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Angled interventricular septum on echocardiography: anatomic anomaly or technical artifact?
Journal of the American College of Cardiology
|August 1, 1983
Summary
A specific transducer angle in echocardiography can create a false appearance of asymmetric septal hypertrophy. Two-dimensional echocardiography helps distinguish this artifact from true cardiac conditions.
Area of Science:
- Cardiovascular Imaging
- Echocardiography
- Cardiac Anatomy
Background:
- Asymmetric septal hypertrophy (ASH) is a cardiac condition.
- M-mode echocardiography can sometimes falsely suggest ASH due to geometric patterns.
- The angle of the interventricular septum relative to the aortic root can vary.
Purpose of the Study:
- To investigate if transducer angulation affects interventricular septal measurements.
- To determine the incidence of false-positive asymmetric septal hypertrophy on M-mode echocardiography.
- To assess the utility of two-dimensional echocardiography in identifying technical artifacts.
Main Methods:
- Prospective study of 45 subjects using two-dimensional and M-mode echocardiography.
- Parasternal views obtained from multiple intercostal spaces.
- Measurements of interventricular septal and posterior wall thickness compared between modalities and angulations.
Main Results:
- The angle between the aortic root and interventricular septum became more acute with lower intercostal spaces (p < 0.001).
- Septal thickness measurements significantly increased with lower intercostal spaces.
- M-mode echocardiography showed apparent ASH in 47% of subjects, but only 9% were confirmed by two-dimensional echocardiography.
Conclusions:
- Acutely angled interventricular septum on two-dimensional echocardiography can mimic ASH.
- Transducer positioning in lower intercostal spaces can create a technical artifact.
- Caution is advised when interpreting M-mode echocardiograms for ASH; two-dimensional echocardiography is crucial for artifact identification.