Author + information
- Received June 1, 2006
- Revision received August 29, 2006
- Accepted August 30, 2006
- Published online November 21, 2006.
- Partho P. Sengupta, MBBS, MD, DM⁎,
- Josef Korinek, MD⁎,
- Marek Belohlavek, MD, PhD, FACC, FESC⁎,
- Jagat Narula, MBBS, MD, DM, PhD, FACC, FAHA†,
- Mani A. Vannan, MBBS, FACC†,
- Arshad Jahangir, MD, FACC⁎ and
- Bijoy K. Khandheria, MD, FESC, FASE, FACC‡,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Bijoy K. Khandheria, Division of Cardiovascular Diseases, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, Arizona 85259.
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.
This work was supported by grant HL68573 and, in parts, grants HL68555 and HL70363 from the National Institutes of Health and a Grant-in-Aid from the American Society of Echocardiography.
- Received June 1, 2006.
- Revision received August 29, 2006.
- Accepted August 30, 2006.
- American College of Cardiology Foundation
- Left ventricular geometry
- Quantitative terms in LV mechanics
- Developmental changes
- Left ventricular architecture in adult life
- Electrical sequence in the adult heart
- Mechanical sequence of an adult heart
- Left ventricular mechanical sequence synchronizes the direction of blood flow
- Final comments