Mapping of the orientation of myocardial cells by means of polarized light and confocal scanning laser microscopy

The Myosin Myocardial Mesh Interpreted as a Biological Analogous of Nematic Chiral Liquid Crystals

There are still grey areas in the understanding of the myoarchitecture of the ventricular mass. This is despite the progress of investigation methods since the beginning of the 21st century (diffusion tensor magnetic resonance imaging, microcomputed tomography, and polarised light imaging). The objective of this article is to highlight the specificities and the limitations of polarised light imaging (PLI) of the unstained myocardium embedded in methyl methacrylate (MMA). Thus, to better differentiate our method from other PLI modes, we will refer to it by the acronym PLI-MMA. PLI-MMA shows that the myosin mesh of the compact left ventricular wall behaves like a biological analogous of a nematic chiral liquid crystal. Results obtained by PLI-MMA are: the main direction of the myosin molecules contained in an imaged voxel, the crystal liquid director n, and a regional isotropy index RI that is an orientation tensor, the equivalent of the crystal liquid order parameter. The vector n is collinear with the first eigenvector of diffusion tensor imaging (DTI-MRI). The RI has not been confounded with the diffusion tensor of DTI that gives information about the three eigenvectors of the ellipsoid of diffusion. PLI-MMA gives no information about the collagen network. The physics of soft matter has allowed the revisiting of Streeter’s conjecture on the myoarchitecture of the compact left ventricular wall: “geodesics on a nested set of toroidal surfaces”. Once the torus topology is understood, this characterisation of the myoarchitecture is more accurate and parsimonious than former descriptions. Finally, this article aims to be an enthusiastic invitation to a transdisciplinary approach between physicists of liquid crystals, anatomists, and specialists of imaging.

Polarized Microscopy Study of 10 Cases of Lichen Sclerosus Using Picro-Sirius Red Stain

Lichen sclerosus (LS) is a chronic mucocutaneous sclerosis most commonly affecting the genital area, although extragenital localizations have also been described1, with unknown pathogenesis.

Our study aims to analyze the morphopathological aspects of LS through the prism of polarized microscopy and with the help of histochemical information provided by special Van Gieson stain for elastic tissue and Picro-Sirius Red special stain.

Picro-Sirius Red staining allows observation of the type of collagen synthesized in pathological conditions such as LS, as well as the appearance of mature hyalinization through loss of elastic tissue, and also the disappearing of piloerectile muscles.

Polarized Light Imaging of the Myoarchitecture in Tetralogy of Fallot in the Perinatal Period

Background: The pathognomonic feature of tetralogy of Fallot (ToF) is the antero-cephalad deviation of the outlet septum in combination with an abnormal arrangement of the septoparietal trabeculations. Aims: The aim of this article was to study perinatal hearts using Polarized Light Imaging (PLI) in order to investigate the deep alignment of cardiomyocytes that bond the different components of the ventricular outflow tracts both together and to the rest of the ventricular mass, thus furthering the classic description of ToF. Methods and Materials: 10 perinatal hearts with ToF and 10 perinatal hearts with no detectable cardiac anomalies (control) were studied using PLI. The orientation of the myocardial cells was extracted and studied at high resolution. Virtual dissections in multiple section planes were used to explore each ventricular structure. Results and Conclusions: Contrary to the specimens of the control group, for all ToF specimens studied, the deep latitudinal alignment of the cardiomyocytes bonds together the left part of the Outlet septum (OS) S to the anterior wall of the left ventricle. In addition, the right end of the muscular OS bonds directly on the right ventricular wall (RVW) superior to the attachment of the ventriculo infundibular fold (VIF). Thus, the OS is a bridge between the lateral RVW and the anterior left ventricular wall. The VIF, RVW, and OS define an "inverted U" that roofs the cone between the interventricular communication and the overriding aorta. The opening angle and the length of the branches of this "inverted U" depend however on three components: the size of the OS, the size of the VIF, and the distance between the points of insertion of the OS and VIF into the RVW. The variation of these three components accounts for a significant part of the diversity observed in the anatomical presentations of ToF in the perinatal period.

