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Functional Morphology of the Heart

  • Branko Furst
Chapter
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Abstract

The primary function of muscles is the generation of force or movement in response to physiological stimulus. The myocardium is a heterogeneous mass of muscle tissue which represents a transition between the involuntary (smooth) and the voluntary (striated) muscles. While the individual muscle fibers in a voluntary muscle are supplied by the nerve endings and can be recruited at will across the spectrum of forces, the cardiomyocytes are electrically connected and function as a single unit, a syncytium that contracts in unison with each impulse autonomously generated by a specialized group of pacemaker cells within the heart itself. Unlike the skeletal muscle and its fibers, the myocardium lacks origin and insertion. Despite hundreds of years of anatomical dissection, many details of the heart’s structure, as related to its function, remain unresolved. Pettigrew demonstrated that the myocardial wall in sheep consists of seven layers which “overlap externally and internally and equilibrate each other according to mathematical law” and maintained that the arrangement of myocardial fibers holds the key to its function. Carl Ludwig introduced the concept of a muscular cylinder as the principal structure of the left ventricle, enveloped by endocardial and epicardial layers, crossing at the right angles of its longitudinal axis in the form of an X. Hunter and Smaill proposed that methods of continuum mechanics provide a suitable theoretical framework for the analysis of the complex interaction between mechanical, metabolic, and electrical functions of the heart. Diffusion tensor magnetic resonance imaging (DTMRI), a novel technique which enables visual “tracking” of the aggregated myocyte chains within ventricular walls, has confirmed the three-dimensional helical fiber patterns proposed by Pettigrew.

Two contrasting models of ventricular function have been developed over the past decades: Torrent-Guasp’s ventricular myocardial band (VMB) and Lunkenheimer’s “antagonistic force” model. Both models assume that the heart functions as a pressure propulsion pump. It is proposed that the vortex-like form of the mature heart, situated at the confluence of the systemic and pulmonary veins, reveals its true, blood-restraining function. This is confirmed by the unique, stretch-resistant myocardial architecture and by the presence of highly organized intracardiac fluid forms, the vortices.

Keywords

Heart-functional morphology Rotational vortex Irrotational vortex Lemniscates Myocardial fibers Myocardial twist Wiggers diagram Ventricular myocardial band Opposing force model Intracardiac flow patterns Helical aortic flow Flow-restraining function 
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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Branko Furst
    • 1
  1. 1.Professor of AnesthesiologyAlbany Medical CollegeAlbanyUSA

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