La teoría de la banda miocárdica. Nuevos descubrimientos que apoyan el complejo mecanismo de torsión miocárdica

Abstract

La función del corazón es de una dimensión mecánica que debe indagarse en los términos de su estructura. En la apreciación de su anatomía se halla el principio de la reflexión que llevó a investigaciones que explicasen su integridad organicofuncional. Si se hace una parada en las descripciones clásicas, se verá que la atención anatómica se prestó a sus superficies externa e interna, con muy poca importancia a la conformación muscular íntima. Se determinó de carácter homogéneo y sólido, con una contracción global uniforme y se soslayó que su capacidad mecánica exigía una reinterpretación de su anatomía espacial y de sus movimientos.

Cardiac Helical Function

“…This occurs when the left ventricle dilates in cardiac remodeling and the bers miss their oblique orientation, loosing muscular and mechanical e ciency. (11) In the progression from the ventricular base to the apex, the number of horizontal bers decreases in relation to the oblique bers, showing that the heart is organized as a continuous muscle helix (Fig. 3).…”

“…Both ends are xed by an osseous, chondroid or tendinous nucleus, depending on the different species (animal or human) used in the studies. This nucleus, which we have called cardiac fulcrum (1,11), is the only perceptible edge where the muscle band bers originate and end (Figs. 5 and 6).…”

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“…Fiber orientation defines function and thus the ejection fraction is 60% when the normal helical fibers contract and falls to nearly 30% if only the transverse fibers shorten, reaching 15-20% if only the subendocardial longitudinal fibers are deformed. This occurs when the left ventricle dilates in cardiac remodeling and the fibers miss their oblique orientation, losing muscular and mechanical efficiency [11].…”

Cardiac Helical Function. Fulcrum and Torsion

“…In the progression from the ventricular base to the apex, the number of horizontal fibers decreases in relation to the oblique fibers, showing that the heart is organized as a continuous muscle helix [11] (Figure 3). Myocardial muscle bundles and bands, which derive from phylogenetic development, essentially shape a master axis of precise dynamic requirement.…”

“…Both ends are fixed by an osseous, chondroid or tendinous nucleus, depending on the different species (animal or human) used in the studies. This nucleus, which we have called cardiac fulcrum, is the only perceptible edge where the muscle band fibers originate and end [1,11] In the myocardium we can distinguish the basal and apical loops.…”