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Aminu AJ, Chen W, Yin Z, Kuniewicz M, Walocha J, Perde F, Molenaar P, Iaizzo PA, Dobrzynski H, Atkinson AJ. Novel micro-computed tomography contrast agents to visualise the human cardiac conduction system and surrounding structures in hearts from normal, aged, and obese individuals. TRANSLATIONAL RESEARCH IN ANATOMY 2022. [DOI: 10.1016/j.tria.2022.100175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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2
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Erdem B, Tutar T, Takci L, Akaydin Bozkurt Y, Ateş S. Morphology of septomarginal trabeculae in Hatay mountain gazelle (Gazella gazella). Anat Histol Embryol 2021; 51:189-196. [PMID: 34927745 DOI: 10.1111/ahe.12777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/26/2021] [Accepted: 12/09/2021] [Indexed: 11/29/2022]
Abstract
This study was conducted to reveal the anatomical and histological features of left and right septomarginal trabeculae in the heart of the Hatay mountain gazelle. In the study, two female and two male adult Hatay mountain gazelle hearts were used. For this purpose, the materials detected in 10% formaldehyde solution were stained with Crossman's modified triple staining technique and examined under a light microscope after anatomical examinations and measurements were made. The presence of trabeculae in both ventricles was demonstrated. While the number of septomarginal trabeculae was 1 in each of the samples in the right ventricle, it was determined that it was 2 in each of three hearts and 3 in one heart in the left ventricle. It was observed that the right trabeculae were unbranched and fleshy, while the left trabeculae were filamentous and mostly branched. The lengths and thicknesses of the right trabeculae were measured 12-17 mm and 3-4 mm and the lengths and thicknesses of the left trabeculae were measured 6-15 mm and 0.5-1 mm. In the histological examination of both trabeculae, connective tissue, Purkinje fibres and blood vessels were observed, in addition, it was detected that the right trabeculae had myocardial fibres. Few capillaries were found in the left trabecula, while both more capillaries and blood vessels were found in the right trabeculae.
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Affiliation(s)
- Baran Erdem
- Department of Anatomy, Faculty of Veterinary Medicine, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Tolga Tutar
- Department of Histology and Embryology, Faculty of Veterinary Medicine, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Lutfi Takci
- Faculty of Veterinary Medicine, Department of Anatomy, Sivas Cumhuriyet University, Sivas, Turkey
| | - Yeşim Akaydin Bozkurt
- Department of Histology and Embryology, Faculty of Veterinary Medicine, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Sevinç Ateş
- Department of Anatomy, Faculty of Veterinary Medicine, Hatay Mustafa Kemal University, Hatay, Turkey
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Meetham K, Taerujjirakul T, Garitjirapath N, Navic P, Shinlapawittayatorn K, Mahakkanukrauh P. The morphometric study of the moderator band in Thais. Anat Sci Int 2021; 97:188-196. [PMID: 34825348 DOI: 10.1007/s12565-021-00641-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Abstract
A moderator band, also known as the septomarginal trabecula, is a group of muscle bundles located in the ventricle of almost all human hearts. The morphology of the moderator band has various forms and several studies have focused mostly on its structure. Thus, in the present study, we sought to study the morphology and morphometry of the moderator band and tried to rearrange the criteria based on the previous studies to classify the moderator band in Thais. The study investigated 67 formalin-fixed human hearts of both sexes obtained from Thai donors aged 24-101 years with mean age at death 69.92 years. The moderator band was evident in 66 of the 67 specimens (98.51%). The moderator band had the mean or median of overall length, thickness, distance to the base of the tricuspid valve, distance to the base of the pulmonary valve, distance to the apex of the right ventricle, the angle at the septal connection, and angle of the papillary, which were 18.9 ± 6.4 mm, 3.17 (2.04-4.55) mm, 33.0 ± 7.97 mm, 38.8 ± 9.62 mm, 56.4 ± 8.09 mm, 50 (30-105)°, 73.9 ± 30.1°, respectively. The mean distance originating point from the supraventricular crest to the anterior papillary muscle was 0.396 ± 0.07 of the distance from the base of the tricuspid valve to the apex of the right ventricle. Our present classification found that crest-like and thick moderator band with complex secondary branching at high origin (type IVc), and low origin (type IVd) were the most common subtypes. This study provided both anatomical and clinical information that should be useful in cardiac surgery, radiology, and cardiac electrophysiological interventions.
