Insights from echocardiography, magnetic resonance imaging, and microcomputed tomography relative to the mid‐myocardial left ventricular echogenic zone

Agger, Peter; Stephenson, Robert S.; Dobrzynski, Halina; Atkinson, Andrew; Iaizzo, Paul A.; Anderson, Robert H.; Jarvis, Jonathan C.; Allan, Sarah L.; Partridge, Jason; Zhao, Jichao; Zhang, Henggui; MacIver, David H.

doi:10.1111/echo.13324

Cited by 20 publications

(20 citation statements)

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“…The OT‐RBM processes both ventricles independently, which gives more flexibility to generate different fiber configurations. Therefore, septal fiber orientation can also be independently modified, allowing the study of its discontinuity, which is still under debate . In this work, the introduced RBM is compared with state‐of‐the‐art fiber generation models such as the ones based on Streeter observations and Bayer et al, as well as with DT‐MRI data.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, septal fiber orientation can also be independently modified, allowing the study of its discontinuity, which is still under debate. [28][29][30] In this work, the introduced RBM is compared with state-of-the-art fiber generation models such as the ones based on Streeter observations 23 and Bayer et al, 25 as well as with DT-MRI data. Additionally, electrophysiological simulations with fiber orientation provided by the OT-RBM are performed in a set of nine patient-specific OTVA biventricular geometries.…”

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confidence: 99%

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A rule‐based method to model myocardial fiber orientation in cardiac biventricular geometries with outflow tracts

Doste

Soto‐Iglesias

Bernardino

et al. 2019

Numer Methods Biomed Eng

102

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Rule‐based methods are often used for assigning fiber orientation to cardiac anatomical models. However, existing methods have been developed using data mostly from the left ventricle. As a consequence, fiber information obtained from rule‐based methods often does not match histological data in other areas of the heart such as the right ventricle, having a negative impact in cardiac simulations beyond the left ventricle. In this work, we present a rule‐based method where fiber orientation is separately modeled in each ventricle following observations from histology. This allows to create detailed fiber orientation in specific regions such as the endocardium of the right ventricle, the interventricular septum, and the outflow tracts. We also carried out electrophysiological simulations involving these structures and with different fiber configurations. In particular, we built a modeling pipeline for creating patient‐specific volumetric meshes of biventricular geometries, including the outflow tracts, and subsequently simulate the electrical wavefront propagation in outflow tract ventricular arrhythmias with different origins for the ectopic focus. The resulting simulations with the proposed rule‐based method showed a very good agreement with clinical parameters such as the 10 ms isochrone ratio in a cohort of nine patients suffering from this type of arrhythmia. The developed modeling pipeline confirms its potential for an in silico identification of the site of origin in outflow tract ventricular arrhythmias before clinical intervention.

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

A rule‐based method to model myocardial fiber orientation in cardiac biventricular geometries with outflow tracts

Doste

Soto‐Iglesias

Bernardino

et al. 2019

Numer Methods Biomed Eng

102

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“…This technique, however, suffers from the obvious disadvantage of failing to visualise the ventricular myocardial mass in its three‐dimensional entirety. In this regard, the cardiomyocytes within the ventricular myocardial mass constitute a highly complex three‐dimensional functional syncytium . This makes the determination of the true myocardial architecture very complicated and consequently the anatomy of the myocardium is still not fully understood and is, therefore, an on‐going subject of intense scientific debate .…”

Section: Introductionmentioning

confidence: 99%

Anatomically correct assessment of the orientation of the cardiomyocytes using diffusion tensor imaging

et al. 2019

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Diffusion tensor imaging has been used for assessing the orientation of cardiac myocytes for decades. Striking methodological differences exist between studies when quantifying these orientations. This limits the comparability between studies, and impedes collaboration and the drawing of appropriate physiological conclusions.We have sought to elucidate these differences, permitting us to propose a standardised "tool set" that might better establish consensus in future studies.We fixed hearts from seven 25 kg pigs in formalin, and scanned them using diffusion tensor imaging. Using various angle definitions as found in literature, we assessed the orientations of cardiomyocytes, comparing them in terms of helical and intrusion angles, along with the orientation of their aggregations. The difference between assessment of the helical angle with and without relation to the epicardial curvature was 25.2°(SD: 7.9) at the base, 5.8°(1.9) at the equatorial level, and 28.0°(7.0) at the apex, ANOVA P = 0.001. In comparable fashion, the intrusion angle differed by 25.9°( 12.9), 7.6°(0.98) and 17.5°(4.7), P = 0.01, and the angle of the aggregates (E3-angle) differed by 25.0°(13.5) at the base, 9.4°(1.7) at the equator, and 23.1°(6.2) apically, P = 0.003. When assessing 14 definitions used in literature to calculate the orientation of aggregates, only 4 rendered identical results. The findings show that any attempt to use projection of eigenvectors introduces considerable bias. The epicardial curvature of the ventricular cone needs to be taken into account when seeking to provide accurate quantification of the orientation of the aggregated cardiomyocytes, especially in the apical and basal regions. This means that projection of eigenvectors should be avoided prior to quantifying myocyte orientation, especially when assessing radial orientation. Based on our results, we suggest appropriate methods for valid assessment of myocyte orientation using diffusion tensor imaging.

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“…Agger and associates from 11 international centers offer a proposed way to explain the reasons for the mid‐myocardial left ventricular echogenic zone. This echogenic band appears during cardiac motion, and an anatomic basis for its existence must exist.…”

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confidence: 99%

Echogenic zone in mid‐septum: its structure/function relationship

Buckberg

2016

Echocardiography

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Insights from echocardiography, magnetic resonance imaging, and microcomputed tomography relative to the mid‐myocardial left ventricular echogenic zone

Abstract: JB et al (2016) Insights from echocardiography, magnetic resonance imaging, and microcomputed tomography relative to the midmyocardial left ventricular echogenic zone. Echocardiography, 33 (10).

Cited by 20 publications

References 50 publications

A rule‐based method to model myocardial fiber orientation in cardiac biventricular geometries with outflow tracts

A rule‐based method to model myocardial fiber orientation in cardiac biventricular geometries with outflow tracts

Anatomically correct assessment of the orientation of the cardiomyocytes using diffusion tensor imaging

Echogenic zone in mid‐septum: its structure/function relationship

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