Table 1. Clinical studies in diagnosis and prevalence of LVT.
| Author, year (reference) | Type of study [number of patients] | Conclusion |
|---|---|---|
| Ezekowitz, 1982 (9) | Prospective [53] | Compared to surgical or autopsy confirmation, sensitivity of indium-111 platelet scintigraphy for LVT 71%, echocardiography 77%. Specificity of scintigraphy 100%, echocardiography 93% |
| Gottdiener, 1983 (3) | Retrospective [123] | Prevalence of LVT was 36% in nonischemic cardiomyopathy, systemic emboli in 11% |
| Bhatnagar, 1991 (8) | Prospective [88] | After STEMI, LVT incidence was 5.5% in those receiving thrombolytics and 18% in control group, likely due to better wall motion score indexes in the treatment group |
| Pizzetti, 1996 (7) | Retrospective [418] | After thrombolysis treatment, 16% prevalence of LVT, 39% in those with anterior MI |
| Thanigaraj, 1999 (10) | Retrospective [409] | Use of ECA increase diagnostic yield of LVT in 79% of patients with nondiagnostic non-contrast images |
| Gottdiener, 2003 (4) | Secondary analysis of RCT [1,343] | Prevalence of LVT was 2.1% in nonischemic cardiomyopathy treated with triple therapy |
| Srichai, 2006 (5) | Retrospective [361] | 29% prevalence of LVT. CMR showed the highest sensitivity and specificity (88% and 99%, respectively) compared with TTE (23% and 96%) and TEE (40% and 96%) for LVT detection |
| Rehan, 2006 (11) | Prospective [92] | After STEMI treated with PCI and glycoprotein IIb/IIIa inhibitors, incidence of LVT was 4.3% |
| Kurisu, 2011 (12) | Retrospective [95] | Prevalence of LVT was 5.3% in the setting of Takotsubo cardiomyopathy |
| Weinsaft, 2008 (13) | Retrospective [784] | Delayed enhancement-CMR detected thrombus in 7% and cine-CMR in 4.7% of patients with ischemic cardiomyopathy |
| Weinsaft, 2009 (14) | Retrospective [121] | Contrast echo nearly doubled sensitivity (61% vs. 33%) and yielded improved accuracy (92% vs. 82%) versus non-contrast echo. Contrast echo and cine-CMR correlated well on the diagnosis of thrombus |
| Delewi, 2012 (15) | Prospective [200] | CMR had the highest sensitivity of 88% and specificity of 99%, followed by TEE with 40% and 96% respectively, and TTE with 23% and 96%, respectively |
| Bittencourt, 2012 (16) | Retrospective [31] | In a contrast-enhanced coronary computed tomography angiography dataset, a threshold of 65 Hounsfield units provided a sensitivity and specificity of 94% and 97% for detection of LVT |
| Mir, 2014 (17) | Retrospective [85] | Prevalence of LVT of 43.1% in STEMI and 5% in NSTEMI |
| Gianstefani, 2014 (18) | Retrospective [1,059] | After STEMI treated with PCI, prevalence of LVT =4%. Apical akinesis noted in all LVT regardless of the territory infarcted. No difference in mortality in patients treated with warfarin for 3–6 months |
| Wada, 2014 (19) | Retrospective [392] | Sensitivity and specificity of non-contrast echocardiography for detection of LVT were 88% and 96%, respectively, compared with 100% each with contrast echocardiography |
| Robinson, 2016 (1) | Meta-analysis [10,076] | After STEMI treated with PCI, summary rate of LVT =2.7%, 9.1% in those with anterior MI |
| Zeng, 2016 (20) | Retrospective [24] | Iodine densities were significantly lower in the LVT than the LV cavity, whereas blood densities in the two areas did not differ significantly |
| Mao, 2018 (21) | Retrospective [1,698] | After STEMI treated with PCI, prevalence of LVT =1.6% |
| Rowin, 2017 (22) | Retrospective [1,940] | In patients with HCM, incidence of apical aneurysm of 4.8% and LVT was present in 19.3% of them, 0.9% of the entire cohort |
| Maron, 2008 (23) | Retrospective [1,299] | Among patients with HCM, incidence of apical aneurysm of 1.7% and LVT was present in 9.1% of them, 0.2% of the entire cohort |
| Kitkungvan, 2018 (24) | Retrospective [121] | Prevalence of LVT was 7.4% in patients with chemotherapy-related LV dysfunction |
| Weber, 2018 (25) | Case series [11] | In patients requiring VA-ECMO, prevalence of LVT was 3.1% |
| Hamada, 2019 (26) | Case series [5] | All presented patients with HCM had apical aneurysm, only 2 with outflow obstruction |
| Ding, 2020 (27) | International Registry [1,676] | Prevalence of LVT was 3.3% in the International Takotsubo Registry |
CMR, cardiac magnetic resonance; ECA, echocardiographic contrast agent; HCM, hypertrophic cardiomyopathy; LVT, left ventricular thrombus; MI, myocardial infarction; NSTEMI, non-ST elevation myocardial infarction; RCT, randomized clinical trial; STEMI, ST elevation myocardial infarction; TEE, transesophageal echocardiogram; TTE, transthoracic echocardiogram; VA-ECMO, veno-arterial extracorporeal membrane oxygenation.