A reappraisal of the prevalence and clinical importance of left ventricular false tendons in children and adults.

Abstract

SUMMARY The prevalence and clinical importance of false tendons were studied in 488 consecutive patients referred for echocardiography. Two hundred and eighty three (58%) patients had acquired heart disease, 91 (19%) had congenital heart disease, and 114 (23%) had normal hearts. Sixty six patients with normal hearts had innocent systolic murmurs and one had recurrent ventricular tachycardia. The overall prevalence of false tendons was 25% compared with 1 6% in a retrospective analysis of 763 cross sectional echocardiograms. When patients with innocent murmurs were excluded from statistical analysis, there was no significant difference in the prevalence of these tendons between children and adults, boys and girls, men and women, or between patients with acquired or congenital heart disease and normal patients. The prevalence of false tendons in patients with dilated left ventricles (57%), however, resembled that seen in necropsy studies. The prevalence of false tendons in patients with an innocent systolic murmur was 76% in children and 40% in adults, with an overall prevalence of 52%.False tendons are a common echocardiographic finding of no clinical importance except for their possible role in the genesis of innocent murmurs and ventricular arrhythmias. The echocardiographic detection of false tendons increases considerably when these structures are specifically sought and in conditions that result in left ventricular chamber dilatation.The echocardiographic features of left ventricular false tendons have been reported,`and the reliability of cross sectional echocardiography in the recognition of false tendons has been established.4 In a recent morphological study these left ventricular bands were found in 48% of children and 52% of adults.5 The reported prevalence of false tendons in patients referred for echocardiography, however, has varied widely between 0-4% to 61% (Table 1). We have re-evaluated the prevalence, location, and clinical importance of false tendons in patients referred for echocardiography and have attempted to explain the major discrepancies between morphological studies and most echocardiographic studies.

Echocardiographic and morphologic examination of left ventricular false tendons in human and animal hearts

“…In gross anatomic studies, however, the prevalence of false tendons is more consistent: 46 -55% (Okamoto et al, 1981;Di Gregorio et al, 1983;Neri et al, 1984;Malouf et al, 1986;Suwa et al, 1984Suwa et al, , 1988Cocchieri and Bardelli, 1992). We examined eight human hearts and found false tendons in five (62.5%).…”

Left ventricular false tendons: echocardiographic characteristics in the Polish population

“…The prevalence of FT in a prospective echocardiographic study of 488 subjects, published in 1986, amounted to 25%. In a group of subjects with an innocent systolic murmur, the prevalence was as high as 76% in children, whereas in adults it was lower (40%) [17]. Of note, in the same study, the prevalence was substantially lower when assessed retrospectively (1.6% of 763 echocardiograms).…”

“…In our group of 1,679 adult subjects, the prevalence of FT was 6%, i.e. relatively low, when compared to adult population of the study of Malouf et al [17].…”

“…It is described in 40-62% of the examined hearts depending on age and additional heart abnormalities. On echocardiography, the range is much wider, depending mainly on study design and age group, ranging 1.6-78% [11,17,21]. The prevalence of FT in a prospective echocardiographic study of 488 subjects, published in 1986, amounted to 25%.…”

False Tendons in the Left Ventricle

“…producing structures like thrombi, thickened interventri cular septum, subvalvular membranes, and vegetations [3,9,[11][12][13][14][15][16],…”