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2066 Clefts can be seen in the basal inferior wall of the left ventricle and the interventricular septum in healthy volunteers as well as patients by cardiovascular magnetic resonance

  • Bengt Johansson1,
  • Alicia M Maceira1,
  • Sonya V Babu-Narayan1,
  • James C Moon1,
  • Dudley J Pennell1 and
  • Philip J Kilner1
Journal of Cardiovascular Magnetic Resonance200810(Suppl 1):A335

Published: 22 October 2008


Healthy VolunteerLeft VentricleCardiovascular Magnetic ResonanceHypertrophic CardiomyopathyInterventricular Septum


Indentations or crypts in the inferoseptal wall of the left ventricle have recently been reported in carriers of hypertrophic cardiomyopathy mutations.


To report the visibility of intramyocardial clefts in cardiovascular magnetic resonance (CMR) cine acquisitions in healthy volunteers and four patient groups.


CMR was performed in 399 adults for reasons other than the identification of intramyocardial clefts in 120 healthy volunteers, 91 patients with hypertrophic cardiomyopathy (HCM), 44 with systemic hypertension, 104 with repaired Tetralogy of Fallot (rToF) and 40 with relieved pulmonary stenosis (rPS). We reviewed the 2, 3 and 4-chamber long axis steady state free precession cines for discrete V-shaped extensions of blood signal penetrating >50% of the thickness of the compact myocardial wall of the left ventricle in diastole, interpreting these as clefts.


Single or, more rarely, paired clefts were seen in the basal inferior wall in 2-chamber cines in 7/120 volunteers (6%), 5/91 HCM patients (5.5%), 5/44 hypertensives (11.4%), 1/104 rToF patients (1%) and 9/40 rPS patients (22.5%). Clefts were seen in the interventricular septum in 24/399 (6%), most of these being adjacent to the insertions of trabecular bands.


Single or paired clefts are occasionally visible in routine CMR cine acquisitions in the basal inferior wall of the left ventricle and the interventricular septum in healthy volunteers as well as patients. Awareness of this may, in certain cases, avert unwarranted further investigation and anxiety.

Authors’ Affiliations

Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, UK


© Johansson et al; licensee BioMed Central Ltd. 2008

This article is published under license to BioMed Central Ltd.