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Affiliation(s)
- Kantapit Meetham
- Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | | | | | - Pagorn Navic
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Krekwit Shinlapawittayatorn
- Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.,Cardiac Electrophysiology Research and Training (CERT) Center, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Pasuk Mahakkanukrauh
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand. .,Excellence in Osteology Research and Training Center (ORTC), Chiang Mai University, Chiang Mai, 50200, Thailand.
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Supraventricular crest: Structure, function and implications for surgical resection in tetralogy of Fallot. INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE 2021. [DOI: 10.1016/j.ijcchd.2021.100112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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5
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Drábková Z, Amory H, Kabeš R, Melková P, van Loon G. Partial atrioventricular septal defect in an adult sport horse. J Vet Cardiol 2020; 31:8-14. [PMID: 32858392 DOI: 10.1016/j.jvc.2020.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 06/01/2020] [Accepted: 06/22/2020] [Indexed: 11/25/2022]
Abstract
A partial atrioventricular septal defect, represented as a large ostium primum atrial septal defect and common (bridging) atrioventricular valve leaflets with cleft septal leaflet of the mitral valve, was diagnosed incidentally in a nine-year-old warmblood gelding used for show jumping. Initial examination findings and a three-year follow-up are documented in this report. The horse was first presented for the evaluation of chronic coughing. A left-sided, grade 4/6 holosystolic (band-shaped) murmur was identified along with a similar right-sided, grade 3/6 heart murmur. Echocardiography revealed a 6.4 cm diameter communication in the ventral atrial septum, considered an ostium primum atrial septal defect, with bidirectional shunting. A hypertrophic septomarginal trabecula, a thickened tricuspid valve, a cleft septal leaflet of the mitral valve, moderate mitral and tricuspid regurgitation likely related to leaflet prolapse, mild aortic regurgitation, and signs of moderate right ventricular volume overload were found as well. Electrocardiography showed no arrhythmias neither at rest nor during treadmill exercise. The owner continued to use the horse for show jumping. No exercise intolerance or other signs of disease were noted. Follow-up examination was performed three years after initial presentation. Contrast echocardiography confirmed the presence of right-to-left shunting through the atrial septal defect. Compared with the initial examination, the left ventricular internal diameter on M-mode echocardiography had increased. Occasional ventricular premature depolarizations were noted on the resting and exercise electrocardiogram. This is the first description of a clinically asymptomatic partial atrioventricular septal defect in an adult sport horse.
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Affiliation(s)
- Z Drábková
- Equine Clinic, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, Palackeho Trida 1946/1, 61242 Brno, Czech Republic.
| | - H Amory
- Equine Teaching Hospital, Clinical Department of Companion Animals and Equids, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, Avenue de Cureghem 7b, B-4000 Liège, Belgium
| | - R Kabeš
- Equine Clinic, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, Palackeho Trida 1946/1, 61242 Brno, Czech Republic
| | - P Melková
- Equine Clinic, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, Palackeho Trida 1946/1, 61242 Brno, Czech Republic
| | - G van Loon
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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Fontaine GH, Li G, Saguner AM, Frank R. Mechanisms of torsade de pointes tachycardia in patients with spontaneous high-degree atrioventricular block: A modern look at old data. J Electrocardiol 2019; 56:55-63. [PMID: 31295680 DOI: 10.1016/j.jelectrocard.2019.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 05/01/2019] [Accepted: 05/17/2019] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The mechanisms of torsade de pointes tachycardia (TdP) are incompletely understood. We aimed to investigate the mechanisms underlying TdP tachycardia in patients with spontaneous high-degree atrioventricular block (AVB). METHODS AND RESULTS This retrospective study reviewed old TdP recordings after ventricular temporary pacing interruption in 16 patients with spontaneous high-degree AVB. Five of them had also bipolar endocardial right ventricular (RV) apex recordings. The QT interval during AVB at a mean heart rate of 38.9 ± 7.5 bpm was 653.0 ± 67.2 ms. The critical coupling interval (CCI) between the last escape QRS during AVB and the first premature ventricular complex (PVC) was significantly shorter before the onset of TdP than before single PVCs and couplets. A morphologic crescendo of the escape T wave was observed before the onset of TdP, followed by a rhythmic and morphologic crescendo of PVCs. The escape RV apex electrograms (EGMs) showed the constant pattern of a rapid deflection similar to a Purkinje potential 40 to 80 ms after the onset of the QRS, superimposed on a smooth low amplitude signal in 4 out of 5 patients. CONCLUSIONS The major endocardial T wave prolongation and augmentation (morphologic crescendo) of the escape beat prior to the first PVC suggests a phase 2 reentry mechanism due to early afterdepolarization. The induced TdP can be due to the changing outputs from one or two simultaneous RV moving reentry circuits between depressed fibers and fast conducting ones, possibly located in the thin crista supraventricularis structure which has several connections with the septum and the RV free wall.
