Left Ventricular False Tendon Research Articles

Left ventricular false tendons: Unseen or overlooked?

Left ventricular false tendons are cord like fibromuscular bands seen commonly in the left ventricle and attach septum to free wall. Described as early as in late 1800s, their functional significance is still not well established. We present the imaging findings in a 13-year-old boy who presented with failure to thrive. Echocardiography and cardiac CT showed the presence of aortic valve thickening, sub-aortic membrane, and patent ductus arteriosus with the left ventricular false tendon.

Cardiovascular risks in children with congenital anomalies of the kidney and urinary tract

Congenital anomalies of the kidney and urinary tract (CAKUT) occupy a leading place in the structure of nephro-urological pathology and are often accompanied by changes in the cardiovascular system, which requires an interdisciplinary approach in the management of this category of patients. Purpose: assessment of the nature and frequency of cardiovascular disorders in children with CAKUT to optimize their follow-up monitoring. The study included 190 children with CAKUT, of which 24 (15.0 %) had duplicated ureters; 30 (18.75 %) — hypoplasia; 40 (25.0 %) — cysts; 30 (18.75 %) — an autosomal dominant type of polycystosis, 36 (22.5 %) — varying degrees of severity of hydronephrosis, and 30 practically healthy children without kidney pathology (group 2). The age of children by groups: 34 children were up to 3 years, 41 children — 3–6 years, 59 children — 7–11 years, and 26 children — 12–15 years. In group 1, there were 73 (45.6 %) boys and 87 (54.4 %) girls aged 4 to 16 years (mean age 8±5.82 years), and in group 2, there were 13 (43.3 %) boys and 17 (56.7 %) girls aged 4 to 15 years (average age 6±6.73 years). A comprehensive examination of the urinary and cardiovascular systems using ultrasound diagnostics and Holter monitoring of pulse, ECG, and blood pressure was carried out. Statistical processing was performed using Statistica 8.0 for Windows (Statsoft Inc., USA). Conclusions. With CAKUT, chronic infection was often recorded in children with duplicated ureters (91.7 %) and hydronephrosis (88.9 %); persistent and increased crystalluria was noted in every third patient (33.3 %) with duplicated ureters, in 47.2 % of children with hydronephrosis, and in almost 2/3 of patients (73.3 %) with polycystosis. In children with CAKUT syndrome, CHD was detected in 15.0 % of cases; the frequency of small developmental heart anomalies is high with the prevalence of left ventricular false tendon (38.9 %) and mitral valve prolapse (33.6 %). This justifies the need to include an examination by a pediatric cardiologist 1–2 times a year with an additional examination of the cardiovascular system (ECG, heart ultrasound, and daily monitoring of blood pressure) in the standard of follow-up monitoring of children with CAKUT.

Three-dimensional echocardiographic assessment of Chiari’s network relationship with the left ventricular false tendon

BackgroundLeft ventricular false tendon (LVFT) is a fibromuscular band crossing the left ventricular cavity. And Chiari’s network (CN) is a highly mobile, mesh-like, echogenic structure in right atrium. In this study, we aimed to evaluate the coexistence of LVFT in patients with CN. CN patients were examined with live/real-time three-dimensional transthoracic echocardiography (TTE) for visualization of LVFT.ResultsThis is a single-center prospective study of 49 patients with CN. In literature studies, the average ratios of LVFT were 22% in the normal population. In our study, an increased ratio of LVFT (n = 31, 63.3%) was found in CN patients evaluated with a three-dimensional TTE (63.3% versus 22%) (p = 0.01). The interatrial septal aneurysm was found in 31 (63.3%) patients with CN. And, the positive contrast echocardiography examination was determined in 22 (61.1%) patients with CN.ConclusionsOur study reveals that CN is associated with LVFT and is also associated with cardiac anomalies like an interatrial septal aneurysm, and atrial septal defect. And LVFT can be evaluated better with three-dimensional TTE than with traditional two-dimensional TTE. Patients with CN should be evaluated more carefully by three-dimensional echocardiography as they can be in synergy in terms of the cardiac pathologies they accompany.

Catheter ablation of premature ventricular complexes associated with left ventricular false tendons.

Clinical studies have suggested that there is a significant correlation between left ventricular (LV) false tendon and premature ventricular complexes (PVCs). This study aimed to investigate the electrophysiological characteristics and the outcome of radiofrequency catheter ablation (RFCA) for this category of PVCs. From a total of 2284 patients with idiopathic PVCs who underwent catheter ablation at 6 institutions in China, intracardiac echocardiography (ICE) was used during the procedure in 346 cases; 10 patients (2.9%) with PVCs associated with false tendon were retrospectively reviewed and enrolled in the present study. Activation mapping and pace mapping were performed to localize the origin of PVCs. ICE was used in all patients. If the false tendon was directly visualized and identified, we attempted to identify the distinct relationship with the PVC origin. The PVCs were successfully eliminated by ablation in all patients. The target sites were confirmed to be related to false tendon. The origin of PVCs was located at the attachment of the false tendon to the papillary muscle, LV septum, or LV apex. At the target site, high-frequency Purkinje potentials were observed preceding local ventricular activation in 7 patients. LV false tendon can be associated with PVCs, which can be cured by RFCA. An ICE-guided electroanatomical approach should be considered to improve the safety and feasibility of this procedure.

