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Eur J Cardiothorac Surg 2007;32:231-249. doi:10.1016/j.ejcts.2007.03.032
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Review

Regional localisation of left ventricular sheet structure: integration with current models of cardiac fibre, sheet and band structure

Computational Biology Laboratory, Institute of Membrane and Systems Biology & Cardiovascular Research Institute, Worsley Building, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK

Received 22 January 2007; received in revised form 12 March 2007; accepted 13 March 2007.

^_* Corresponding author. Tel.: +44 113 343 4251. (Email: stephen{at}cbiol.leeds.ac.uk).

The architecture of the heart remains controversial despite extensive effort and recent advances in imaging techniques. Several opposing and non-mutually compatible models have been proposed to explain cardiac structure, and these models, although limited, have advanced the study and understanding of heart structure, function and development. We describe key areas of similarity and difference, highlight areas of contention and point to the important limitations of these models. Recent research in animal models on the nature, geometry and interaction of cardiac sheet structure allows unification of some seemingly conflicting features of the structural models. Intriguingly, evidence points to significant inter-individual structural variability (within constrained limits) in the canine, leading to the concept of a continuum (or distribution) of cardiac structures. This variability in heart structure partly explains the ongoing debate on myocardial architecture. These developments are used to construct an integrated description of cardiac structure unifying features of fibre, sheet and band architecture that provides a basis for (i) explaining cardiac electromechanics, (ii) computational simulations of cardiac physiology and (iii) designing interventions.

Key Words: Ventricle • Sheet structure • Laminar myocardium • Continuum • Syncytial mesh • Helical ventricular myocardial band

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