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Affiliation(s)
- Guy H Fontaine
- Institut de Cardiologie, Unité de Rythmologie, Hôpital Universitaire La Pitié-Salpêtrière, 47-83 boulevard de l'Hôpital, 75651 Paris, France
| | - Guoliang Li
- Institut de Cardiologie, Unité de Rythmologie, Hôpital Universitaire La Pitié-Salpêtrière, 47-83 boulevard de l'Hôpital, 75651 Paris, France; Arrhythmia Unit, Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an 710061, China
| | - Ardan M Saguner
- Department of Cardiology, University Heart Center Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
| | - Robert Frank
- Institut de Cardiologie, Unité de Rythmologie, Hôpital Universitaire La Pitié-Salpêtrière, 47-83 boulevard de l'Hôpital, 75651 Paris, France.
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8
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Cope LA. Multiple ventricular bands and the associated trabecula septomarginalis dextra in the right ventricle of the domestic dog (
Canis familiaris
). Anat Histol Embryol 2019; 48:397-403. [DOI: 10.1111/ahe.12451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 02/18/2019] [Accepted: 04/26/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Lee Anne Cope
- Division of Biomedical Sciences Mercer University School of Medicine Macon Georgia
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Lee JY, Hur MS. Morphological classification of the moderator band and its relationship with the anterior papillary muscle. Anat Cell Biol 2019; 52:38-42. [PMID: 30984450 PMCID: PMC6449581 DOI: 10.5115/acb.2019.52.1.38] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 12/03/2018] [Accepted: 12/11/2018] [Indexed: 11/27/2022] Open
Abstract
This study investigated and classified the various types of moderator band (MB) in relation to the anterior papillary muscle, with the aim of providing anatomical reference information and fundamental knowledge for use when repairing the congenital defects and understanding the conduction system. The study investigated 38 formalin-fixed human hearts of both sexes obtained from donors aged 38–90 years. The MB was evident in 36 of the 38 specimens (94.7%). The morphology of the MB and its connection with the APM took various forms. The MBs that had a distinct shape were classified into three types according to their shape: cylindrical column, long and thin column, and wide and flat column. Types 2 and 3 were the most common, appearing in 15 (41.7%) and 14 (38.9%) of the 36 specimens, respectively, while type 1 was observed in seven specimens (19.4%). Type 3 was divided into subtypes based on their length. The MB usually originated from a single root (91.7%), with the remainder exhibiting double roots. The pairs of roots in the latter cases had different shapes. The originating point of the MB ranged from the supraventricular crest to the apex of the ventricle. The most-common originating point was in the middle (25 of 36 specimens, 69.4%), followed by the upper third (13.9%), the lower third (11.1%), and the top fifth (5.6%) of the interventricular septum. This study has produced fundamental anatomical and clinical information that will be useful when designing cardiac surgical procedures.
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Affiliation(s)
- Ju-Young Lee
- Department of Biomedical Engineering, College of Medical Convergence, Catholic Kwandong University, Gangneung, Korea
| | - Mi-Sun Hur
- Department of Anatomy, Catholic Kwandong University College of Medicine, Gangneung, Korea
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Nascimento SRR, Ruiz CR, de Oliva SU. Histological and anatomical variations of septomarginal trabecula in bovine hearts. Anat Histol Embryol 2019; 48:228-233. [PMID: 30666708 DOI: 10.1111/ahe.12427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 09/13/2018] [Accepted: 12/17/2018] [Indexed: 11/28/2022]
Abstract
The use of hearts from different animals as models in the experimental pharmacology and surgical clinic has led, in recent years, to an increase on interest of research with this organ. The heart's conducting system, from the septomarginal trabecula, presents several variations, which generates numerous controversies in the literature. So, the objective of the present study is to analyse the morphology of the septomarginal trabecula of bovine hearts, identifying possible macro- and microscopic variations. Thirty-four bovine hearts were analysed. Each trabecula was analysed macroscopically to obtain an anatomical description and measurements of its length and thickness. For histological and morphometric analysis, the samples were fixed in Bouin's solution and then subjected to histological processing. In all the analysed bovine hearts, the septomarginal trabecula presented itself as a smooth, tubular meaty structure of muscular consistency, with variable length and diameter. The anatomical variations observed included a trabecula with forked marginal fixation, and single septal fixation, in addition to a trabecula with extremely reduced or excessively thick caliber. The septomarginal trabecula consists of cardiac muscle fibres, connective tissue, vascular tissue and conduction myofibrils or Purkinje fibres. In the samples of smaller thicknesses, there was a predominance of connective tissue and scarce cardiac muscle tissue, whereas in the thicker samples the predominance was of cardiac striated muscle tissue. Therefore, there are significant macro- and microscopic differences between the bovine septomarginal trabecula concerning their diameter and constituent tissue, and that can lead to possible changes in cardiac physiology.
