The Structure and Function of the Helical Heart and Its Buttress Wrapping. I. The Normal Macroscopic Structure of the Heart

Torrent-Guasp, Francisco; Buckberg, Gerald D.; Clemente, Carmine; Cox, James L.; Coghlan, H. Cecil; Gharib, Morteza

doi:10.1053/stcs.2001.29953

Cited by 243 publications

(226 citation statements)

References 11 publications

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“…These findings were in agreement with Francisco Torrent-Guasp's model of the helical heart, although he did not report the laminar trajectory to be in the middle of the left muscular part of the IVS [17]. The septal vessel (kuuselian vessel) may have become patent right to left by the diastolic widening of the foetal heart for the diastolic blood pressure, which is higher in the RV than in the LV.…”

Section: Discussionsupporting

confidence: 80%

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The heart exhibits right to left communication between the fibres of the muscular part of the interventricular septum

Kuusela¹

2014

Folia Morphol

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Section: Discussionsupporting

confidence: 80%

“…The helical course of the laminar trajectories under the endocardium runs in the opposite direction to those at the apex. The heart widens at the end of the diastole by ventricular band relaxation [17].…”

Section: Introductionmentioning

confidence: 99%

The heart exhibits right to left communication between the fibres of the muscular part of the interventricular septum

Kuusela¹

2014

Folia Morphol

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“…1 Left ventricular twist may be related to the helical fiber orientation of the LV, which results in opposing rotational directions of the apex and the base and which determines the magnitude of this torsional deformation. 2,3 It has been proposed that LV twist is a sensitive marker of changes in both regional and global LV function. [4][5][6] Recently, efforts have focused on 2D speckle-tracking imaging (STI) to assess LVrot.…”

mentioning

confidence: 99%

Three-Dimensional Speckle-Tracking Imaging for Left Ventricular Rotation Measurement

Zhou

Ashraf

et al. 2010

Journal of Ultrasound in Medicine

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Objective. Left ventricular (LV) twist is manifested in oppositely directed apical and basal rotation. We studied a new 3-dimensional (3D) echocardiography program (wall motion tracking; Toshiba America Medical Systems, Inc, Tustin, CA) for left ventricular rotation. Methods. We used a rotation model with a variable-speed motor to rotate hearts in a water bath. We studied 10 freshly harvested pig hearts, which were mounted on the rotary actuator of our twist phantom with the heart base rotating and the apex held fixed to avoid translational motion, at rotations of 0°, 15°, 20°, and 25°. Full-volume 3D image loops were acquired on a Toshiba Aplio Artida ultrasound system at a maximized frame rate. Results. As the actual heart rotation increased, computed segmental and global rotation also increased accordingly, with the measured rotations of the basal and middle segments greater than that of the apex (both P < .001). Segmental and global rotation at all 3 levels correlated well with the actual rotation (base: r = 0.93; middle: r = 0.92; apex: r = 0.82; global: r = 0.95; all P < .001). Conclusions. The new 3D program tracked LV rotation accurately. Key words: left ventricular rotation; speckle tracking; 3-dimensional imaging. esearch in clinical deformation cardiac mechanics has recently been focused on 2-dimensional (2D) left ventricular (LV) deformation studies, including LV twist and LV rotation (LVrot). 1 Left ventricular twist may be related to the helical fiber orientation of the LV, which results in opposing rotational directions of the apex and the base and which determines the magnitude of this torsional deformation. 2,3 It has been proposed that LV twist is a sensitive marker of changes in both regional and global LV function. [4][5][6] Recently, efforts have focused on 2D speckle-tracking imaging (STI) to assess LVrot. [7][8][9] Several studies have shown that 2D STI gives equivalent results when compared to magnetic resonance imaging (MRI) or Doppler tissue imaging (DTI) for measuring LVrot. 9 However, because of the 3-dimensional (3D) nature of cardiac deformation, 2D STI based on 2D imaging may not be robust enough for LVrot measurement because of speckle decorrelation or the loss of some speckles due to elevational

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“…This work shows a hitherto not described activation sequence that would explain ventricular torsion. At the crossing point of both band segments, activation spreads from the endocardium towards the epicardium (radial propagation), that is from the descending to the ascending band segment, and more precisely, from approximately the mid-third of the descending band segment to the mid-third of the ascending band [14]. From this point, the ascending band segment depolarizes in a dual direction; towards the apex and towards the base, at the same time as the descending band segment completes its activation towards the apex ( Figure 6).…”

Section: Discussionmentioning

confidence: 99%

Ventricular torsion and cardiac suction effect: The electrophysiological analysis of the cardiac band muscle

Jorge¹,

Benjamen²,

López-Cabanillas³

et al. 2017

Interventional-Cardiology

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Ventricular torsion and cardiac suction effect:The electrophysiological analysis of the cardiac band muscle Introduction and objectives: The Torrent Guasp concept postulates that the ventricles are formed by a continuous muscle band that begins at the level of the pulmonary valve and extends to the aortic root, limiting in this way the two ventricular chambers. This specific anatomical arrangement would support the interpretation of two fundamental aspects of left ventricular dynamics: 1) the torsion mechanism and 2) the physiology of rapid diastolic filling by the suction effect. Methods: Five patients with no structural cardiac abnormalities and normal QRS complexes underwent three-dimensional endoepicardial electroanatomic mapping during ablation of lone atrial fibrillation or concealed epicardial accessory pathways. The propagation times of the electrical activation by the muscular band was measured in milliseconds (ms). Results: 1) The apical loop is activated by a simultaneous depolarization of the distal descending and proximal ascending band segments. 2) At the point of crossing of both bands a radial activation spreads from the descending to the ascending band. From this point, begins a simultaneous and opposing activation of the proximal and distal ascending band.3) The activation of the distal ascending band segment is the latest. Conclusions: The novel activation sequence of the Torrent Guasp band found in this study would explain the previous process triggering the ventricular torsion and suction mechanism. Moreover, this work demonstrates that activation of the ascending band segment completes the QRS. This finding explains the persistent contraction of this muscle segment during early diastole, rejecting the traditional concept of passive relaxation.

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The Structure and Function of the Helical Heart and Its Buttress Wrapping. I. The Normal Macroscopic Structure of the Heart

Cited by 243 publications

References 11 publications

The heart exhibits right to left communication between the fibres of the muscular part of the interventricular septum

The heart exhibits right to left communication between the fibres of the muscular part of the interventricular septum

Three-Dimensional Speckle-Tracking Imaging for Left Ventricular Rotation Measurement

Ventricular torsion and cardiac suction effect: The electrophysiological analysis of the cardiac band muscle

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