Kaolawanich Y, et al. - Considering the possible significance of structural changes that alter the size and shape of the left ventricular (LV) apex in predicting LV thrombus, researchers assessed factors related to thrombus, including sphericity index and “new” apical area index (ratio of apical area to entire LV area from a cine four-chamber view) in a case-control cardiac magnetic resonance (CMR) study of 150 patients with LV systolic dysfunction (left ventricular ejection fraction < 40%; 30 patients with LV thrombus, 120 patients without thrombus; average age 63.48 ± 12.82 years; mean LVEF 29.22 ± 8.53%). A significantly higher apical area index was seen in patients with LV thrombus vs those without thrombus; no difference was seen in sphericity index in both groups. In univariate analysis, factors related to thrombus included male gender, prior myocardial infarction, presence of apical aneurysm, ischemic-typed scar, apical scar and apical area index. Overall, in patients with LV systolic dysfunction, apical area index from CMR represents a novel index to predict LV thrombus and may have a future role in early anticoagulant therapy.