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Affiliation(s)
- Sérgio Ricardo Rios Nascimento
- Department of Morphology and Genetics, Developmental Biology Laboratory, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Samara Urban de Oliva
- Department of Morphology and Genetics, Developmental Biology Laboratory, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
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11
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Chagas C, Pires L, Leite T, Babinski M. The artery of Mouchet: blood supply of the septomarginal trabecula in 50 human hearts. Rev Assoc Med Bras (1992) 2018; 64:916-921. [PMID: 30517239 DOI: 10.1590/1806-9282.64.10.916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 01/27/2018] [Indexed: 11/21/2022] Open
Abstract
The septomarginal trabecula is a muscular structure which transmits the right branch of the atrioventricular bundle. It is usually supplied by a branch from the second anterior septal artery. Anastomoses between the right and left coronary arteries may happen on the septomarginal trabecula. They are of great significance in order to prevent ischemia during a myocardial infarction. Surgeries such as Konno's and Ross' procedures implies in knowledge of these vessels anatomy. The coronary arteries of 50 human hearts were injected with latex and subsequentely dissected with the purpose of identifying the arterial branch that supplied the septomarginal trabecula. The trabecular branch arose from the second anterior septal artery in 38% of cases, and the branch arose from the first anterior septal artery in 26%. One of the hearts had its septomarginal trabecula supplied by the conus arteriosus arteryliterature. Anastomoses between the right and left coronary arteries were found inside the septomarginal trabecula. The right branch of the atrioventricular bundle is subject to a great number of clinical conditions and is often manipulated during surgery, thus, the study of the septal branches of the coronary arteries and the trabecular branch is essential.
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Affiliation(s)
- Carlos Chagas
- Morphology Department, Fluminense Federal University, Niterói/RJ, Brasil.,Carlos Chagas Postgraduate Medical Institute, Rio de Janeiro/RJ, Brasil
| | - Lucas Pires
- Morphology Department, Fluminense Federal University, Niterói/RJ, Brasil
| | - Tulio Leite
- Interventional Radiology Unit, São Paulo University, São Paulo/SP, Brasil
| | - Marcio Babinski
- Morphology Department, Fluminense Federal University, Niterói/RJ, Brasil
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12
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Zajączkowski MA, Gajić A, Kaczyńska A, Zajączkowski S, Kobiela J, Kamiński R, Kosiński A. Individual variability of vascularization of the anterior papillary muscle within the right ventricle of human heart. PLoS One 2018; 13:e0205786. [PMID: 30321241 PMCID: PMC6188782 DOI: 10.1371/journal.pone.0205786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 10/02/2018] [Indexed: 11/18/2022] Open
Abstract
Background To date there is scarce published evidence reporting the dual blood supply reaching anterior papillary muscle (APM), which descends from both major coronary arteries. Such a vascular configuration can prevent the dysfunction of right ventricular entire valvular system in case of the occlusion of proximal part of either right coronary artery (RCA) or left coronary artery (LCA). The aim of our study was to determine the vascular pattern of APM blood supply which originates from two main coronary arteries, in the context of the APM and septomarginal trabecula (SMT) topography. Methods The study was carried out using tissue obtained from 36 human hearts. The material was divided into four morphological types of SMT/APM arrangement. Vascularization and blood supply pattern of papillary muscle was investigated following the analysis of multiple tissue cross sections. The origin of APM arterial supply was traced back to both main coronary arteries. Cross-sectional area of the arteries was estimated at the base of APM and compared within mixed male-female population, aged 18–76. Results We noted that as much as 78% of entire APM material had a blood supply vasculature originating from both LCA and RCA branches. In contrast, 22% of cases APM was supplied by a single coronary artery, while in each case it proved to be LCA. We have never found APM arterial supply provided exclusively by RCA. In case of double AMP blood supply an average of total cross-section area of the arteries branching from LCA, was noted to be in excess of two and a half times bigger in type III and more than two times bigger in type IV, as compared with the arteries originating from RCA. Conclusions Our research confirm the possibility of double blood supply which vascularizes APM, but the finding does not necessarily apply in all cases. However, APM seems to be predominantly vascularized by arteries deriving from LCA, regardless of their morphological type.
