Ventricular myoarchitecture in tetralogy of Fallot.

BACKGROUND: Little attention has been paid to the architecture of the muscle fibres of the ventricular walls in congenitally malformed hearts. In this study the gross pattern of myocardial fibres in normal hearts was compared with that in cases of tetralogy of Fallot. METHODS AND RESULTS: After morphological examination nine specimens with tetralogy were dissected to study the ventricular myoarchitecture. Changes were found in the shape of the malformed ventricles. The ventricular walls were arranged in layers in all hearts. Superficial and deep layers were present in both ventricles, with the superficial layer showing a more oblique orientation in the specimens with tetralogy than in normal hearts. Modifications of muscle fibre that were related to the type of malformation were seen in the deep layer. A middle layer was present in the left ventricles of normal hearts and specimens with tetralogy: this showed a horizontal orientation in both groups. In contrast, a middle layer was found in the right ventricle only in specimens showing tetralogy. CONCLUSIONS: The malformed hearts showed modifications in ventricular shape, in the arrangement of muscle in the right ventricle, and in the overall myoarchitecture. These changes could well be the consequence of the same agent (or agents) that caused the structural defect.

[1]  D. Sánchez-Quintana,et al.  Morphological changes in the normal pattern of ventricular myoarchitecture in the developing human heart , 1995, The Anatomical record.

[2]  P. Hunter,et al.  Laminar structure of the heart: ventricular myocyte arrangement and connective tissue architecture in the dog. , 1995, The American journal of physiology.

[3]  M. Gatzoulis,et al.  Right ventricular diastolic function 15 to 35 years after repair of tetralogy of Fallot. Restrictive physiology predicts superior exercise performance. , 1995, Circulation.

[4]  F. Parazza,et al.  Method for the study of the three‐dimensional orientation of the nuclei of myocardial cells in fetal human heart by means of confocal scanning laser microscopy , 1994, Journal of microscopy.

[5]  K. Weber,et al.  Collagen network of the myocardium: function, structural remodeling and regulatory mechanisms. , 1994, Journal of molecular and cellular cardiology.

[6]  Robert H. Anderson,et al.  The Surgical Anatomy of Tetralogy of Fallot with Pulmonary Atresia Rather than Pulmonary Stenosis , 1991, Journal of cardiac surgery.

[7]  A. Aránega,et al.  Morphometric study of right ventricle in 32 cases of tetralogy of Fallot. , 1988, Herz.

[8]  J Prothero,et al.  Coordinated three‐dimensional reconstruction from serial sections at macroscopic and microscopic levels of resolution: The human heart , 1987, The Anatomical record.

[9]  D. Sánchez-Quintana,et al.  Ventricular myocardial architecture in marine fishes , 1987, The Anatomical record.

[10]  T. Miura,et al.  Age-related changes in right and left ventricular function in tetralogy of Fallot. , 1986, Japanese circulation journal.

[11]  Arthur C. Guyton,et al.  Handbook of Physiology—The Cardiovascular System , 1985 .

[12]  J. Hurlé,et al.  Myocardial fiber architecture of the human heart ventricles , 1982, The Anatomical record.

[13]  P H Heintzen,et al.  Left and right ventricular adaptation to right ventricular overload before and after surgical repair of tetralogy of Fallot. , 1982, The American journal of cardiology.

[14]  A E Becker,et al.  Left ventricular fibre architecture in man. , 1981, British heart journal.

[15]  G W Moore,et al.  Shape of the human cardiac ventricles. , 1978, The American journal of cardiology.

[16]  A. Becker,et al.  What should we call the 'crista'? , 1977, British heart journal.

[17]  J. Jarmakani,et al.  Right Ventricular Function in Children with Tetralogy of Fallot before and after Aortic‐to‐Pulmonary Shunt , 1976, Circulation.

[18]  A. Becker,et al.  Tetralogy of Fallot: a morphometric and geometric study. , 1975, The American journal of cardiology.

[19]  R. Rowe,et al.  Ventricular septal defect in tetralogy of Fallot. , 1973, The American journal of cardiology.

[20]  A. Muster,et al.  Tetralogy of Fallot: underdevelopment of the pulmonary infundibulum and its sequelae. , 1970, The American journal of cardiology.

[21]  L. D. Krymsky,et al.  Pathologic Anatomy of Congenital Heart Disease , 1965, Circulation.

[22]  R. P. Grant,et al.  Notes on the Muscular Architecture of the Left Ventricle , 1965, Circulation.

[23]  F. Eckner,et al.  THE PATHOLOGIC ANATOMY OF TETRALOGY OF FALLOT AND ITS VARIATIONS. , 1964, Diseases of the chest.

[24]  Jane Sands Robb,et al.  The normal heart , 1942 .

[25]  F. P. Mall,et al.  On the muscular architecture of the ventricles of the human heart , 1911 .

[26]  James Bell Pettigrew,et al.  On the Arrangement of the Muscular Fibres in the Ventricles of the Vertebrate Heart: With Physiological Remarks , 1866, Philosophical Transactions of the Royal Society of London.

[27]  D. Sánchez-Quintana,et al.  Myocardial fiber architecture in the human heart. Anatomical demonstration of modifications in the normal pattern of ventricular fiber architecture in a malformed adult specimen. , 1990, Acta anatomica.

[28]  Damián Sánchez-Quintana,et al.  Myocardial Fiber Architecture in the Human Heart , 1990 .

[29]  F. TorrentGuasp Macroscopic structure of the ventricular myocardium , 1980 .

[30]  Dd. Streeter,et al.  Gross morphology and fiber geometry of the heart , 1979 .