thrombus
- Follow-up
- During index admission or
Methodological detailspeak apical rotation quantified post-hoc, multivariable regression models, receiver-operating characteristic analysis
- Peak apical rotation quantified post-hoc
- Multivariable regression models
- Receiver-operating characteristic analysis
Main finding
As reported in the abstract
LV thrombus identified in eligible patients
33%
Observational data: associations, not effects.
Further findings
| Outcome | Values | Estimate | P value |
|---|---|---|---|
| Peak apical rotation | patients with thrombus 5.0° · patients without thrombus 9.8° | ||
| LV thrombusAfter multivariate adjustment | OR 0.45 | P < 0.001 | |
| Delayed thrombus developmentIndependently predicted | measure not stated 0.46 | P < 0.001 | |
| Discrimination for thrombus (AUC) | Apical rotation AUC 0.91 · AUC, LVEF ≤40% subgroup 0.89 · LVEF AUC 0.62 · AUC, LVEF ≤40% subgroup 0.48 |
- Peak apical rotation: p < 0.001
- Discrimination for thrombus (AUC): overall p < 0.001
- Discrimination for thrombus (AUC): LVEF ≤40% subgroup p < 0.001
LV thrombus
- ≈2-fold increase in thrombus odds for every 1° reduction in rotation
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.
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