Left ventricular structure and function: basic science for cardiac imaging.
The myofiber geometry of the left ventricle (LV) changes gradually from a right-handed helix in the subendocardium to a left-handed helix in the subepicardium. In this review, we associate the LV myofiber architecture with emerging concepts of the electromechanical sequence in a beating heart. We discuss: 1) the morphogenesis and anatomical arrangement of muscle fibers in the adult LV; 2) the sequence of depolarization and repolarization; 3) the physiological inhomogeneity of transmural myocardial mechanics and the apex-to-base sequence of longitudinal and circumferential deformation; 4) the sequence of LV rotation; and 5) the link between LV deformation and the intracavitary flow direction observed during each phase of the cardiac cycle. Integrating the LV structure with electrical activation and motion sequences observed in vivo provides an understanding about the spatiotemporal sequence of regional myocardial performance that is essential for noninvasive cardiac imaging.
Sengupta
Partho P
PP
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
Korinek
Josef
J
Belohlavek
Marek
M
Narula
Jagat
J
Vannan
Mani A
MA
Jahangir
Arshad
A
Khandheria
Bijoy K
BK
D000375:Aging; D003326:Coronary Circulation; D003952:Diagnostic Imaging; D004562:Electrocardiography; D004594:Electrophysiology; D006321:Heart / Q000254:growth & development; D006352:Heart Ventricles / Q000033:anatomy & histology*; D006801:Humans; D009200:Myocardial Contraction; D016277:Ventricular Function, Left