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(Circulation. 2008;118:699-701.)
© 2008 American Heart Association, Inc.

Editorial

Tissue Structure and Ventricular Wall Mechanics

James W. Covell, MD

From the Department of Medicine, University of California, San Diego, La Jolla, Calif.

Correspondence to James W. Covell, MD, Department of Medicine, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093-0613. E-mail jcovell@ucsd.edu

Key Words: Editorials • myocardium • ventricles

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Considering that the left ventricle is a thick-walled body that maintains its volume while reducing intracavitary volume by two thirds, it should come as no surprise that the ventricular wall thickens during systole and that there is a transmural gradient in wall thickening. Wall thickening on the inner wall may exceed values of 40% measured by a variety of techniques. These values far exceed the 8% diameter increase estimated by simple conservation of volume in an individual myocyte shortening by 15%. Physiologists have long understood that changes in the macrostructure of the wall (cellular rearrangement) must account for the difference between wall thickening and estimates of cell thickening.¹ Reorientation of laminae or sheets of muscle cells has been proposed to account for this change in macrostructure.^2,3 The dichotomy between wall thickening and estimated change in myocyte diameter has been elegantly framed by Cheng et al⁴ in this issue of Circulation, which shows nearly identical transmural fiber shortening at 2 ventricular sites, with very different wall thickening in the ovine ventricle. Similar data have been shown for other species.^5,6 However, the data presented by Cheng et al⁴ provide strong evidence that the cellular rearrangements are different at the 2 sites. Cheng et al⁴ used a method developed by Costa et al⁵ in which regional histological measurements of muscle fiber and sheet orientations were used to resolve 3-dimensional transmural strain distributions obtained from implanted arrays of radiopaque markers into components. These components were defined by local axes that are parallel to . . . [Full Text of this Article]