Δημοσίευση ανασκόπησης στο Trends in Cardiovascular Medicine για την προσέγγιση ασθενών με θρόμβο στην αριστερή κοιλία, τα κενά στη βιβλιογραφία και την εξατομίκευση της θεραπείας τους: Current insights and challenges in the management of left ventricular thrombus (Katsouras CS, Sakellariou XM, Bechlioulis A, Lakkas L, Korantzopoulos P, Chen QF, Zhou XD. Current insights and challenges in the management of left ventricular thrombus. Trends Cardiovasc Med. 2025 Sep 15:S1050-1738(25)00130-6. doi: 10.1016/j.tcm.2025.09.006. Epub ahead of print. PMID: 40962039). Η δημοσίευση συνοδεύτηκε από Editorial commentary: Unanswered questions for an age-old problem: Rethinking left ventricular thrombus management (Trends in Cardiovascular Medicine, Available online 7 October 2025, Aloysius Sheng-Ting Leow, Ching-Hui Sia)
Review
Trends Cardiovasc Med. 2025 Sep 15:S1050-1738(25)00130-6.
doi: 10.1016/j.tcm.2025.09.006. Online ahead of print.
Current insights and challenges in the management of left ventricular thrombus
Christos S Katsouras 1, Xenofon M Sakellariou 2, Aris Bechlioulis 2, Lampros Lakkas 3, Panagiotis Korantzopoulos 4, Qin-Fen Chen 5, Xiao-Dong Zhou 6
Affiliations
· 1st Cardiology Department, University Hospital of Ioannina, Ioannina, Greece; Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece. Electronic address: chkatsou@uoi.gr.
· 2nd Cardiology Department, University Hospital of Ioannina, Ioannina, Greece.
· Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
· 1st Cardiology Department, University Hospital of Ioannina, Ioannina, Greece; Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
· Medical Care Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Institute of Aging, The Center for Geriatric Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
· MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. Electronic address: zhouxiaodong@wmu.edu.cn.
· DOI: 10.1016/j.tcm.2025.09.006
Abstract
Left ventricular thrombus is a relatively common and serious complication in patients with left ventricular systolic dysfunction, resulting in an increased risk of embolic events such as ischemic stroke and contributing to higher mortality rates. Current clinical guidelines recommend anticoagulation therapy for 3 to 6 months in patients with left ventricular thrombus; however, the evidence supporting this approach primarily derives from small-scale randomized trials or retrospective observation studies, which limit the generalizability of findings across diverse patient populations. Several critical aspects of left ventricular thrombus identification and management remain inadequately studied, and these areas include optimal time and detection imaging methods, anticoagulation strategies (treatment of choice and optimal duration), and the need for periodic re-evaluation. This review consolidates the current evidence, identifies gaps in left ventricular thrombus management, and proposes individualized strategies that consider factors like left ventricular function and bleeding risks.
Keywords: Anticoagulation; Cardiac magnetic resonance; Echocardiography; Embolic risk; Imaging; Left ventricular thrombus; Recurrence; Resolution.
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