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Agger P, Stephenson RS. Assessing Myocardial Architecture: The Challenges and Controversies. J Cardiovasc Dev Dis. 2020;7(4)doi: 10.3390/jcdd7040047.
Agger, P., & Stephenson, R. S. (2020). Assessing Myocardial Architecture: The Challenges and Controversies. Journal of cardiovascular development and disease, 7(4), . https://doi.org/10.3390/jcdd7040047
Agger, Peter, and Stephenson, Robert S. "Assessing Myocardial Architecture: The Challenges and Controversies." Journal of cardiovascular development and disease vol. 7,4 (2020). doi: https://doi.org/10.3390/jcdd7040047
Agger P, Stephenson RS. Assessing Myocardial Architecture: The Challenges and Controversies. J Cardiovasc Dev Dis. 2020 Oct 29;7(4). doi: 10.3390/jcdd7040047. PMID: 33137874; PMCID: PMC7711767.
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J Cardiovasc Dev Dis. 2020 Oct 29;7(4). doi: 10.3390/jcdd7040047.

Assessing Myocardial Architecture: The Challenges and Controversies.

Journal of cardiovascular development and disease

Peter Agger, Robert S Stephenson

Affiliations

  1. Comparative Medicine Lab, Department of Clinical Medicine, Aarhus University, 8220 Aarhus N, Denmark.
  2. Department of Pediatrics, Randers Regional Hospital, Skovlyvej 15, 8930 Randers NE, Denmark.
  3. Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK.

PMID: 33137874 PMCID: PMC7711767 DOI: 10.3390/jcdd7040047

Abstract

In recent decades, investigators have strived to describe and quantify the orientation of the cardiac myocytes in an attempt to classify their arrangement in healthy and diseased hearts. There are, however, striking differences between the investigations from both a technical and methodological standpoint, thus limiting their comparability and impeding the drawing of appropriate physiological conclusions from the structural assessments. This review aims to elucidate these differences, and to propose guidance to establish methodological consensus in the field. The review outlines the theory behind myocyte orientation analysis, and importantly has identified pronounced differences in the definitions of otherwise widely accepted concepts of myocytic orientation. Based on the findings, recommendations are made for the future design of studies in the field of myocardial morphology. It is emphasised that projection of myocyte orientations, before quantification of their angulation, introduces considerable bias, and that angles should be assessed relative to the epicardial curvature. The transmural orientation of the cardiomyocytes should also not be neglected, as it is an important determinant of cardiac function. Finally, there is considerable disagreement in the literature as to how the orientation of myocardial aggregates should be assessed, but to do so in a mathematically meaningful way, the normal vector of the aggregate plane should be utilised.

Keywords: diffusion tensor imaging; heart; methodology; micro computed tomography; myocardial aggregation; myocyte orientation; review

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