Left ventricular false tendons and electrocardiogram repolarization abnormalities in healthy young subjects

AIMTo describe echocardiographically left ventricular false tendon characteristics and the correlation with ventricular repolarization abnormalities in young athletes.METHODSThree hundred and sixteen healthy young athletes from different sport disciplines were evaluated from 2009 to 2011 during routine screening for agonistic sports eligibility. All subjects, as part of standard pre-participation screening medical evaluation, underwent a basal and post step test 12-lead electrocardiogram (ECG). The athletes with abnormal T-wave flattening and/or inversion were considered for an echocardiogram evaluation and an incremental maximal exercise test on a cycle ergometer. Arterial blood pressure and heart rate, during and after exercise, were also measured.RESULTSTwenty-one of the 316 subjects (6.9%) showed false tendons in the left ventricle. The majority of false tendons (52.38%) were localized between the middle segments of the inferior septum and the lateral wall, 19.06% between the distal segments of the septum and the lateral wall, in 5 subjects between the middle segments of the anterior and inferior walls, and in one subject between the middle segments of the anterior septum and the posterior wall. ECG abnormalities, represented by alterations of ventricular repolarization, were found in 11 subjects (52.38%), 90% of these anomalies were T wave abnormalities from V1 to V3. These anomalies disappeared with an increasing heart rate following the three minute step test as well as during the execution of the maximal exercise.CONCLUSIONLeft ventricular false tendons are frequently localized between the middle segments of the inferior septum and the lateral wall and are statistically associated with ventricular repolarization abnormalities.

Comet in left Ventricle: a Case of False Tendon Creating a False Impression!

Left ventricular false tendon in a structure with unknown physiology. It was first described by Turner. It has been implicated in origin of innocent murmur and some form of ventricular tachycardia but the significance has not been proven beyond doubt. During echocardiography the false tendon may be misleading many times. Here we present such a case where the false tendon really created a false impression to begin with. Key words: Aortic regurgitation, False tendon, Hyperechogenic, Left ventricle, Interventricular septum.

Left ventricular false tendons: echocardiographic characteristics in the Polish population.

False tendon (FT) is described in a wide range (40% to 62%) of the examined hearts depending on age and additional heart abnormalities. On echocardiography, the range is even wider (1.6-78%), depending on study design and inclusion criteria. Ultrasonographic characteristics of left ventricular FTs in the Polish population are not well known. Echocardiographic examinations of 1,679 consecutive patients were evaluated. All cases were classified according to American Society of Echocardiography Committee of Nomenclature and Standards Document on Identification of the Segments of the Heart Muscle. In our study, fibrous structures in the lumen of the left ventricle were detected in 100 (6%) subjects of the study group. The age of the subjects ranged from 16 to 87 years (mean age 47.9), 50 were males and 50 were females. In 94% of the subjects, FT was a single structure. No patient had clinically evident arrhythmia. In the Polish population, FT can be identified in all age groups, and the prevalence is similar to that reported in the literature.

Echocardiographic Assessment of the Vibratory Innocent Murmur in Children: a Case-Control Study

Background: Vibratory innocent murmur is the most common precordial innocent murmur in children. The mechanism of vibratory innocent murmur is still unclear. Objectives: The aim of this study is to learn the mechanism of the vibratory innocent murmur. Patients and Methods: The prospective cross-sectional study was conducted using 32 children who had the vibratory innocent murmur (cases) in Chiang Mai University Hospital and 27 normal healthy children (controls). Two-dimension, Doppler, and tissue Doppler echocardiography were performed on each subject to examine the difference between cases and controls. Results: The left ventricular false tendon was present in 84% of cases and 22% of controls (P < 0.001). Left ventricular outflow tract velocity was significantly higher in cases than in controls (P < 0.001). Early diastolic myocardial velocity at the base of the interventricular septum was lower in cases with false tendon than those without false tendon (P = 0.048). No significant difference was found regarding ascending aorta diameter, cardiac output and ejection fraction between the two groups. Left ventricular diastolic function was normal in all cases and controls. Conclusions: The vibratory innocent murmur is associated with the presence of left ventricular false tendon and higher left ventricular outflow tract velocity. The presence of the left ventricular false tendon was somewhat associated with decreased early diastolic myocardial velocity. Normal left ventricular systolic and diastolic function can be used as a reassurance in cases with the vibratory innocent murmur.

Basic Study and Clinical Implications of Left Ventricular False Tendon. Is it Associated With Innocent Murmur in Children or Heart Disease?

Introduction and objectivesLeft 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. MethodsThe 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. ResultsFalse 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. ConclusionsLeft 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.