Postnatal myocardium remodelling generates inhomogeneity in the architecture of the ventricular mass

Background

The 3D architecture of the ventricular mass is poorly known, although in vivo imaging techniques show the physiological inhomogeneity of ventricular walls mechanics. Polarized light imaging makes it possible to quantitatively analyse the myosin filament orientation.

Aims

In this paper, we focus on the study the 3D architecture and regional isotropy of myocardial cells.

Methods

Twenty normal human hearts, 10 from the perinatal period and 10 from the post-neonatal period were studied by polarized light microscopy. In each voxel of the ventricular mass (90 × 90 × 500 µm) the principal orientation segment was automatically and unambiguously extracted as well as a regional isotropy index (regional orientation tensor of the voxel neighbourhood).

Results

During the first months of postnatal age, the median regional isotropy values decreased in the ventricular mesh. This global decrease was not homogeneous across the ventricular walls. From the perinatal to the neonatal period, this decrease was more marked in the inner two-third of the lateral left ventricular wall and in the right part of the interventricular septum. There was a progressive post-neonatal appearance of a particularly inhomogeneous secondary arrangement of myocardial cells with alternation of thick low-RI and thin high-RI areas.

Conclusions

This study has shown a postnatal change in ventricular myocardial architecture, which became more inhomogeneous. The cell rearrangements responsible for the inhomogeneity in ventricular myocardial architecture are revealed by a variation of the regional isotropy index. These major changes are probably an adaptive consequence of the major haemodynamic changes occurring after birth during the neonatal period that generates major parietal stress variations and parietal remodelling.

Electronic supplementary material

The online version of this article (10.1007/s00276-017-1945-5) contains supplementary material, which is available to authorized users.

Study of myocardial cell inhomogeneity of the human heart: Simulation and validation using polarized light imaging

PURPOSE

The arrangement or architecture of myocardial cells plays a fundamental role in the heart's function and its change was shown to be directly linked to heart diseases. Inhomogeneity level is an important index of myocardial cell arrangements in the human heart. The authors propose to investigate the inhomogeneity level of myocardial cells using polarized light imaging simulations and experiments.

METHODS

The idea is based on the fact that the myosin filaments in myocardial cells have the same properties as those of a uniaxial birefringent crystal. The method then consists in modeling the myosin filaments of myocardial cells as uniaxial birefringent crystal, simulating the behavior of the latter by means of the Mueller matrix, and measuring the final intensity of polarized light and consequently the inhomogeneity level of myocardial cells in each voxel through the use of crossed polarizers. The method was evaluated on both simulated and real tissues and under various myocardial cell configurations including parallel cells, crossed cells, and cells with random orientations.

RESULTS

When myocardial cells run perfectly parallel to each other, all the polarized light was blocked by those parallel myocardial cells, and a high homogeneity level was observed. However, if myocardial cells were not parallel to each other, some leakage of the polarized light was observed, thus causing the decrease of the polarized light amplitude and homogeneity level. The greater the crossing angle between myocardial cells, the smaller the amplitude of the polarized light and the greater the inhomogeneity level. For two populations of myocardial cell crossing at an angle, the resulting azimuth angle of the voxel was the bisector of this angle. Moreover, the value of the inhomogeneity level began to decrease from a nonzero value when the voxel was not totally homogeneous, containing for example cell crossing.

CONCLUSIONS

The proposed method enables the physical information of myocardial tissues to be estimated and the inhomogeneity level of a volume or voxel to be quantified, which opens new ways to study the microstructures of the human myocardium and helps understanding how heart diseases modify myocardial cells and change their mechanical properties.

Polarized Microscopy in Lesions With Altered Dermal Collagen

Alterations in dermal collagen are noted in dermatofibroma, dermatofibrosarcoma protuberans, morphea, lichen sclerosus et atrophicus, hypertrophic scars, and keloids. The authors sought to determine whether variations in birefringence of collagen by polarized microscopy could be of help in diagnosing such conditions. Representative hematoxylin and eosin sections of 400 cases, including dermatofibroma, dermatofibrosarcoma protuberans, hypertrophic scars, keloid, morphea, and lichen sclerosus, were examined under polarized microscopy. Distinct patterns of birefringence of collagen for each disease were noted under polarized microscopy. This study highlights the use of polarized microscopy as adjunctive tool in differentiating different diseases with collagen alteration.

