Diversity and determinants of the sigmoid septum and its impact on morphology of the outflow tract as revealed using cardiac computed tomography
Diversity and determinants of the sigmoid septum and its impact on morphology of the outflow tract as revealed using cardiac computed tomography
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DOI：
10.1111/echo.15298
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发表时间：
2022-01-17
影响因子：
1.5
通讯作者：
Hirata，Ken-ichi
中科院分区：
文献类型：
--
作者：
Tsuda，Daisuke;Mori，Shumpei;Hirata，Ken-ichi
BackgroundThe乙状结肠隔已普遍评价主观和定性，没有详细检查其多样性，左心室流出道（LVOT）的形态的影响，解剖background.MethodsWe纳入100例患者没有任何背景心脏疾病（67.5 ± 12.8岁，43%的妇女）进行心脏计算机断层扫描。使用前壁-上级和内侧膨胀角（基底隔相对于LVOT的双向成角）评价基底隔形态。LVOT的偏心率指数、面积狭窄率（LVOT/虚拟基底环面积），主动脉-左心室轴向角（主动脉根部相对于左心室的角度）和楔形高度结果左室前壁上级膨出、内侧膨出、主动脉-左室轴向角、左室流出道偏心指数、面积狭窄比、楔高分别为76° ± 17°、166° ± 27°、127° ± 9°、1.8 ± 0.5、1.0 ± 0.2和41.2 ± 9.1mm。两个凸出角度彼此相关，并导致LVOT变窄和变形。成角主动脉根部与双向间隔膨出或LVOT狭窄无关。主动脉根部旋转的回旋支旋转是突出的前房-上级间隔隆起的独立预测因素。深主动脉楔入是一个共同的独立预测双向septal bulk.ConclusionsThe程度的septal bulk. In正常心脏。沿着深主动脉楔入，基底隔的双向隆起变形并使LVOT变窄，而不影响虚拟基底环形态。
BackgroundThe sigmoid septum has been generally evaluated subjectively and qualitatively, without detailed examination of its diversity, impact on the morphology of the left ventricular outflow tract (LVOT), and anatomical background.MethodsWe enrolled 100 patients without any background cardiac diseases (67.5 ± 12.8 years old; 43% women) who underwent cardiac computed tomography. Basal septal morphology was evaluated using antero‐superior and medial bulging angles (bidirectional angulation of the basal septum relative to the LVOT). The eccentricity index of the LVOT, area narrowing ratio (LVOT/virtual basal ring area), aortic‐to‐left ventricular axial angle (angulation of the aortic root relative to the left ventricle), and wedged height (non‐coronary aortic sinus to inferior epicardium distance) were also quantified.ResultsThe antero‐superior bulging, medial bulging, aortic‐to‐left ventricular axial angles, LVOT eccentricity index, area narrowing ratio, and wedged height were 76° ± 17°, 166° ± 27°, 127° ± 9°, 1.8 ± 0.5, 1.0 ± 0.2, and 41.2 ± 9.1 mm, respectively. Both bulging angles were correlated with each other and contributed to the narrowing and deformation of the LVOT. Angulated aortic root was not correlated with either bidirectional septal bulge or LVOT narrowing. Clockwise rotation of the aortic root rotation was an independent predictor of prominent antero‐superior septal bulge. Deeper aortic wedging was a common independent predictor of bidirectional septal bulge.ConclusionsThe extent of septal bulge varies in normal hearts. Along with deep aortic wedging, the bidirectional bulge of the basal septum deforms and narrows the LVOT without affecting the virtual basal ring morphology.