Gullace G, Yuste P, Letouzey J P, Gentile F, Arrigo F, Evans J, Mancini R, Ravizza P, Savoia M T, Careri G
Divisione di Cardiologia, Ospedale di Lecco, CO.
G Ital Cardiol. 1987 Apr;17(4):318-28.
A series of 4260 consecutive echocardiographic examinations, performed in 5 Cardiological Centers was examined, identifying 125 intraventricular false tendons (FTs) in 100 cases (55 normals and 45 with heart disease) of whom 31 were female and 69 male, aged 3 to 82 years. An anatomo-morphological study was possible in 9 cases, dead for stroke or heart failure, on autopsy, and in 7, on heart surgery. A phonocardiogram was performed in all normals and in 20 patients. On echocardiography, FTs appeared as an echo-producing string-like structure, straight between the septum and the ventricular free wall, mobile during the cardiac cycle, without systolic thickening and any relation with the atrioventricular valvular apparatus. The prevalence of FTs was 2.3%; it was 3.2% to 5.3% in younger people. FTs were located in the right ventricle (4 cases), left ventricle (95 cases) or in both (1 case). Their site was left apical (45 FTs), right apical (2 FTs), right (3 FTs) and left (20 FTs), upper septum-to-free wall (55 cases). In 1 case hypertrophy of trabeculae of the left ventricle was detected. FTs were single (79 cases), double (19 cases), multiple (2 cases), short (42 cases), long (58 cases), thick (45 cases) and thin (55 cases). They showed a membrane-like motion (thick FTs-45 cases) and a valve-like motion (thin FTs-55 cases). Innocent murmur was detected in 50 of 55 normals and related to thin FTs. Of 16 cases examined anatomically and histologically, FTs were fibrous in their distal portion and fibro-muscular in the proximal one in 12 cases, whereas they were entirely fibrous-muscular in 4 cases. The site and location of FTs detected by echo were confirmed by anatomy in all cases. In 4 cases other 9 FTs, not detected on echocardiography, were found. These data suggest that echocardiography is a useful tool to detect intraventricular FTs and differentiate them from other echo-producing structures. Although a relationship between FTs and heart disease has not been found, their presence could be responsible of innocent murmur in many normal subjects.
对5个心脏病中心进行的连续4260例超声心动图检查进行了分析,在100例患者(55例正常人和45例心脏病患者)中发现了125条心室内假腱索(FTs),其中女性31例,男性69例,年龄3至82岁。对9例因中风或心力衰竭死亡并进行尸检的患者以及7例接受心脏手术的患者进行了解剖形态学研究。对所有正常人和20例患者进行了心音图检查。在超声心动图上,FTs表现为产生回声的条索状结构,在室间隔和心室游离壁之间呈直线,在心动周期中可移动,无收缩期增厚,且与房室瓣膜装置无任何关联。FTs的患病率为2.3%;在年轻人中为3.2%至5.3%。FTs位于右心室(4例)、左心室(95例)或两者均有(1例)。其位置为左心尖(45条FTs)、右心尖(2条FTs)、右(3条FTs)和左(20条FTs)、上间隔至游离壁(55例)。在1例中检测到左心室小梁肥厚。FTs为单条(79例)、双条(19例)、多条(2例)、短(42例)、长(58例)、粗(45例)和细(55例)。它们表现为膜样运动(粗FTs - 45例)和瓣膜样运动(细FTs - 55例)。在55例正常人中有50例检测到无害性杂音,与细FTs有关。在16例进行了解剖和组织学检查的病例中,12例FTs的远端部分为纤维性,近端部分为纤维 - 肌性,而4例则完全为纤维 - 肌性。所有病例中,超声检测到的FTs的位置和部位均经解剖证实。在4例中发现了超声心动图未检测到的另外9条FTs。这些数据表明,超声心动图是检测心室内FTs并将其与其他产生回声的结构区分开来的有用工具。虽然尚未发现FTs与心脏病之间的关系,但它们的存在可能是许多正常受试者无害性杂音的原因。