Cardiac fiber unfolding by semidefinite programming

Diffusion-tensor imaging allows noninvasive assessment of the myocardial fiber architecture, which is fundamental in understanding the mechanics of the heart. In this context, tractography techniques are often used for representing and visualizing cardiac fibers, but their output is only qualitative. We introduce here a new framework toward a more quantitative description of the cardiac fiber architecture from tractography results. The proposed approach consists in taking three-dimensional (3-D) fiber tracts as inputs, and then unfolding these fibers in the Euclidean plane under local isometry constraints using semidefinite programming. The solution of the unfolding problem takes the form of a Gram matrix which defines the two-dimensional (2-D) embedding of the fibers and whose spectrum provides quantitative information on their organization. Experiments on synthetic and real data show that unfolding makes it easier to observe and to study the cardiac fiber architecture. Our conclusion is that 2-D embedding of cardiac fibers is a promising approach to supplement 3-D rendering for understanding the functioning of the heart.

Studying dynamic events in the developing myocardium

Differentiation and conduction properties of the cardiomyocytes are critically dependent on physical conditioning both in vitro and in vivo. Historically, various techniques were introduced to study dynamic events such as electrical currents and changes in ionic concentrations in live cells, multicellular preparations, or entire hearts. Here we review this technological progress demonstrating how each improvement in spatial or temporal resolution provided answers to old and provoked new questions. We further demonstrate how high-speed optical mapping of voltage and calcium can uncover pacemaking potential within the outflow tract myocardium, providing a developmental explanation of ectopic beats originating from this region in the clinical settings.

Regional localisation of left ventricular sheet structure: integration with current models of cardiac fibre, sheet and band structure

The architecture of the heart remains controversial despite extensive effort and recent advances in imaging techniques. Several opposing and non-mutually compatible models have been proposed to explain cardiac structure, and these models, although limited, have advanced the study and understanding of heart structure, function and development. We describe key areas of similarity and difference, highlight areas of contention and point to the important limitations of these models. Recent research in animal models on the nature, geometry and interaction of cardiac sheet structure allows unification of some seemingly conflicting features of the structural models. Intriguingly, evidence points to significant inter-individual structural variability (within constrained limits) in the canine, leading to the concept of a continuum (or distribution) of cardiac structures. This variability in heart structure partly explains the ongoing debate on myocardial architecture. These developments are used to construct an integrated description of cardiac structure unifying features of fibre, sheet and band architecture that provides a basis for (i) explaining cardiac electromechanics, (ii) computational simulations of cardiac physiology and (iii) designing interventions.

Polarized light imaging of white matter architecture

Polarized light imaging (PLI) is a method to image fiber orientation in gross histological brain sections based on the birefringent properties of the myelin sheaths. The method uses the transmission of polarized light to quantitatively estimate the fiber orientation and inclination angles at every point of the imaged section. Multiple sections can be assembled into a 3D volume, from which the 3D extent of fiber tracts can be extracted. This article describes the physical principles of PLI and describes two major applications of the method: the imaging of white matter orientation of the rat brain and the generation of fiber orientation maps of the human brain in white and gray matter. The strengths and weaknesses of the method are set out.

Understanding stress concentration about a nutrient foramen

We investigated the microstructural basis of a reduced stress concentration around the primary nutrient foramen of the equine third metacarpus. We quantified the spatial variations of compositional parameters (mineral content, volume fraction, histological architecture, and osteonal trajectories) from microradiographs and polarizing microscopic images of thin sections. These variations in composition and organization in turn cause variations in mechanical properties of cortical bone. We modeled the spatially inhomogeneous anisotropic elastic properties based on the measured compositional parameters and used the properties as inputs to a finite element model of the bone containing the foramen. This model, spatially constructed solely from the microscopic images, was subsequently validated by our mechanical test results. We found that: (1) a primary mechanism for stress concentration reduction appears to be due to an increased compliance near the foramen: the sharp discontinuity represented by the hole is softened by embedding it in a compliant region; (2) a reinforcing ring of increased stiffness exists at some distance from the foramen; and (3) a ring of lamellar bone exists along the foramen inside edge, which might serve to reduce the chance of cracks forming there. Our work is allowing us to design biomimetic structures with holes by mimicking the microstructure near the nutrient foramen.

