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© 2017 Wiley Periodicals, Inc. The location of the heart within the thorax varies significantly between individuals. The resultant diversity of the anatomical cardiac long axis, however, and its determinants, have yet to be systematically investigated. We enrolled 100 consecutive patients undergoing coronary arterial computed tomographic angiography, decomposing the vector of the anatomical cardiac long axis by projecting it to horizontal, frontal, and sagittal planes. The projected vectors on each plane were then converted into three rotation angles using coordinate transformation. We then measured the extent of aortic wedging, using the vertical distance between the inferior margins of the non-adjacent aortic sinus and the epicardium. We took the aortic root rotation angle to be zero when an "en face" view of the right coronary aortic sinus was obtained in the frontal view, defining leftward rotation to be positive. The mean horizontal, frontal, and sagittal rotation angles were 48.7°±9.5°, 52.3°±12.0°, and 34.0°±11.2°, respectively. The mean extent of aortic wedging, and the aortic root rotation angle, were 42.7±9.8 mm, and 5.3°±16.4°. Horizontal rotation of the anatomical axis was associated with leftward and ventral rotation, and vice versa. Multivariate analysis showed aortic root rotation to be associated with horizontal cardiac rotation, while aortic wedging is associated with frontal and sagittal cardiac rotation. We have quantified the marked individual variation observed in the anatomical axis of the living heart, identifying the different mechanisms involved in producing the marked three-dimensional diversity of the living heart.
Author(s): Mori S, Anderson RH, Tahara N, Izawa Y, Toba T, Fujiwara S, Shimoyama S, Watanabe Y, Nishii T, Kono AK, Hirata K-I
Publication type: Article
Publication status: Published
Journal: Anatomical Record
Year: 2017
Volume: 300
Issue: 6
Pages: 1083-1092
Print publication date: 01/06/2017
Online publication date: 08/02/2017
Acceptance date: 07/09/2016
ISSN (print): 1932-8486
ISSN (electronic): 1932-8494
Publisher: Wiley-Blackwell
URL: https://doi.org/10.1002/ar.23564
DOI: 10.1002/ar.23564
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