ReviewEuropean heart journal. Imaging methods and practice2023
A systematic review and meta-analysis of transthoracic echocardiogram vs. cardiac magnetic resonance imaging for the detection of left ventricular thrombus.
Review in European heart journal. Imaging methods and practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Cardioembolic sources and stroke prevention: a systematic review.Cardiovascular ultrasound · 2026Pooled it
- Direct oral anticoagulants or warfarin in patients with left ventricular thrombus after ST-elevation myocardial infarction: a pilot trial and a prespecified meta-analysis of randomised trials.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Pooled it
- Determinants, risk score, and prognostic implications of left ventricular thrombus in ischemic cardiomyopathy assessed by cardiac magnetic resonance: a retrospective cohort study.Annals of medicine · 2026Article
- Direct Oral Anticoagulants Versus Vitamin K Antagonists for Treatment of Left Ventricular Thrombus: A Review of Efficacy and Safety.Reviews in cardiovascular medicine · 2026Review
- Left Ventricular Thrombus in Ischemic Heart Failure: Machine-learning-based Prediction of Six-month Persistence and One-year Outcomes.Journal of cardiovascular translational research · 2026Article
- Giant Left Ventricular Intracavitary Mass: Diagnostic Challenges in Distinguishing Thrombus From Tumor.Cureus · 2026Article
- Unmasking the Apex: Multimodality Imaging for the Evaluation of Left Ventricular Apical Obliteration.Diagnostics (Basel, Switzerland) · 2026Review
- From heart to brain: a Case Report of individualized antithrombotic management for left ventricular thrombus and stroke in a young patient with acute myocardial infarction.Frontiers in pharmacology · 2026Article
- Detection of left ventricular thrombus in newly diagnosed heart failure patients: diagnostic accuracy of 2D transthoracic echocardiography compared with cardiac MRI in a Kenyan cohort.Echo research and practice · 2025Article
- Left Ventricular Thrombosis in Ischemic and Non-Ischemic Cardiomyopathies: Focus on Evidence-Based Treatment.Journal of clinical medicine · 2025Review
- Evolution of left ventricular thrombus on serial cardiovascular magnetic resonance imaging.European heart journal. Cardiovascular Imaging · 2025Article
- Postprocessing Method for Enhanced Left Ventricular Thrombus Detection in Echocardiography.Medicina (Kaunas, Lithuania) · 2024Article
- Celebrating 1 year ofEuropean heart journal. Imaging methods and practice · 2024Article
- Electrical cardioversion in patients with left ventricular thrombus: A systematic review of safety and thromboembolic risk.JRSM cardiovascular diseaseReview
- [Clinical, diagnostic and therapeutic profile of patients with left intraventricular thrombus in three high-complexity centers during the period 2000-2022].Archivos peruanos de cardiologia y cirugia cardiovascularArticle
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Transthoracic echocardiography (TTE) is the most commonly used imaging modality to diagnose left ventricular thrombus (LVT), however, cardiac magnetic resonance (CMR) remains the gold standard investigation. A comparison of the diagnostic performance between two modalities is needed to inform guidelines on a diagnostic approach towards LVT. We performed a systematic review and meta-analysis to investigate the diagnostic performance of three methods of TTE (non-contrast, contrast, and apical wall motion scoring) for the detection of LVT compared to CMR as a reference test. Studies comprising 2113 patients investigated for LVT using both TTE and CMR were included in the meta-analysis. For non-contrast TTE, pooled sensitivity and specificity were 47% [95% confidence interval (CI): 32-62%], and 98% (95% CI: 96-99%), respectively. In contrast, TTE pooled sensitivity and specificity values were 58% (95% CI: 46-69%), and 98% (95% CI: 96-99%), respectively. Apical wall motion scoring on non-contrast TTE yielded a sensitivity of 100% [95% CI: 93-100%] and a specificity of 54% (95% CI: 42-65%). The area under the curve (AUC) values from our summary receiver operating characteristic curve (SROC) for non-contrast and contrast TTE were 0.87 and 0.86 respectively, with apical wall motion studies having the highest AUC of 0.93. Despite high specificity, routine contrast and non-contrast TTE are likely to miss a significant number of LVT, making it a suboptimal screening tool. The addition of apical wall motion scoring provides a promising method to reliably identify patients requiring further investigations for LVT, whilst excluding others from unnecessary testing.
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