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Affiliation(s)
| | - Andrej Gajić
- Department for Pathology, Faculty for Veterinary Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Agata Kaczyńska
- Department of Clinical Anatomy, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Jarosław Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Rafał Kamiński
- Department of Clinical Anatomy, Medical University of Gdańsk, Gdańsk, Poland
| | - Adam Kosiński
- Department of Clinical Anatomy, Medical University of Gdańsk, Gdańsk, Poland
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Dong Y, Sun J, Yang D, He J, Cheng W, Wan K, Liu H, Greiser A, Zhou X, Han Y, Chen Y. Right ventricular septomarginal trabeculation hypertrophy is associated with disease severity in patients with pulmonary arterial hypertension. Int J Cardiovasc Imaging 2018; 34:1439-1449. [DOI: 10.1007/s10554-018-1347-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 03/28/2018] [Indexed: 12/15/2022]
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Non-compact myocardium assessment by cardiac magnetic resonance: dependence on image analysis method. Int J Cardiovasc Imaging 2018. [DOI: 10.1007/s10554-018-1331-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Karakus G, Zencirci E, Degirmencioglu A, Güvenc TS, Unal Aksu H, Yildirim A. Easily measurable, noninvasive, and novel finding for pulmonary hypertension: Hypertrophy of the basal segment of septomarginal trabeculation of right ventricle. Echocardiography 2017; 34:290-295. [DOI: 10.1111/echo.13461] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Gultekin Karakus
- Department of Cardiology; Acibadem Maslak Hospital; Istanbul Turkey
| | - Ertugrul Zencirci
- Department of Cardiology; Acibadem University School of Medicine; Istanbul Turkey
| | - Aleks Degirmencioglu
- Department of Cardiology; Acibadem University School of Medicine; Istanbul Turkey
| | - Tolga Sinan Güvenc
- Department of Cardiology; Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital; Istanbul Turkey
| | - Hale Unal Aksu
- Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital; Istanbul Turkey
| | - Aydin Yildirim
- Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital; Istanbul Turkey
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Cope LA. Morphological Variations in the Canine (Canis familiaris) Right Ventricle Trabecula Septomarginalis Dextra and a Proposed Classification Scheme. Anat Histol Embryol 2015; 45:437-442. [DOI: 10.1111/ahe.12217] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 10/07/2015] [Indexed: 12/01/2022]
Affiliation(s)
- L. A. Cope
- Division of Basic Medical Sciences; Mercer University School of Medicine; 1501 Mercer University Drive Macon GA 31207 USA
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17
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Karakus G, Kammerlander AA, Aschauer S, Marzluf BA, Zotter-Tufaro C, Bachmann A, Degirmencioglu A, Duca F, Babayev J, Pfaffenberger S, Bonderman D, Mascherbauer J. Pulmonary artery to aorta ratio for the detection of pulmonary hypertension: cardiovascular magnetic resonance and invasive hemodynamics in heart failure with preserved ejection fraction. J Cardiovasc Magn Reson 2015; 17:79. [PMID: 26318496 PMCID: PMC4553215 DOI: 10.1186/s12968-015-0184-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 08/16/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Previous work indicates that dilatation of the pulmonary artery (PA) itself or in relation to the ascending aorta (PA:Ao ratio) predicts pulmonary hypertension (PH). Whether these results also apply for heart failure with preserved ejection fraction (HFpEF) is unknown. In the present study we evaluated the diagnostic and prognostic power of PA diameter and PA:Ao ratio on top of right ventricular (RV) size, function, and septomarginal trabeculation (SMT) thickness by cardiovascular magnetic resonance (CMR) in HFpEF. METHODS AND RESULTS 159 consecutive HFpEF patients were prospectively enrolled. Of these, 111 underwent CMR and invasive hemodynamic evaluation. By invasive assessment 64 % of patients suffered from moderate/severe PH (mean pulmonary artery pressure (mPAP) ≥30 mmHg). Significant differences between groups with and without moderate/severe PH were observed with respect to PA diameter (30.9 ± 5.1 mm versus 26 ± 5.1 mm, p < 0.001), PA:Ao ratio (0.93 ± 0.16 versus 0.78 ± 0.14, p < 0.001), and SMT diameter (4.6 ± 1.5 mm versus 3.8 ± 1.2 mm; p = 0.008). The strongest correlation with mPAP was found for PA:Ao ratio (r = 0.421, p < 0.001). By ROC analysis the best cut-off for the detection of moderate/severe PH was found for a PA:Ao ratio of 0.83. Patients were followed for 22.0 ± 14.9 months. By Kaplan Meier analysis event-free survival was significantly worse in patients with a PA:Ao ratio ≥0.83 (log rank, p = 0.004). By multivariable Cox-regression analysis PA:Ao ratio was independently associated with event-free survival (p = 0.003). CONCLUSION PA:Ao ratio is an easily measureable noninvasive indicator for the presence and severity of PH in HFpEF, and it is related with outcome.
