Heuristic problems in defining the three-dimensional arrangement of the ventricular myocytes
Heuristic problems in defining the three-dimensional arrangement of the ventricular myocytes
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DOI：
10.1002/ar.a.20330
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发表时间：
2006-06-01
期刊：
影响因子：
--
通讯作者：
Lunkenheimer, Paul P.
中科院分区：
文献类型：
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作者：
Anderson, Robert H.;Ho, Siew Yen;Lunkenheimer, Paul P.
关于心室肌块内肌细胞的三维排列尚缺乏共识。生物工程师们正在设法模拟心脏的结构。虽然这些模型的成功取决于解剖学证据的准确性，但它们中的大多数都是基于远离解剖学现实的概念，忽略了过去400年来提出的许多重要的解剖学解释。在19世纪，小矮星彼得强调，心脏是建立在一个修改血管的基础上，而不是以骨骼肌的形式。世纪，Lev和Simkins以及Grant再次强调了这一事实，但这些作者列出的警告被两个当前概念的支持者所忽视，这两个概念认为心肌以“独特的心肌带”的形式排列，或者心室壁被从心外膜延伸到心内膜的纤维组织层片以统一的方式隔离。这两个概念本身是不相容的，并进一步与大多数解剖学研究，强调区域异质性被发现在三维包装的肌细胞内的纤维组织的支持矩阵的差异。我们再次强调的意义，这种三维肌肉网格，显示如何入侵的肌细胞聚集体的存在下，在斜透壁的方式延伸也反对的概念，即所有的肌细胞的取向与他们的长轴平行的心外膜和endodermal表面。
There is lack of consensus concerning the three-dimensional arrangement of the myocytes within the ventricular muscle masses. Bioengineers are seeking to model the structure of the heart. Although the success of such models depends on the accuracy of the anatomic evidence, most of them have been based on concepts that are far from anatomical reality, which ignore many significant previous accounts of anatomy presented over the past 400 years. During the 19th century, Pettigrew emphasized that the heart was built on the basis of a modified blood vessel rather than in the form of skeletal muscles. This fact was reemphasized by Lev and Simkins as well as Grant in the 20th century, but the caveats listed by these authors have been ignored by proponents of two current concepts, which state either that the myocardium is arranged in the form of a "unique myocardial band", or that the walls of the ventricles are sequestrated in uniform fashion by laminar sheets of fibrous tissue extending from epicardium to endocardium. These two concepts are themselves incompatible and are further at variance with the majority of anatomic studies, which have emphasized the regional heterogeneity to be found in the three-dimensional packing of the myocytes within a supporting matrix of fibrous tissue. We reemphasize the significance of this three-dimensional muscular mesh, showing how the presence of intruding aggregates of myocytes extending in oblique transmural fashion also contends against the notion that all myocytes are orientated with their long axes parallel to the epicardial and enodcardial surfaces.