title: Myofiber Architecture of the Human Atria as Revealed by Submillimeter Diffusion Tensor Imaging.
abstract: BACKGROUND
  Accurate knowledge of the human atrial fibrous structure is paramount in understanding the mechanisms of atrial electric function in health and disease. Thus far, such knowledge has been acquired from destructive sectioning, and there is a paucity of data about atrial fiber architecture variability in the human population.
  
  
  RESULTS
  In this study, we have developed a customized 3-dimensional diffusion tensor magnetic resonance imaging sequence on a clinical scanner that makes it possible to image an entire intact human heart specimen ex vivo at submillimeter resolution. The data from 8 human atrial specimens obtained with this technique present complete maps of the fibrous organization of the human atria. The findings demonstrate that the main features of atrial anatomy are mostly preserved across subjects although the exact location and orientation of atrial bundles vary. Using the full tractography data, we were able to cluster, visualize, and characterize the distinct major bundles in the human atria. Furthermore, quantitative characterization of the fiber angles across the atrial wall revealed that the transmural fiber angle distribution is heterogeneous throughout different regions of the atria.
  
  
  CONCLUSIONS
  The application of submillimeter diffusion tensor magnetic resonance imaging provides an unprecedented level of information on both human atrial structure, as well as its intersubject variability. The high resolution and fidelity of this data could enhance our understanding of structural contributions to atrial rhythm and pump disorders and lead to improvements in their targeted treatment.
authors.affiliation: From the Departments of Biomedical Engineering (F.P., D.A.H., N.A.T., E.R.M.), Medicine (H.A.), and Radiology (S.M., E.R.M), Johns Hopkins University, Baltimore, MD; Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD (N.G, D.A.B.); and Departments of Bioengineering, Medicine, and Radiology, University of California, San Diego (E.R.M.).
authors.forename: Farhad
authors.initials: F
authors.lastname: Pashakhanloo
authors.affiliation: From the Departments of Biomedical Engineering (F.P., D.A.H., N.A.T., E.R.M.), Medicine (H.A.), and Radiology (S.M., E.R.M), Johns Hopkins University, Baltimore, MD; Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD (N.G, D.A.B.); and Departments of Bioengineering, Medicine, and Radiology, University of California, San Diego (E.R.M.).
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Herzka
authors.affiliation: From the Departments of Biomedical Engineering (F.P., D.A.H., N.A.T., E.R.M.), Medicine (H.A.), and Radiology (S.M., E.R.M), Johns Hopkins University, Baltimore, MD; Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD (N.G, D.A.B.); and Departments of Bioengineering, Medicine, and Radiology, University of California, San Diego (E.R.M.).
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ashikaga
authors.affiliation: From the Departments of Biomedical Engineering (F.P., D.A.H., N.A.T., E.R.M.), Medicine (H.A.), and Radiology (S.M., E.R.M), Johns Hopkins University, Baltimore, MD; Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD (N.G, D.A.B.); and Departments of Bioengineering, Medicine, and Radiology, University of California, San Diego (E.R.M.).
authors.forename: Susumu
authors.initials: S
authors.lastname: Mori
authors.affiliation: From the Departments of Biomedical Engineering (F.P., D.A.H., N.A.T., E.R.M.), Medicine (H.A.), and Radiology (S.M., E.R.M), Johns Hopkins University, Baltimore, MD; Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD (N.G, D.A.B.); and Departments of Bioengineering, Medicine, and Radiology, University of California, San Diego (E.R.M.).
authors.forename: Neville
authors.initials: N
authors.lastname: Gai
authors.affiliation: From the Departments of Biomedical Engineering (F.P., D.A.H., N.A.T., E.R.M.), Medicine (H.A.), and Radiology (S.M., E.R.M), Johns Hopkins University, Baltimore, MD; Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD (N.G, D.A.B.); and Departments of Bioengineering, Medicine, and Radiology, University of California, San Diego (E.R.M.).
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.affiliation: From the Departments of Biomedical Engineering (F.P., D.A.H., N.A.T., E.R.M.), Medicine (H.A.), and Radiology (S.M., E.R.M), Johns Hopkins University, Baltimore, MD; Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD (N.G, D.A.B.); and Departments of Bioengineering, Medicine, and Radiology, University of California, San Diego (E.R.M.).
authors.forename: Natalia A
authors.initials: NA
authors.lastname: Trayanova
authors.affiliation: From the Departments of Biomedical Engineering (F.P., D.A.H., N.A.T., E.R.M.), Medicine (H.A.), and Radiology (S.M., E.R.M), Johns Hopkins University, Baltimore, MD; Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD (N.G, D.A.B.); and Departments of Bioengineering, Medicine, and Radiology, University of California, San Diego (E.R.M.). emcveigh@ucsd.edu.
authors.forename: Elliot R
authors.initials: ER
authors.lastname: McVeigh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000473:pathology*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009210:Myofibrils / Q000473:pathology*; D015203:Reproducibility of Results; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis*
keywords: arrhythmias, cardiac; atrial function; atrial myoarchitecture; diffusion magnetic resonance imaging; diffusion tensor imaging; fiber orientation; heart atria