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Francesc Carreras, Jaume Garcia, Debora Gil, Sandra Pujadas, Chi ho Lion, R.Suarez-Arias, et al. (2012). "Left ventricular torsion and longitudinal shortening: two fundamental components of myocardial mechanics assessed by tagged cine-MRI in normal subjects " . International Journal of Cardiovascular Imaging, 28(2), 273–284.
Abstract: Cardiac magnetic resonance imaging (Cardiac MRI) has become a gold standard diagnostic technique for the assessment of cardiac mechanics, allowing the non-invasive calculation of left ventric- ular long axis longitudinal shortening (LVLS) and absolute myocardial torsion (AMT) between basal and apical left ventricular slices, a movement directly related to the helicoidal anatomic disposition of the myocardial fibers. The aim of this study is to determine AMT and LVLS behaviour and normal values from a group of healthy subjects. A group of 21 healthy volunteers (15 males) (age: 23–55 y.o., mean:30.7 ± 7.5) were prospectively included in an obser- vational study by Cardiac MRI. Left ventricular rotation (degrees) was calculated by custom-made software (Harmonic Phase Flow) in consecutive LV short axis planes tagged cine-MRI sequences. AMT was determined from the difference between basal and apical planes LV rotations. LVLS (%) was determined from the LV longitudinal and horizontal axis cine-MRI images. All the 21 cases studied were interpretable, although in three cases the value of the LV apical rotation could not be determined. The mean rotation of the basal and apical planes at end-systole were -3.71° ± 0.84° and 6.73° ± 1.69° (n:18) respectively, resulting in a LV mean AMT of 10.48° ± 1.63° (n:18). End-systolic mean LVLS was 19.07 ± 2.71%. Cardiac MRI allows for the calculation of AMT and LVLS, fundamental functional components of the ventricular twist mechanics conditioned, in turn, by the anatomical helical layout of the myocardial fibers. These values provide complementary information about systolic ventricular function in relation to the traditional parameters used in daily practice.
Keywords: Magnetic resonance imaging (MRI); Tagging MRI; Cardiac mechanics; Ventricular torsion
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Alberto Hidalgo, Ferran Poveda, Enric Marti, Debora Gil, Albert Andaluz, Francesc Carreras, et al. (2012). "Evidence of continuous helical structure of the cardiac ventricular anatomy assessed by diffusion tensor imaging magnetic resonance multiresolution tractography " . European Radiology, 3(1), 361–362.
Abstract: Deep understanding of myocardial structure linking morphology and func- tion of the heart would unravel crucial knowledge for medical and surgical clinical procedures and studies. Diffusion tensor MRI provides a discrete measurement of the 3D arrangement of myocardial fibres by the observation of local anisotropic
diffusion of water molecules in biological tissues. In this work, we present a multi- scale visualisation technique based on DT-MRI streamlining capable of uncovering additional properties of the architectural organisation of the heart. Methods and Materials: We selected the John Hopkins University (JHU) Canine Heart Dataset, where the long axis cardiac plane is aligned with the scanner’s Z- axis. Their equipment included a 4-element passed array coil emitting a 1.5 T. For DTI acquisition, a 3D-FSE sequence is apply. We used 200 seeds for full-scale tractography, while we applied a MIP mapping technique for simplified tractographic reconstruction. In this case, we reduced each DTI 3D volume dimensions by order- two magnitude before streamlining.
Our simplified tractographic reconstruction method keeps the main geometric features of fibres, allowing for an easier identification of their global morphological disposition, including the ventricular basal ring. Moreover, we noticed a clearly visible helical disposition of the myocardial fibres, in line with the helical myocardial band ventricular structure described by Torrent-Guasp. Finally, our simplified visualisation with single tracts identifies the main segments of the helical ventricular architecture.
DT-MRI makes possible the identification of a continuous helical architecture of the myocardial fibres, which validates Torrent-Guasp’s helical myocardial band ventricular anatomical model.
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Ferran Poveda, Enric Marti, Debora Gil, Francesc Carreras, & Manel Ballester. (2012). "Helical Structure of Ventricular Anatomy by Diffusion Tensor Cardiac MR Tractography " . Journal of American College of Cardiology, 5(7), 754–755.
Abstract: It is widely accepted that myocardial fiber architecture plays a critical role in myocardial contractility and relaxation (1). However, there is a lack of consensus about the distribution of the myocardial fibers and their spatial arrangement in the left and right ventricles. An understanding of the cardiac architecture should benefit the ventricular functional assessment, left ventricular reconstructive surgery planning, or resynchronization therapy in heart failure. Researchers have proposed several conceptual models to describe the architecture of the heart, ranging from gross dissection to histological presentation. The cardiac mesh model (2) proposes that the myocytes are arranged longitudinally and radially change their angulation along the myocardial depth. By contrast, the helical ventricular myocardial model states that the ventricular myocardium is a continuous anatomical helical layout of myocardial fibers (1
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