A model of the structural and functional development of the normal human fetal left ventricle based on a global growth law

The purpose of this research is to study the growth of the normal human left ventricle (LV) during the fetal period from 14 to 40 weeks of gestation. A new constitutive law for the active myocardium describing the mechanical properties of the active muscle during the whole cardiac cycle has been proposed. The LV model is a thick-walled, incompressible, hyperelastic cylinder, with families of helicoidal fibers running on cylindrical surfaces [1]. Based on the works of Lin and Taber [2] done on the embryonic chick heart, we use for the human fetal heart a growth law in which the growth rate depends on the wall stresses. The parameters of the growth law are adapted to agree with sizes and volumes inferred from two dimensional ultrasound measurements performed on 18 human fetuses.Then calculations are performed to extrapolate the cardiac performance during normal growth of the fetal LV. The results presented support the idea that a growth law in which the growth rate depends linearly on the mean wall stresses averaged through the space and during whole cardiac cycle, is adapted to the normal human fetal LV development.

Fibre Orientation in Human Fetal Heart and Ventricular Mechanics : A Small Perturbation Analysis

The study of the topological organisation of myocardial cells is a basic requirement for understanding the mechanical design of the normal and pathological heart. Anatomical observations show that cardiac muscle tissue has a highly specialized architecture. We have made new quantitative measurements of fibre orientation through the heart wall by means of polarized light analysis on some thick sections of human fetal heart embedded in a resin and polymerized. A small perturbation method to find an equilibrium solution in a cylindrical left ventricular (LV) geometry with fibres running on toroidal shells of revolution is used to investigate the mechanical behaviour of three human fetal hearts (FH) of 14, 20 and 33 weeks of gestational age. The results of fibre strains and stresses presented for end-systolic state show significant differences when compared to results of the cylindrical geometry with regular helicoidal fibres running on cylindrical surfaces. Moreover, the toroidal shells of revolution explain shear stresses and strains in the transverse plane which also exist in the adult heart.

Quantitative estimation of 3-D fiber course in gross histological sections of the human brain using polarized light

Series of polarized light images can be used to achieve quantitative estimates of the angles of inclination (z-direction) and direction (in xy-plane) of central nervous fibers in histological sections of the human brain. (1) The corpus callosum of a formalin-fixed human brain was sectioned at different angles of inclination of nerve fibers and at different thicknesses of the samples. The minimum, and maximum intensities, and their differences revealed a linear relationship to the angle of inclination of fibers. It was demonstrated that sections with a thickness of 80--120 microm are best suited for estimating the angle of inclination. (2) Afterwards the optic tracts of eight formalin-fixed human brains were sliced at different angles of fiber inclination at 100 microm. Measurements of intensity in 30 pixels in each section were used to calculate a linear function of calibration. The maximum intensities and the differences between maximum and minimum values measured with two polars only were best suited for estimation of fiber inclination. (3) Gross histological brain slices of formalin-fixed human brains were digitized under azimuths from 0 to 80 degrees using two polars only. These sequences were used to estimate the inclination of fibers (in z-direction). The same slices were digitized under azimuths from 0 to 160 degrees in steps of 20 degrees using a quarter wave plate additionally. These sequences were used to estimate the direction of the fibers in xy-direction. The method can be used to produce maps of fiber orientation in gross histological sections of the human brain similar to the fiber orientation maps derived by diffusion weighted magnetic resonance imaging.

Visualization of nerve fiber orientation in gross histological sections of the human brain

Diffusion weighted magnetic resonance imaging (DWMRI) allows visualization of the orientation of the nervous fibers in the living brain. For comparison, a method was developed to examine the orientation of fibers in histological sections of the human brain. Serial sections through the entire human brain were analyzed regarding fiber orientation using polarized light. Direction of fibers in the cutting plane was obtained by measuring the azimuth with the lowest intensity value at each point, and inclination of fibers in the section was evaluated using fuzzy logic approximations. Direction and inclination of fibers revealing their three-dimensional orientation were visualized by colored arrows mapped into the images. Using this procedure, various fiber tracts were identified (pyramidal tract, radiatio optica, radiatio acustica, arcuate fascicle, and 11 more). Intermingled fibers could be separated from each other. The orientation of the fiber tracts derived from polarized light microscopy was validated by confocal laser scanning microscopy in a defined volume of the internal capsule, where the fiber orientation was studied in four human brains. The polarization method visualizes the high degree of intermingled fiber bundles in the brain, so that distinct fiber pathways cannot be understood as solid, compact tracts: Neighbouring bundles of fibers can belong to different systems of fibers distinguishable by their orientation.

