The ventricular myocardium is known to exhibit a complex spatial organization, with fiber orientation varying as a function of transmural location. It is now well established that diffusion tensor magnetic resonance imaging (DTMRI) may be used to measure this fiber orientation at high spatial resolution. Cardiac fibers are also known to be organized in sheets with surface orientation varying throughout the ventricles. This article reviews results on use of DTMRI for measuring ventricular fiber orientation, as well as presents new results providing strong evidence that the tertiary eigenvector of the diffusion tensor is aligned locally with the cardiac sheet surface normal. Considered together, these data indicate that DTMRI may be used to reconstruct both ventricular fiber and sheet organization. This article also presents the large deformation diffeomorphic metric mapping (LDDMM) algorithm and shows that this algorithm may be used to bring ensembles of imaged and reconstructed hearts into correspondence (e.g., registration) so that variability of ventricular geometry, fiber, and sheet orientation may be quantified. Ventricular geometry and fiber structure is known to be remodeled in a range of disease processes; however, descriptions of this remodeling have remained subjective and qualitative. We anticipate that use of DTMRI for reconstruction of ventricular anatomy coupled with application of the LDDMM method for image volume registration will enable the detection and quantification of changes in cardiac anatomy that are characteristic of specific disease processes in the heart. Finally, we show that epicardial electrical mapping and DTMRI imaging may be performed in the same hearts. The anatomic data may then be used to simulate electrical conduction in a computational model of the very same heart that was mapped electrically. This facilitates direct comparison and testing of model versus experimental results and opens the door to quantitative measurement, modeling, and analysis of the ways in which remodeling of ventricular microanatomy influences electrical conduction in the heart.

A three-dimensional (3D) diffusion-weighted imaging (DWI) method for measuring cardiac fiber structure at high spatial resolution is presented. The method was applied to the ex vivo reconstruction of the fiber architecture of seven canine hearts. A novel hypothesis-testing method was developed and used to show that distinct populations of secondary and tertiary eigenvalues may be distinguished at reasonable confidence levels (P ≤ 0.01) within the canine ventricle.

A cyclic peptide specific for type I collagen is derivatized with three {Gd(dtpa)} moieties to create a molecular MRI contrast agent for fibrosis imaging. In a mouse model of myocardial infarction (heart attack), collagen levels are elevated in the infarct zone. MRI after injection of the contrast agent selectively enhances and delineates the infarct zone (see preinjection and postinjection images); dtpa=diethylenetriaminepentaacetate.

Ventricular remodeling of both geometry and fiber structure is a prominent feature of several cardiac pathologies. Advances in MRI and analytical methods now make it possible to measure changes of cardiac geometry, fiber, and sheet orientation at high spatial resolution. In this report, we use diffusion tensor imaging to measure the geometry, fiber, and sheet architecture of eight normal and five dyssynchronous failing canine hearts, which were explanted and fixed in an unloaded state. We apply novel computational methods to identify statistically significant changes of cardiac anatomic structure in the failing and control heart populations. The results demonstrate significant regional differences in geometric remodeling in the dyssynchronous failing heart versus control. Ventricular chamber dilatation and reduction in wall thickness in septal and some posterior and anterior regions are observed. Primary fiber orientation showed no significant change. However, this result coupled with the local wall thinning in the septum implies an altered transmural fiber gradient. Further, we observe that orientation of laminar sheets become more vertical in the early-activated septum, with no significant change of sheet orientation in the late-activated lateral wall. Measured changes in both fiber gradient and sheet structure will affect both the heterogeneity of passive myocardial properties as well as electrical activation of the ventricles.