title: Incidence and characteristics of left ventricular false tendons and trabeculations in the normal and pathologic heart by second harmonic echocardiography.
abstract: We sought to review echocardiographic incidence of anomalous images (AI) as false tendons and trabeculations of the left ventricle (LV) in light of recent advancements in echocardiographic evaluation of heart anatomy. In 1580 patients the presence of false tendons, trabeculations, or thrombi was evaluated with transthoracic echocardiography and correlated to clinical characteristics and echocardiographic parameters. Incidence of AI was 46.7% (75% false tendons, 23% trabeculations, 2% thrombi), slightly higher in pathologic (48.9%) than in normal hearts (40.8%). AI were more frequent in male patients (52%) than in female patients (39.7%) and associated with LV dilatation, hypertrophy, and systolic dysfunction. False tendons and trabeculations were not related to age. Male sex was the most significant independent predictor of AI. In 2 patients, isolated LV noncompaction of myocardium was diagnosed and confirmed by magnetic resonance imaging. This study shows a high prevalence of AI for patients with and without pathologic hearts suggesting the need of updating LV echocardiographic anatomy. It also emphasizes the necessity for an awareness of these anatomic variants when evaluating patients for mural thrombi and cardiomyopathies.
authors.affiliation: Centro Cardiologico Monzino, I.R.C.C.S, Institute of Cardiology, University of Milan, Italy. gtamborini@cardiologicomonzino.it
authors.forename: Gloria
authors.initials: G
authors.lastname: Tamborini
authors.forename: Mauro
authors.initials: M
authors.lastname: Pepi
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Celeste
authors.forename: Manuela
authors.initials: M
authors.lastname: Muratori
authors.forename: Francesca
authors.initials: F
authors.lastname: Susini
authors.forename: Anna
authors.initials: A
authors.lastname: Maltagliati
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Veglia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D002648:Child; D004452:Echocardiography; D018618:Echocardiography, Doppler, Color; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000473:pathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009206:Myocardium / Q000473:pathology; D015588:Observer Variation; D011237:Predictive Value of Tests; D013223:Statistics as Topic; D013318:Stroke Volume / Q000502:physiology; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology