Congenital left ventricular wall abnormalities in adults detected by gated cardiac multidetector computed tomography: Clefts, aneurysms, diverticula and terminology problems

Erol, Cengiz; Koplay, Mustafa; Olcay, Ayhan; Kivrak, Ali Sami; Özbek, Seda; Şeker, Mehmet; Paksoy, Yahya

doi:10.1016/j.ejrad.2012.03.025

Cited by 31 publications

(44 citation statements)

References 19 publications

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“…1 The depth of clefts is also of interest, with a case-control study of HCM gene carriers and healthy controls (non-gene-carrying family members) showing that the gene carriers had deeper clefts, penetrating to 74% of the myocardium in comparison with 59% in controls (P<0.01). The presence of ≥3 clefts was highly specific for being a HCM gene carrier in this study.…”

Section: Discussionmentioning

confidence: 99%

Multiple Myocardial Clefts on Cardiac Magnetic Resonance Imaging

McGorrian

O’Hanlon²,

Galvin

et al. 2013

Circulation

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Section: Discussionmentioning

confidence: 99%

Multiple Myocardial Clefts on Cardiac Magnetic Resonance Imaging

McGorrian

O’Hanlon²,

Galvin

et al. 2013

Circulation

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“…Although they were first identified macroscopically at autopsy in cases of HCM [5] they have subsequently been reported in a wide variety of cardiac diseases [6,7], as well as normal control subjects [8–10]. Microscopically described in the context of HCM, crypts are seen to extend inwards from the endocardial surface, lined by endocardium ending in a blind pocket [9] within areas of marked fascicular disarray [10].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of myocardial crypts in a large retrospective cohort study by cardiovascular magnetic resonance

Child

Muhr

Sammut

et al. 2014

Journal of Cardiovascular Magnetic Resonance

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BackgroundMyocardial crypts are discrete clefts or fissures in otherwise compacted myocardium of the left ventricle (LV). Recent reports suggest a higher prevalence of crypts in patients with hypertrophic cardiomyopathy (HCM) and also within small samples of genotype positive but phenotype negative relatives. The presence of a crypt has been suggested to be a predictor of gene carrier status. However, the prevalence and clinical significance of crypts in the general population is unclear. We aimed to determine the prevalence of myocardial crypts in a large cohort of subjects using clinical cardiovascular magnetic resonance (CMR).MethodsConsecutive subjects referred for clinical CMR during a 12-month period (n = 1020, age 52.6 ± 17, males: 61%) were included. Crypts were defined as >50% invagination into normal myocardium and their overall prevalence, location and shape was investigated and compared between different patient groups.ResultsThe overall prevalence of crypts was 64/1020 (6.3%). In a predefined ‘normal’ control group the prevalence was lower (11/306, 3.6%, p = 0.031), but were equally prevalent in ischemic heart disease (12/236, 5.1%, p = n/s) and the combined non-ischemic cardiomyopathy (NICM) groups (24/373; 6.4%, p = n/s). Within the NICM group, crypts were significantly more common in HCM (9/76, 11.7%, p = 0.04) and hypertensive CM subjects (3/11, 27%, p = 0.03). In patients referred for CMR for family screening of inherited forms of CM, crypts were significantly more prevalent (10/41, 23%, p < 0.001), including a smaller group with a first degree relative with HCM (3/9, 33%, p = 0.01).ConclusionMyocardial crypts are relatively common in the normal population, and increasingly common in HCM and hypertensive cardiomyopathy. Crypts are also more frequently seen in normal phenotype subjects referred because of a family history of an inherited cardiomyopathy and HCM specifically. It is uncertain what the significance of crypts are in this group, and because of variability in the imaging protocols used and their relative frequency within the normal population, should not be used to clinically stratify these patients. Prospective studies are required to confirm the clinical significance of myocardial crypts, as their significance remains unclear.Electronic supplementary materialThe online version of this article (doi:10.1186/s12968-014-0066-0) contains supplementary material, which is available to authorized users.

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“…1A-D). Multidetector row CT is a noninvasive tool with a high spatial resolution able to exclude CAD, to identify the composition of an eventual plaque and to evaluate cardiac structures besides the coronary arteries [9] (Fig. 2A-F).…”

Section: Discussionmentioning

confidence: 99%

“…The muscular type is more frequent and not prone to rupture [10,12]. It is usually associated with other congenital malformations, particularly with Cantrell's syndrome [9,[13][14][15]. The fibrous diverticulum is usually located either in the base of the heart or in the subvalvular area, leading to possible aortic or mitral regurgitation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Congenital left ventricular diverticulum: Multimodality imaging evaluation and literature review

Romagnoli

Ricci

Morosetti

et al. 2015

Journal of the Saudi Heart Association

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Congenital ventricular diverticulum is a rare cardiac malformation. We present the case of a 57-year-old man who underwent cardiac catheterization for suspected unstable angina. No coronary artery disease was diagnosed and a left ventricular diverticulum was incidentally found. Coronary CT and cardiac MRI were performed in order to confirm the diagnosis of a muscular type diverticulum and to exclude a post-ischemic aneurysm.

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Congenital left ventricular wall abnormalities in adults detected by gated cardiac multidetector computed tomography: Clefts, aneurysms, diverticula and terminology problems

Cited by 31 publications

References 19 publications

Multiple Myocardial Clefts on Cardiac Magnetic Resonance Imaging

Multiple Myocardial Clefts on Cardiac Magnetic Resonance Imaging

Prevalence of myocardial crypts in a large retrospective cohort study by cardiovascular magnetic resonance

Congenital left ventricular diverticulum: Multimodality imaging evaluation and literature review

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