The shape and movements of the human left ventricle during systole: A study by cineangiography and by cineradiography of epicardial markers

doi:10.1016/0002-9149(70)90787-3

The American Journal of Cardiology

Volume 26, Issue 3, September 1970, Pages 221-230

https://doi.org/10.1016/0002-9149(70)90787-3 Get rights and content

Abstract

The shape of the left ventricular cavity and the movements of the mitral valve, aorta and coronary arteries were studied in cineangiograms obtained from normal subjects and patients with coronary arterial disease, mitral stenosis or atrial septal defect. Movements of the left ventricular epicardial surface were studied by postoperative cineradiography of radiopaque markers previously attached during closed mitral valvotomy. The pre-ejection and ejection phases of systole were identified from the simultaneously recorded phonocardiogram, apex cardiogram, indirect carotid pulse pressure tracing and electrocardiogram.

The left ventricular epicardial surface contracted in an approximately symmetrical fashion with slight rotational movements about the long axis most marked at the beginning and end of systole, but contraction of the left ventricular cavity appeared less symmetrical because of the systolic increase in wall thickness, approximation of trabeculae and movements of the mitral valve. During pre-ejection, the left ventricular cavity narrowed anteroposteriorly, the descent of the base began and a slight anticlockwise rotation of the epicardial surface was accompanied by a slight thrust of the apex toward the chest wall. During ejection, narrowing of the left ventricular cavity and the descent of the base continued, and a slight clockwise rotation and retraction of the apex occurred in late systole.

The symmetry of left ventricular contraction may be due to the similarity of contractility and afterload of individual myocardial fibers, and the slight rotational movements may be a result of sequential activation of the left ventricular myocardium from endocardial to epicardial surface.

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In the past decade, the introduction of speckle-tracking echocardiography has enabled the quantification of global and regional LV function, longitudinal, radial, and circumferential deformation, and rotation as a more complex assessment of systolic function. LV systole involves a shortening of the ventricular longitudinal axis, a reduction of the inner diameter in the short axis, and a slight rotational movement about the long axis.27-29 In most chronic heart diseases with preserved LV ejection fraction in the early stages, with the exception of pericardial diseases or transmural damage in ischemic heart disease, reduced LV long-axis function with preserved or even increased radial and circumferential deformation and LV torsion can be found.11,30
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^☆: This study was supported by a grant-in-aid from the National Heart Foundation of Australia.

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Clinical studyThe shape and movements of the human left ventricle during systole: A study by cineangiography and by cineradiography of epicardial markers☆

Abstract

Amer J Med

J Thorac Cardiovasc Surg

Amer J Cardiol

Amer J Cardiol

Amer Heart J

Amer Heart J

Amer Heart J

Force-velocity relations in mammalian heart muscle

Amer J Physiol

The relationship of left ventricular circumferential contraction to left ventricular ejection time as an inotropic index in man (abstr)

Clin Res

Contractile state of the left ventricle in man: instantaneous tension-velocity-length relations in patients with and without disease of the left ventricular myocardium

Circ Res

Studies on cardiac dimensions in intact unanesthetized man. 1. Description of techniques and their validation

Circ Res

Myocardial force-velocity relations studied in intact unanesthetized man

J Clin Invest

On the muscular architecture of the ventricles of the human heart

Amer J Anat

The functional anatomy of ventricular contraction

Circ Res

The diastolic filling of the mammalian heart

J Physiol

The contour of ventricular volume curves under different conditions

Amer J Physiol

Movements of the base of the ventricle and the relative constancy of the cardiac volume

Amer J Physiol

Röntgenkinematographische Darstellung der Fliehkrafwirkung

Luftfahrtmed

Changes in configuration of the ventricular chambers during the cardiac cycle

Circulation

The mechanics of ventricular contraction: A cinefluorographic study

Circulation

Continuous measurements of left ventricular dimensions in intact unanesthetized dogs

Circ Res

Clinical study
The shape and movements of the human left ventricle during systole: A study by cineangiography and by cineradiography of epicardial markers☆