title: Basic Study and Clinical Implications of Left Ventricular False Tendon. Is it Associated With Innocent Murmur in Children or Heart Disease?
abstract: OBJECTIVE
  Left ventricular false tendon is a structure of unknown function in cardiac physiology that was first described anatomically by Turner. This condition may be related to various electrical or functional abnormalities, but no consensus has ever been reached. The purpose of this study was to determine the time of appearance, prevalence and histologic composition of false tendon, as well as its association with innocent murmur in children and with heart disease.
  
  
  METHODS
  The basic research was performed by anatomic dissection of hearts from adult human cadavers to describe false tendon and its histology. The clinical research consisted of echocardiographic study in a pediatric population to identify any relationship with heart disease, innocent murmur in children, or other abnormalities. Fetal echocardiography was performed prenatally at different gestational ages.
  
  
  RESULTS
  False tendon was a normal finding in cardiac dissection and was composed of muscle and connective tissue fibers. In the pediatric population, false tendon was present in 83% on echocardiography and showed a statistically significant association only with innocent murmur in children and slower aortic acceleration. The presence of false tendon was first observed on fetal echocardiography from week 20 of pregnancy.
  
  
  CONCLUSIONS
  Left ventricular false tendon is a normal finding visualized by fetal echocardiography from week 20 and is present until adulthood with no pathologic effects except for innocent murmur during childhood. It remains to be determined if false tendon is the cause of the murmurs or if its absence or structural anomalies are related to disease.
authors: Servicio de Pediatría, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain. Electronic address: Pacosanchezferrer0@hotmail.com.
authors: Francisco
authors: F
authors: Sánchez Ferrer
authors: Servicio de Obstetricia y Ginecología, Hospital Virgen de la Arrixaca, El Palmar, Murcia, Spain.
authors: María Luisa
authors: ML
authors: Sánchez Ferrer
authors: Instituto de Bioingeniería, Universidad Miguel Hernández, Elche, Alicante, Spain.
authors: María Dolores
authors: MD
authors: Grima Murcia
authors: Servicio de Pediatría, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain.
authors: Marina
authors: M
authors: Sánchez Ferrer
authors: Departamento de Histología y Anatomía, Universidad Miguel Hernández, Elche, Alicante, Spain.
authors: Francisco
authors: F
authors: Sánchez del Campo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis*; D006337:Heart Murmurs / Q000175:diagnosis* / Q000209:etiology; D006352:Heart Ventricles / Q000002:abnormalities* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male
keywords: Anatomía humana; Basic research; Echocardiography; Ecocardiografía; Falso tendón del ventrículo izquierdo; Fetal period; Histology; Histología; Human anatomy; Innocent murmur; Investigación básica; Left ventricular false tendon; Pediatrics; Pediatría; Periodo fetal; Soplo inocente