Freeman G L, LeWinter M M, Engler R L, Covell J W
Circ Res. 1985 Jan;56(1):31-9. doi: 10.1161/01.res.56.1.31.
Myocardial fiber orientation undergoes an orderly transition from the epicardium to the endocardium in the left ventricle, with circumferential fibers predominating in the middle one-third of the heart wall. How fibers lying at different depths in the myocardium, running in different directions, interact to produce local deformation is not known. To define the relationship between the orientation of uniaxial myocardial fibers and local wall motion, we placed three sets of ultrasonic dimension gauges in the middle one-third of the apex-to-base distance of the left ventricle of nine dogs. One pair was placed in line and two intentionally out of line with the presumed local fiber direction. The relative angle between the gauge and the local myofibers was determined by the use of postmortem radiography and histological techniques. Our results show that in the midwall of the left ventricle, myocardial segment shortening is maximal in the direction of local fibers; the shortening measured by gauges placed out of line with the local fiber axis by more than 30 degrees was significantly less than the actual in-line fiber shortening which occurred. This suggests that functional tethering between midwall fibers and endocardial or epicardial fibers does not play a major role in the pattern of midwall deformation. We also documented that an external reference line can be used to predict midwall myofiber direction. Using this line as a guide, ultrasonic dimension gauges could be placed within an average of 12 degrees (range: 0.5 to 18.5 degrees) from the local fiber axis.
在左心室中,心肌纤维的方向从心外膜到心内膜经历有序转变,圆周纤维在心脏壁的中间三分之一处占主导地位。心肌中不同深度、不同方向的纤维如何相互作用以产生局部变形尚不清楚。为了确定单轴心肌纤维的方向与局部壁运动之间的关系,我们在9只狗的左心室心尖到心底距离的中间三分之一处放置了三组超声尺寸测量仪。一对测量仪沿假定的局部纤维方向放置,另外两对故意与该方向不一致。通过死后放射摄影和组织学技术确定测量仪与局部肌纤维之间的相对角度。我们的结果表明,在左心室的中壁,心肌节段在局部纤维方向上的缩短最大;与局部纤维轴成30度以上角度放置的测量仪所测得的缩短明显小于实际发生的沿纤维方向的缩短。这表明中壁纤维与心内膜或心外膜纤维之间的功能束缚在中壁变形模式中不起主要作用。我们还证明了可以使用外部参考线来预测中壁肌纤维方向。以这条线为指导,超声尺寸测量仪可以放置在距局部纤维轴平均12度(范围:0.5至18.5度)以内。