Case-based session: cardiac masses: Wednesday 3 December 2014, 11:00-12:30 * Location: Agora

Case-based session: cardiac masses: Wednesday 3 December 2014, 11:00-12:30 * Location: Agora

Massive calcification involving a left ventricular false tendon

© 2014 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.

Massive calcification involving a left ventricular false tendon

© 2014 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.

Successful ablation of a narrow complex tachycardia arising from a left ventricular false tendon: Mapping and optimizing energy delivery

Ventricular tachycardia (VT) arising in the His-Purkinje system is an important cause of narrow complex tachycardia that is often amenable to catheter ablation. Ventricular arrhythmias may require targeted mapping and ablation of endocavitary structures, such as papillary muscles or false tendons to eliminate symptomatic arrhythmia. We describe a patient with narrow QRS (NQRS) tachycardia who required mapping and ablation of a left ventricular false tendon (LVFT). Intracardiac echocardiography (ICE) was used to identify the target and optimize contact to successfully ablate this unique focus for arrhythmia.

Echogenic focus in the fetal left ventricular cavity: Is it a false tendon?

ObjectiveTo draw attention to the left ventricular false tendon which can be misinterpreted as echogenic focus in the fetus. MethodsThe study group consisted of 9 fetuses out of the 161 who had been misdiagnosed for left ventricular false tendon as echogenic focus by obstetricians. Fetal echocardiography and 2-D color Doppler echocardiography were performed in the pre–postnatal period. The standard fetal echocardiographic views (4,5 chamber views, long axis view of the left ventricle, short axis view of the ventricles and great arteries, three vessels and trachea view, long axis views of the duct and aortic arch) were obtained for each case. ResultsOf the 161 fetuses with echogenic focus in the left ventricle which underwent fetal echocardiography, 9 (5.6%) were diagnosed with false tendons present in the left ventricular cavity with no other cardiovascular anomaly. Six out of 9 patients underwent amniocentesis as follows: for age of over 35years (two patients), abnormal double-triple screening tests plus echogenic focus (two patients) and soft ultrasonographic markers including echogenic focus (two patients). These fetuses revealed no cardiovascular and other systemic pathology or dysmorphism except for false tendons in the left ventricular cavity. ConclusionFalse tendon should be taken into account as differential diagnosis of left ventricular echogenic focus in the fetus. Misinterpretation of false tendon as echogenic focus may cause unnecessary fetal invasive approach and maternal anxiety, especially when it arises with a background of borderline fetal findings and knowledge.

An intracardiac mobile mass: ruptured left-ventricular false tendon with big vegetation due to Brucella endocarditis

An intracardiac mobile mass: ruptured left-ventricular false tendon with big vegetation due to Brucella endocarditis

Prenatal Diagnosis of Left Ventricular False Tendon

A case of prenatal diagnosis of left ventricular false tendon is reported. The in utero echographic features of false tendon are described, together with their differential diagnosis. The management of neonates with false tendons is described.

Left Ventricular False Tendon Detected by 2-Dimensional Echocadiography

Left Ventricular False Tendon Detected by 2-Dimensional Echocadiography

87 LEFT VENTRICULAR FALSE TENDONS (BANDS): ECHOCARDIOGRAPHIC AND ANGIOCARDIOGRAPHIC DELINEATION

Left ventricular false tendons have been demonstrated by two-dimensional echocardiography in adults (5%) and children (61%). After identifying 3 children with left ventricular false tendons and mitral stenosis, a prospective study was designed. Over a 4 month period, 62 children underwent complete two-dimensional echocardiographic exam for either suspected heart disease or pericardial effusion. Ages ranged between 1 day and 18 years. In 7 children, a single left ventricular false tendon was identified in the apical 4 chamber view. The diagnoses included congenital heart disease (5), cardiomyopathy (1) and functional murmur (1). The left ventricular false tendon usually extended from the left ventricular apical free-wall to the mid portion of the interventricular septum. Left ventricular angiography was performed in 6 children (including the 3 prior to the prospective study). In 5 of 6, a fine radiolucent line was seen towards the apex of the left ventricle after careful review, confirming the echocardiographic finding. No left ventricular outflow tract obstruction was detected by pressure recordings in these 6 patients.Left ventricular false tendons were identified in 11% of children by two-dimensional echocardiography and were successfully detected during left ventricular angiography. Left ventricular false tendons appear to have a benign course and should not be mistaken for structures that can produce left ventricular outflow tract obstruction.

Left ventricular false tendons: echocardiographic incidence in India and clinical importance

In a prospective study of 1012 patients above the age of 12 years, we detected 4 (0.4%) cases of left ventricular false tendon (LVFT) by echocardiography. Two patients had significant heart disease and LVFT was perhaps a chance occurrence; two others had no significant heart disease and LVFT probably had a causal association with S3 gallop in one and systolic murmur in the other. Diagnosis of LVFT may help to explain cardiac findings of uncertain origin.