Beginning from the epidemiology of coronary heart disease, the authors firstly analyze the pathology and pathophysiology of the infarcted heart. Back to the basic anatomy of heart muscles, the authors then review the development history of basic anatomy theory of heart muscle fibers, focusing mainly on the helical myocardial band theory. This part covers theories of evolutionary biology, developmental biology, and modern imaging evidence on cardiac structures, as well as the intrinsic link between structures and functions of the heart. The relation between cardiac geometry and function is analyzed with helical myocardial band theory. Then returning to clinical problems, the authors introduce the development of left ventricular reconstruction (LVR), the impact of helical myocardial band theory on LVR, current status and disputes of LVR, and future prospect of LVR.
ObjectiveTo investigate dyssynchrony of non-infarction areas before and after surgical ventricular reconstruction after acute myocardial infarction. MethodsTwelve patients with postinfarction ventricular aneurysm and heart failure who underwent left ventricular reconstruction surgery in Fu wai Hospital from June 1,2010 to June 31,2011 were enrolled in this study. There were 9 male and 3 female patients with their age of 53.9±7.0 years. Another 12 healthy volunteers were chosen as the control group including 10 males and 2 females with their age of 30.6±3.8 years. Magnetic resonance imaging (MRI) was examined preoperatively and within 3 months after discharge with same sequences. Tagging images were analysis by using Harmonic Phase (HARP) software to extract the data and the data were put into another software to calculate dyssynchrony index. ResultsAfter operation,left ventricular ejection fraction (LVEF) improved from 30.3%±7.7% to 43.4%±6.3% (P<0.05) and left ventricular end-systolic volume index decreased from 68.6±10.8 ml/m2 to 32.7±9.0 ml/m2 (P<0.05). However,left ventricular dyssynchrony index of non-infarction areas remained stable from 0.82±0.13 to 0.83±0.17 (P>0.05). ConclusionSurgical ventricular reconstruction can significantly improve LVEF and reduce left ventricular volume,but left ventricular synchrony index of non-infarction areas is not changed.