Affiliation:
1. From the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Md; Department of Biomedical Engineering (H.A.), Technion IIT, Haifa, Israel; and the University of Antwerp (F.E.R.), Belgium.
Abstract
Background
Studies in anesthetized dogs have shown that myocardial fibers shorten ≈8%. However, in the endocardium, shortening occurs to a much greater extent at 90° to the fiber orientation (“cross-fiber shortening”) than it does along the fiber direction. The purpose of this study was to estimate the extent of fiber and cross-fiber shortening in the normal human left ventricle and in patients with idiopathic dilated cardiomyopathy (IDC).
Methods and Results
Ten normal subjects and nine patients with IDC were imaged with magnetic resonance tissue tagging. Finite strain analysis was used to calculate endocardial and epicardial shortening in the fiber and cross-fiber directions using anatomic fiber angles from representative autopsy specimens as references. Anatomic fiber angles were not different between normal subjects and IDC patients. Epicardial fiber strain was −0.14±0.01 in normal subjects and −0.08±0.01 in IDC patients (
P
<.0001 versus normal subjects). Epicardial cross-fiber strain was −0.08±0.01 in normal subjects and −0.06±0.01 in IDC patients (
P
=NS). Endocardial fiber strain was −0.16±0.01 in normal subjects and −0.09±0.01 in IDC patients (
P
<.0001), and endocardial cross-fiber strain was −0.26±0.01 in normal subjects and −0.15±0.01 in IDC patients (
P
<.0001). Cross-fiber shortening was greater than fiber shortening at the endocardium in both normal subjects (
P
<.0001) and IDC patients (
P
<.05).
Conclusions
In normal humans, the direction of maximal deformation aligns with the fiber direction in the epicardium but is perpendicular to the fiber direction in the endocardium. When strain in a coordinate system aligned to the fibers is estimated, cross-fiber shortening is found to be the dominant shortening strain at the endocardium. Normal fiber shortening is ≈15%, and this is markedly reduced in IDC. The normal transition in fiber orientation through the wall is not altered in IDC, and cross-fiber shortening is still the dominant strain at the endocardium, suggesting that interactions between myocardial layers persist in these patients.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
Cited by
130 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献