Evidence map›Paper›PMID 41594160›Full record

ReviewDiagnostics (Basel, Switzerland)2026

Unmasking the Apex: Multimodality Imaging for the Evaluation of Left Ventricular Apical Obliteration.

Ilaria Dentamaro, Marco Maria Dicorato, Paolo Basile, Maria Cristina Carella, Francesco Mangini, Rita Musci, Roberta Ruggieri, Eduardo Urgesi, Laura Piscitelli, Sergio Dentamaro and 4 more

Abstract readReview
In one paragraph

Review in Diagnostics (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Ilaria DentamaroUniversity Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari "Aldo Moro", 70124 Bari, Italy.
Marco Maria DicoratoUniversity Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari "Aldo Moro", 70124 Bari, Italy.ORCID 0009-0008-4865-2522
Paolo BasileUniversity Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari "Aldo Moro", 70124 Bari, Italy.ORCID 0000-0002-2327-7585
Maria Cristina CarellaUniversity Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari "Aldo Moro", 70124 Bari, Italy.
Francesco ManginiCardiology Division, Miulli Hospital, 70021 Acquaviva delle Fonti, Italy.ORCID 0000-0003-3767-7595
Rita MusciUniversity Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari "Aldo Moro", 70124 Bari, Italy.
Roberta RuggieriUOC Cardiologia, Ospedale Di Venere, Asl Bari, 70124 Bari, Italy.
Eduardo UrgesiUniversity Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari "Aldo Moro", 70124 Bari, Italy.ORCID 0000-0002-0458-1469
Laura PiscitelliCardiology Unit, A. Perrino Hospital, 72100 Brindisi, Italy.ORCID 0000-0003-3918-8680
Sergio DentamaroVascular Surgery, Polyclinic University Hospital, University of Bari "Aldo Moro", 70124 Bari, Italy.
Gianluca PontoneCentro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
Cinzia ForleoUniversity Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari "Aldo Moro", 70124 Bari, Italy.ORCID 0000-0002-9452-4037
Marco Matteo CicconeUniversity Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari "Aldo Moro", 70124 Bari, Italy.
Andrea Igoren GuaricciUniversity Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari "Aldo Moro", 70124 Bari, Italy.ORCID 0000-0001-7133-4401

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Left ventricular (LV) apical obliteration represents a convergent imaging phenotype arising from diverse cardiac conditions, including thrombotic, hypertrophic, infiltrative, congenital, and neoplastic diseases. These conditions, despite sharing overlapping morphological features, require profoundly different management strategies. In this context, an accurate characterization of the LV apex is a cornerstone point, and can be performed through various techniques. Advances in multimodality imaging have substantially improved diagnostic precision, allowing clinicians to differentiate true obliteration from mimicking conditions such as hypertrabeculation, apical hypertrophy, or subendocardial fibrosis. This review provides a comprehensive overview of the anatomical variability of the LV apex and its implications for imaging interpretation. We appraise the role of echocardiography, including contrast-enhanced and speckle-tracking studies-alongside cardiac magnetic resonance (CMR), computed tomography (CT), and selective nuclear imaging in the evaluation of apical pathology. For each principal cause of apical obliteration-LV thrombus, apical hypertrophic cardiomyopathy, left ventricular non-compaction, endomyocardial fibrosis, cardiac amyloidosis, and intracardiac tumors-we outline key diagnostic clues, imaging red flags, and distinguishing tissue characteristics. Special emphasis is given to the incremental value of CMR for tissue characterization, thrombus detection, and fibrosis mapping, as well as to the interpretative challenges posed by apical foreshortening, near-field artefacts, and suboptimal acoustic windows. A practical, stepwise imaging framework is proposed to guide clinicians through the differential diagnosis of apical obliteration using an integrated multimodality approach. Future directions include the incorporation of 4D flow, advanced mapping techniques, and artificial intelligence-powered analysis to refine apical phenotyping and identify early disease signatures. Recognizing the full spectrum of apical pathology and its imaging manifestations is essential to prevent misdiagnosis, enable timely therapeutic decisions, and improve risk stratification.

Indexed as

apical cardiomyopathiesapical obliterationcardiac magnetic resonanceleft ventricular apexmultimodality imaging

Identifiers

PMID41594160
PMCPMC12840084

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.