Abnormal Chords of Left Ventricle as Cardiac Manifestations of Connective Tissue Dysplasia Syndrome

Abstract

The article highlights the major problems of diagnostics and clinical relevance of such minor structural heart abnormalities as left ventricular abnormal chords. Possible hemodynamic changes, clinical manifestations and cardio-vascular complications associated with abnormal chords are presented. Abnormal chords of the ventricles (VAC) are connective tissue and muscular formations, which have ectopic attachment unlike normal chords. Abnormal chords are the most common cardiac manifestations of non-differentiated connective tissue dysplasia syndrome (CTDS). Commonly, they are associated with mitral valve prolapse as well as with other phenotypical manifestations of connective tissue dysplasia – joint hypermobility, increased skin extensibility, scoliotic posture, duplication and ptosis of kidneys etc. Modern views concerning the prevalence of this pathology, its clinical manifestations, diagnostic peculiarities as well as prognostic value of different topical and quantitative variants of abnormal chords are given. The effect of abnormal chords on arrhythmogenesis of left ventricle, development of cardialgia and myocardial ischemia development, heart cavity remodeling, systolic and diastolic function of the left ventricle are discussed. Pathogenetic relationship between multiple abnormal chords and such serious hereditary disease as left ventricular non-compaction is emphasized. The article focuses on the statement that the patients with left ventricular abdominal chords like all patients with minor structural heart abnormalities should be placed into “the risk group” because of possible development of ventricular arrhythmias, heart remodeling and chronic heart failure.