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Lookup NU author(s): Professor Bob Anderson
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BackgroundThe anatomical substrate for the mid-mural ventricular hyperechogenic zone remains uncertain, but it may represent no more than ultrasound reflected from cardiomyocytes orientated orthogonally to the ultrasonic beam. We sought to ascertain the relationship between the echogenic zone and the orientation of the cardiomyocytes.MethodsWe used 3D echocardiography, diffusion tensor imaging, and microcomputed tomography to analyze the location and orientation of cardiomyocytes within the echogenic zone.ResultsWe demonstrated that visualization of the echogenic zone is dependent on the position of the transducer and is most clearly seen from the apical window. Diffusion tensor imaging and microcomputed tomography show that the echogenic zone seen from the apical window corresponds to the position of the circumferentially orientated cardiomyocytes. An oblique band seen in the parasternal view relates to cardiomyocytes orientated orthogonally to the ultrasonic beam.ConclusionsThe mid-mural ventricular hyperechogenic zone represents reflected ultrasound from cardiomyocytes aligned orthogonal to the ultrasonic beam. The echogenic zone does not represent a space, a connective tissue sheet, a boundary between ascending and descending limbs of a hypothetical helical ventricular myocardial band, nor an abrupt change in cardiomyocyte orientation.
Author(s): Agger P, Stephenson RS, Dobrzynski H, Atkinson A, Iaizzo PA, Anderson RH, Jarvis JC, Allan SL, Partridge JB, Zhao JC, Zhang HG, MacIver DH
Publication type: Article
Publication status: Published
Journal: Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques
Year: 2016
Volume: 33
Issue: 10
Pages: 1546-1556
Online publication date: 26/10/2016
Acceptance date: 01/01/1900
ISSN (print): 0742-2822
ISSN (electronic): 1540-8175
Publisher: Wiley-Blackwell Publishing, Inc.
URL: http://dx.doi.org/10.1111/echo.13324
DOI: 10.1111/echo.13324
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