title: The functional architecture of skeletal compared to cardiac musculature: Myocyte orientation, lamellar unit morphology, and the helical ventricular myocardial band.
abstract: How the cardiomyocytes are aggregated within the heart walls remains contentious. We still do not fully understand how the end-to-end longitudinal myocytic chains are arranged, nor the true extent and shape of the lamellar units they aggregate to form. In this article, we show that an understanding of the complex arrangement of cardiac musculature requires knowledge of three-dimensional myocyte orientation (helical and intrusion angle), and appreciation of myocyte packing within the connective tissue matrix. We show how visualization and segmentation of high-resolution three-dimensional image data can accurately identify the morphology and orientation of the myocytic chains, and the lamellar units. Some maintain that the ventricles can be unwrapped in the form of a "helical ventricular myocardial band," that is, as a compartmentalized band with selective regional innervation and deformation, and a defined origin and insertion like most skeletal muscles. In contrast to the simpler interpretation of the helical ventricular myocardial band, we provide insight as to how the complex myocytic chains, the heterogeneous lamellar units, and connective tissue matrix form an interconnected meshwork, which facilitates the complex internal deformations of the ventricular wall. We highlight the dangers of disregarding the intruding cardiomyocytes. Preparation of the band destroys intruding myocytic chains, and thus disregards the functional implications of the antagonistic auxotonic forces they produce. We conclude that the ventricular myocardium is not analogous to skeletal muscle, but is a complex three-dimensional meshwork, with a heterogeneous branching lamellar architecture.
authors.affiliation: Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Stephenson
authors.affiliation: Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Agger
authors.affiliation: Department of Experimental Thoracic and Cardiovascular Surgery, University Hospital Munster, Munster, DE, Germany.
authors.forename: Paul P
authors.initials: PP
authors.lastname: Lunkenheimer
authors.affiliation: Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand.
authors.forename: Jichao
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Cardiothoracic & Vascular Surgery, Aarhus University, Aarhus, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Smerup
authors.affiliation: Institute for Biomedical Engineering, University of Zurich, Zurich, CH, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Niederer
authors.affiliation: Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.|Division of Biomedical Sciences, University College London, London, United Kingdom.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Anderson
authors.affiliation: Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Jarvis
mesh_terms: D000818:Animals; D056324:Diffusion Tensor Imaging; D006321:Heart / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006329:Heart Conduction System / Q000033:anatomy & histology; D018482:Muscle, Skeletal / Q000166:cytology; D009206:Myocardium / Q000166:cytology*; D032383:Myocytes, Cardiac / Q000166:cytology*
keywords: cardiac muscle; lamellar units; myocyte orientation; three-dimensional meshwork