Developmental patterning of the myocardium

The heart in higher vertebrates develops from a simple tube into a complex organ with four chambers specialized for efficient pumping at pressure. During this period, there is a concomitant change in the level of myocardial organization. One important event is the emergence of trabeculations in the luminal layers of the ventricles, a feature which enables the myocardium to increase its mass in the absence of any discrete coronary circulation. In subsequent development, this trabecular layer becomes solidified in its deeper part, thus increasing the compact component of the ventricular myocardium. The remaining layer adjacent to the ventricular lumen retains its trabeculations, with patterns which are both ventricle- and species-specific. During ontogenesis, the compact layer is initially only a few cells thick, but gradually develops a multilayered spiral architecture. A similar process can be charted in the atrial myocardium, where the luminal trabeculations become the pectinate muscles. Their extent then provides the best guide for distinguishing intrinsically the morphologically right from the left atrium. We review the variations of these processes during the development of the human heart and hearts from commonly used laboratory species (chick, mouse, and rat). Comparison with hearts from lower vertebrates is also provided. Despite some variations, such as the final pattern of papillary or pectinate muscles, the hearts observe the same biomechanical rules, and thus share many common points. The functional importance of myocardial organization is demonstrated by lethality of mouse mutants with perturbed myocardial architecture. We conclude that experimental studies uncovering the rules of myocardial assembly are relevant for the full understanding of development of the human heart.

Mapping of fiber orientation in human internal capsule by means of polarized light and confocal scanning laser microscopy

The nervous fibers in the human internal capsule were mapped according to their three-dimensional orientation. Four human cadaver brains were cut into comparable and standardized sections parallel to the ACPC-plane, stained with DiI, and analyzed using a combination of confocal and polarized light microscopy at the same time. This combination provides information about the structure and orientation of the fibers in great detail with confocal microscopy, and information about the localization and orientation of long myelinated fiber tracts with polarization microscopy. The internal capsule was parcellated in the areas CI 1 to CI 4 containing fibers of distinct orientation and structure, which enriches the macroscopically definable parcellation in the anterior and posterior limb. Fibers of the anterior thalamic peduncle intermingle with frontopontine tract fibers. Single fibers connect the caudate and the lentiform nucleus. The pyramidal tract is located in the anterior half of the posterior limb intermingled with fibers of the superior thalamic peduncle. Parietooccipitopontine fibers are located in the posterior part of the posterior limb. The slopes of the different systems of fibers change continuously in the anterior posterior direction of the internal capsule. Using the 3D orientation of fibers as a criterion for parcellation, as well as the description of bundles as a collection of fibers belonging to particular tracts leads to a more function-related description of the anatomy of the internal capsule. The method can be used for interindividual, sex- or age-related comparisons of particular systems of fibers.

Remodeling of chick embryonic ventricular myoarchitecture under experimentally changed loading conditions

Adult myocardium adapts to changing functional demands by hyper- or hypotrophy while the developing heart reacts by hyper- or hypoplasia. How embryonic myocardial architecture adjusts to experimentally altered loading is not known. We subjected the chick embryonic hearts to mechanically altered loading to study its influence upon ventricular myoarchitecture. Chick embryonic hearts were subjected to conotruncal banding (increased afterload model), or left atrial ligation or clipping, creating a combined model of increased preload in right ventricle and decreased preload in left ventricle. Modifications of myocardial architecture were studied by scanning electron microscopy and histology with morphometry. In the conotruncal banded group, there was a mild to moderate ventricular dilatation, thickening of the compact myocardium and trabeculae, and spiraling of trabecular course in the left ventricle. Right atrioventricular valve morphology was altered from normal muscular flap towards a bicuspid structure. Left atrial ligation or clipping resulted in hypoplasia of the left heart structures with compensatory overdevelopment on the right side. Hypoplastic left ventricle had decreased myocardial volume and showed accelerated trabecular compaction. Increased volume load in the right ventricle was compensated primarily by chamber dilatation with altered trabecular pattern, and by trabecular proliferation and thickening of the compact myocardium at the later stages. A ventricular septal defect was noted in all conotruncal banded, and 25% of left atrial ligated hearts. Increasing pressure load is a main stimulus for embryonic myocardial growth, while increased volume load is compensated primarily by dilatation. Adequate loading is important for normal cardiac morphogenesis and the development of typical myocardial patterns.

