title: Clinical significance of incidentally detected aneurysms of the membranous ventricular septum in adults by multidetector computed tomography.
abstract: Although the clinical relevance of aneurysm of the membranous ventricular septum (AMVS) in adults is unclear, the frequency of AMVS detection has been increased because cardiac multidetector computed tomography has been widely adopted for the evaluation of coronary artery disease. Therefore, we aimed to assess the clinical significance of AMVS in a longitudinal study. In 30,120 adults with suspected coronary artery disease who underwent cardiac multidetector computed tomography in 3 hospitals, 52 patients with AMVS were retrospectively selected. We evaluated the clinical symptoms and electrocardiographic abnormalities (cross-sectional study) and the prevalence of embolic stroke (observational study) during a median 40-month (range 6 to 74 months) observation period. For the assessment of embolic stroke, we excluded 9 patients with other explainable embolic sources. Conduction abnormalities were noted in 13 of 52 adults (25%) with AMVS on electrocardiography and embolic stroke occurred in 6 of 43 patients (14%). The mean age and the prevalence of hypertension were significantly higher in the embolic stroke group than in the event-free group (p <0.05). Thrombi were detected in the 11.6% of AMVS, which was significantly related with embolic stroke (p <0.05). The size and morphology did not change in 15 patients with serial follow-up images. In conclusion, our study suggests that AMVS in adults should not be ignored because AMVS may be related to conduction abnormality or embolic stroke, and it does not spontaneously resolve or diminish in size.
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggido, Korea.
authors.forename: Ja Yeon
authors.initials: JY
authors.lastname: You
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggido, Korea. Electronic address: drejchun@hanmail.net.
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Chun
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggido, Korea.
authors.forename: Sang Il
authors.initials: SI
authors.lastname: Choi
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggido, Korea.
authors.forename: Eugene
authors.initials: E
authors.lastname: Joe
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Whal
authors.initials: W
authors.lastname: Lee
authors.affiliation: Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Joon-Won
authors.initials: JW
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Myung-Ki
authors.initials: MK
authors.lastname: Seo
authors.affiliation: Department of Internal Medicine and Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggido, Korea.
authors.forename: Yeonyee E
authors.initials: YE
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine and Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggido, Korea.
authors.forename: Il-Young
authors.initials: IY
authors.lastname: Oh
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggido, Korea.
authors.forename: Eunhee
authors.initials: E
authors.lastname: Kim
authors.affiliation: Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Tae-Hwan
authors.initials: TH
authors.lastname: Lim
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D055424:Cardiac-Gated Imaging Techniques; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D004562:Electrocardiography; D005260:Female; D006322:Heart Aneurysm / Q000150:complications / Q000000981:diagnostic imaging*; D006331:Heart Diseases / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D006973:Hypertension / Q000150:complications; D033162:Incidental Findings; D020766:Intracranial Embolism / Q000209:etiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D012189:Retrospective Studies; D020521:Stroke / Q000209:etiology*; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D054088:Ventricular Septum / Q000000981:diagnostic imaging*