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Affiliation(s)
| | - Andreas A Kammerlander
- Department of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Stefan Aschauer
- Department of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | | | - Caroline Zotter-Tufaro
- Department of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Alina Bachmann
- Department of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | | | - Franz Duca
- Department of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Jamil Babayev
- Department of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Stefan Pfaffenberger
- Department of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Diana Bonderman
- Department of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Julia Mascherbauer
- Department of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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18
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Terpenning S, White CS. Imaging pitfalls, normal anatomy, and anatomical variants that can simulate disease on cardiac imaging as demonstrated on multidetector computed tomography. Acta Radiol Short Rep 2015; 4:2047981614562443. [PMID: 25610617 PMCID: PMC4299369 DOI: 10.1177/2047981614562443] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 11/10/2014] [Indexed: 12/02/2022] Open
Abstract
Advances in computed tomography have led to continuous improvement in cardiac imaging. Dedicated postprocessing capabilities, faster scan times, and cardiac gating methods reveal details of normal cardiac anatomy and anatomic variants that can mimic pathologic conditions. This article will review normal cardiac anatomy and variants that can mimic disease. Radiologists should be familiar with normal cardiac anatomy and anatomic variants to avoid misinterpretation of normal findings for pathologic processes.
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Affiliation(s)
| | - Charles S White
- Department of Radiology, University of Maryland, Baltimore, MD, USA
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19
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Quick S, Speiser U, Kury K, Schoen S, Ibrahim K, Strasser R. Evaluation and classification of right ventricular wall motion abnormalities in healthy subjects by 3-tesla cardiovascular magnetic resonance imaging. Neth Heart J 2014; 23:64-9. [PMID: 25339203 PMCID: PMC4268217 DOI: 10.1007/s12471-014-0620-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Right ventricular (RV) shape and function serves as an indicator in several types of heart disease such as arrhythmogenic right ventricular dysplasia (ARVD). However, there is no in-depth knowledge of RV motion, even in healthy subjects. The aim of our study was to provide a quantitative analysis of normal variations in RV wall motion in healthy subjects by cardiac magnetic resonance imaging (CMRI). MATERIAL AND METHODS The study population consisted of 65 consecutive patients referred for the evaluation of cardiac function by 3 Tesla CMR. Balanced steady-state free-precession images were obtained and areas of disordered RV wall motion were evaluated and classified based on a standardised segmental model for the right ventricle. RESULTS In 59 patients (90.8 %) wall motion abnormalities (WMA) of the right ventricle were evident. WMA were predominately detected in the apicolateral segments (72 %) compared with mediolateral (24 %, P < 0.001) and inferolateral segments (4 %, P < 0.001). Dyskinesia was the most frequent wall motion disorder (62.4 %), followed by hypokinesia (20.8 %) and bulging (16.8 %). The mean WMA diameter in the transverse plane (6.4 ± 1.9 mm) was significantly shorter compared with the diameter in the horizontal long-axis (8.1 ± 3.6 mm, P = 0.002) and short-axis plane (10.7 ± 4.6 mm). CONCLUSION WMA of the right ventricle are common. Therefore, one should be aware that these nonpathological wall motion disorders can easily be mistaken for a pathological regional wall motion contraction, particularly in ARVD where to date, clear wall motion criteria are lacking.
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Affiliation(s)
- S Quick
- Department of Internal Medicine and Cardiology, Technische Universitaet Dresden Heart Center University Hospital, Fetscherstr 76, 01307, Dresden, Germany,
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