Myoarchitecture and connective tissue in hearts with tricuspid atresia

OBJECTIVE

To compare the atrial and ventricular myoarchitecture in the normal heart and the heart with tricuspid atresia, and to investigate changes in the three dimensional arrangement of collagen fibrils.

METHODS

Blunt dissection and cell maceration with scanning electron microscopy were used to study the architecture of the atrial and ventricular musculature and the arrangement of collagen fibrils in three specimens with tricuspid atresia and six normal human hearts.

RESULTS

There were significant modifications in the myoarchitecture of the right atrium and the left ventricle, both being noticeably hypertrophied. The middle layer of the ventricle in the abnormal hearts was thicker than in the normal hearts. The orientation of the superficial layer in the left ventricle in hearts with tricuspid atresia was irregular compared with the normal hearts. Scanning electron microscopy showed coarser endomysial sheaths and denser perimysial septa in hearts with tricuspid atresia than in normal hearts.

CONCLUSIONS

The overall architecture of the muscle fibres and its connective tissue matrix in hearts with tricuspid atresia differed from normal, probably reflecting modelling of the myocardium that is inherent to the malformation. This is in concordance with clinical observations showing deterioration in pump function of the dominant left ventricle from very early in life.

Measuring collagen fiber orientation: a two-dimensional quantitative macroscopic technique

This paper describes the design, evaluation, and application of a new system for quantifying two-dimensional collagen fiber orientation in soft tissue. Series of transmitted polarized light images were collected using a custom-designed macroscope. Combined analysis of pixel brightness, and hue from images collected with a compensator plate, permitted the assignment of each pixel into the appropriate orientation band. Experiments were performed to quantify the linearity and noise of the system. Validation was performed on a specimen composed of strain-birefringent plastic strips at various orientations. Preliminary collagen fiber orientation data is presented from a tendon specimen. This study demonstrates the utility of this approach for studying collagen fiber orientation across large areas.

Developmental changes in the myocardial architecture of the chick

BACKGROUND

Numerous studies describing myocardial architecture have been performed on the adult heart but considerably fewer have been made during embryonic or fetal development. To serve as a basis for interspecies comparison of ventricular morphology, and as a reference for studying the effects of experimental perturbations, we examined the development of chick throughout the entire incubation period.

METHODS

Chick hearts from stage 14 (day 2) to stage 46 (day 21) were perfusion-fixed, and sectioned in transverse, frontal and sagittal planes. The ventricular myocardial architecture was examined and photographed in the scanning electron microscope.

RESULTS

At embryonic stage 16 and earlier, the smooth-walled heart loop had an outer myocardial mantle, cardiac jelly, and endocardium. From stage 18, there was an outer compact and inner trabeculated myocardium. Trabeculated myocardium could be subdivided into the outer (basal) portion adjacent to the compact layer and the central (luminal) part. The outer basal layer could be distinguished from the inner luminal by shorter and finer trabeculae with small, round intertrabecular spaces. From stage 24, the patterns of trabeculae and intertrabecular spaces were ventricle-specific. Between stages 24 to 31, abundant trabeculations were present throughout both ventricular cavities. The trabeculae were initially radially arranged, but later adopted a spiral course, which persisted in a simplified form into adulthood.

CONCLUSIONS

The ventricular myocardium undergoes distinctive morphogenesis, characterized by changes in trabecular patterning and orientation. We speculate that the embryonic trabecular architecture reflects the directions of the main stresses. Unlike fetal and adult hearts, which rely mostly on the compact myocardial layer, the trabeculae play a crucial role in the contractile function of the embryonic heart.