Left Ventricular Apical Thin Point Viewed with Two‐Dimensional Echocardiography

Abstract

The aim of this study was to evaluate the usefulness of two-dimensional echocardiography in observing the left ventricular apical thin point (LVATP) and to view the change in thickness and width of the LVATP during the cardiac cycle. Transthoracic echocardiography was performed in 32 healthy adult volunteers to observe the LVATP in an apical three-chamber view. The width and thickness of the LVATP were measured at the end-diastole as well as at the end-systole. With two-dimensional echocardiography, the LVATP could be clearly shown. The width of the LVATP at the end-diastole and end-systole was 3.3 mm +/- 1.4 mm versus 0.9 mm+/-0.4 mm, P < 0.001; the thickness of the LVATP at the end-diastole and end-systole was 1.7 mm +/- 0.6 mm versus 1.8 mm +/- 0.8 mm, P > 0.05. The LVATP can be viewed with two-dimensional echocardiography; the LVATP changes significantly in width during the cardiac cycle, whereas the thickness of the LVATP changes insignificantly.

Left ventricular apical thinning

“…Hence various studies may differ on the localization of its territory. Forth, as noted by Baosheng et al, 3 the width of the LVATP varies across the cardiac cycle. These may lead to different measurements if these measurements were taken at different phases of the cardiac cycle.…”

“…Multiple studies are reported on the left ventricular apex, as it contains, at its very tip, a thin‐point. Some authors have described it as the “left ventricular apical thin‐point” (LVATP) 1–4 . In 1977, Bradfield et al 1 provided the earliest documented confirmation of the apical thin‐point, measured at necropsy the apical thin‐point and found it to be ≤1 mm in 67% of examined hearts and ≤2 mm in 97% of examined hearts.…”

“…The measured values were 1.2 ± 1.1, 4.4 ± 2.9, and 14.3 mm 2 , respectively 4 . Baosheng et al 3 also used the two‐dimensional echocardiogram to measure the LVATP parameters as it allowed clear visualization of the LVATP The LVATP's mean width at end‐systole was 0.9 ± 0.4 and 3.3 ± 1.4 mm at end‐diastole. The thickness of the LVATP, on the other hand, did not appear to vary along the cardiac cycle as it measured around 1.7 mm throughout the cardiac cycle 3 .…”

“…Dynamic ventricular changes, on the other hand, are best visualized on echocardiograms even allowing the detection of perioperative complications 21 . Moreover, the precise measurement of anatomic variables, such as the LVATP is also achievable through echocardiograms 3 …”

Normal variations and anatomic pitfalls that may mimic diseases on coronary CT angiography

“…Thinning of the myocardium associated with a segmental wall motion abnormality suggests an area of infarction or scarring. However, focal wall thinning at the ventricular apex can be seen in normal populations that have normal cardiac function without symptoms or a previous history of a myocardial infarction [24][25][26] (Fig. 13).…”