Tamborini Gloria, Pepi Mauro, Celeste Fabrizio, Muratori Manuela, Susini Francesca, Maltagliati Anna, Veglia Fabrizio
Centro Cardiologico Monzino, I.R.C.C.S, Institute of Cardiology, University of Milan, Italy.
J Am Soc Echocardiogr. 2004 Apr;17(4):367-74. doi: 10.1016/j.echo.2003.12.020.
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.
鉴于心脏解剖结构超声心动图评估的最新进展，我们试图回顾异常影像（AI）作为左心室（LV）假腱索和小梁的超声心动图发生率。在1580例患者中，通过经胸超声心动图评估假腱索、小梁或血栓的存在情况，并将其与临床特征和超声心动图参数相关联。AI的发生率为46.7%（75%为假腱索，23%为小梁，2%为血栓），在病理性心脏中（48.9%）略高于正常心脏（40.8%）。AI在男性患者（52%）中比女性患者（39.7%）更常见，且与左心室扩张、肥厚和收缩功能障碍相关。假腱索和小梁与年龄无关。男性是AI最显著的独立预测因素。在2例患者中，经磁共振成像诊断并证实为孤立性左心室心肌致密化不全。这项研究表明，无论有无病理性心脏，AI在患者中都有较高的发生率，提示需要更新左心室超声心动图解剖结构。它还强调了在评估患者是否存在壁血栓和心肌病时，认识这些解剖变异的必要性。
