Echocardiography of left ventricular trabeculations, bands and false tendons

Witter, Brat A.; DeCristofaro, Dominic

doi:10.1016/0002-9149(93)90484-t

Cited by 6 publications

(4 citation statements)

References 7 publications

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“…[1][2][3][4][5]12,18 It is, of course, also necessary to distinguish this abnormal bilaminar appearance from the normal presence of false tendons and crisscrossing apical trabeculations, these being normal variants of left ventricular anatomy. [44][45][46][47][48][49][50][51][52][53][54][55] These normal trabeculations never produce a discrete trabecular layer rivalling in thickness the compact layer.…”

Section: Definitionmentioning

confidence: 99%

The morphological spectrum of ventricular noncompaction

et al. 2005

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T HE RECENTLY RECOGNIZED MYOCARDIAL malformation known as ventricular noncompaction is a fascinating disorder, characterized by the presence of an extensive trabeculated myocardial layer reinforcing the luminal aspect of the compact portion of the ventricular wall. Usually described thus far in the left ventricle, it is typically associated with abnormal systolic function, albeit also recorded with restrictive physiology and segmental hypokinesis. 1-5 Seen most frequently in the structurally normal heart, increasing recognition shows that the lesion can also accompany diverse forms of congenital cardiac disease (Figs 1 and 2). 1-10 When seen in the left ventricle, it is currently considered an unclassified form of cardiomyopathy, being neither dilated, hypertrophic, nor restrictive. 2,3,11,12 Although once considered rare, 13-15 it is now being seen with increasing frequency, from the fetus to the adult. 16-29 Diagnosis has now moved from the autopsy table to recognition during life, albeit the debate continues with regard to the features displayed by angiography, echocardiography, computed tomography, and magnetic resonance imaging that permit unequivocal recognition. In this review, we will consider myocardial noncompaction from the stance of comparative vertebrate biology, as well as discussing the genetic, developmental, clinical, and imaging characteristics of patients with noncompaction, seen both in isolation and in the setting of congenital cardiac disease. In the latter setting, we must ask whether noncompaction is a homogeneous process that, in its many clinical and pathological expressions, can be explained on the basis of a developmental abnormality. In this respect, it is of interest to note that, in the evolution of the vertebrates, myocardial noncompaction is advantageous, and indeed necessary, for the circulatory function of some

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Section: Definitionmentioning

confidence: 99%

The morphological spectrum of ventricular noncompaction

et al. 2005

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“…For most of the 20th century, human LVFTs have been regarded as anatomic variations with no clinical significance, and more recently, echocardiographic studies have erroneously diagnosed FTs as hypertrophic cardiomyopathy, thrombi, tumors, subaortic membranes, and abnormalities of both mitral and aortic valves (Witter & DeCristofaro, 1993). Perry et al (1983) confirmed early reports of LVFTs having an association with Still's murmur (Roberts, 1969), also known as innocent murmur or functional murmur, which refers to a benign flow murmur across the aortic valve from high cardiac output and increased ventricular contractility.…”

Section: Discussionmentioning

confidence: 99%

Cardiac ventricular false tendons: A meta‐analysis

Carrasco,

Cabrito,

Montalbano

et al. 2023

Clinical Anatomy

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Ventricular false tendons are fibromuscular structures that travel across the ventricular cavity. Left ventricular false tendons (LVFTs) have been examined through gross dissection and echocardiography. This study aimed to comprehensively evaluate the prevalence, morphology, and clinical importance of ventricular false tendons using a systematic review. In multiple studies, these structures have had a wide reported prevalence ranging from less than 1% to 100% of cases. This meta‐analysis found the overall pooled prevalence of LVFTs to be 30.2%. Subgroup analysis indicated the prevalence to be 55.1% in cadaveric studies and 24.5% in living patients predominantly studied by echocardiography. Morphologically, left and right ventricular false tendons have been classified into several types based on their location and attachments. Studies have demonstrated false tendons have important clinical implications involving innocent murmurs, premature ventricular contractions, early repolarization, and impairment of systolic and diastolic function. Despite these potential complications, there is evidence demonstrating that the presence of false tendons can lead to positive clinical outcomes.

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“…According to one theory LVHT is assumed to be caused by an arrest or failure of the compaction process of the myocardium during embryonal development 11 . Differential diagnoses of LVHT are intraventricular thrombi, 12 false tendons, 13–15 aberrant bands, 15,16 intramyocardial hematoma, 17 cardiac metastases, 18 and the apical type of hypertrophic cardiomyopathy 19 . Intramyocardial abscesses have not been reported as a differential diagnosis of LVHT.…”

Section: Discussionmentioning

confidence: 99%

Histological detection of intramyocardial abscesses in Candida sepsis mimicking left ventricular non‐compaction/hypertrabeculation on echocardiography

Stöllberger¹,

Preiser²,

Finsterer

2004

Mycoses

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Left ventricular non-compaction/hypertrabeculation (LVHT) is a rare cardiac abnormality characterized by more than three trabeculations protruding from the left ventricular wall, apically to the papillary muscles, visible in one echocardiographic image plane and intertrabecular spaces, perfused from the ventricular cavity. LVHT is frequently associated with neuromuscular disorders. Differential diagnoses of LVHT are intraventricular thrombi, false tendons, aberrant bands, intramyocardial hematoma, cardiac metastases and the apical type of hypertrophic cardiomyopathy. Intramyocardial abscesses have not been reported as a differential diagnosis of left ventricular non-compaction. In the presented case, cardiac microabscesses as a result of Candida sepsis mimicked left ventricular non-compaction in a 55-year-old man with hypopharyngeal carcinoma who died 20 days after chemotherapy. These microabscesses were not visible on echocardiography but were detected only at histologic examination of the myocardium. This case shows that intramyocardial abscesses as a result of Candida sepsis are a rare differential diagnosis of LVHT.

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Echocardiography of left ventricular trabeculations, bands and false tendons

Cited by 6 publications

References 7 publications

The morphological spectrum of ventricular noncompaction

The morphological spectrum of ventricular noncompaction

Cardiac ventricular false tendons: A meta‐analysis

Histological detection of intramyocardial abscesses in Candida sepsis mimicking left ventricular non‐compaction/hypertrabeculation on echocardiography

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