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Pipeline for Multi-Scale Three-Dimensional Anatomic Study of the Human Heart

Detailed study of non-failing human hearts rejected for transplantation provides a unique opportunity to perform structural analyses across microscopic ...

David Geffen School of Medicine at UCLA

Photogrammetry of Perfusion-Fixed Heart: Innovative Approach to Study 3-Dimensional Cardiac Anatomy.

Photogrammetry generates a 3-dimensional high-resolution model from multiple 2-dimensional photographs. Herein, we demonstrate a photogrammetry of a perfusion-fixed cardiac sample around the left ventricular summit. The single photogrammetric model can be observed from almost all directions and illustrates important anatomical features for the general cardiologist. ().

Precise appreciation of the 3-dimensional relationship between the edge-to-edge clips and mitral valve apparatus remains clinically challenging. We demonstrate the images of clips observed in situ 4 years after implantation. Detailed observation from this case helps improve our understanding of 3-dimensional clinical cardiac anatomy related to transcatheter edge-to-edge mitral valve repair. ().

Insights Into Interaction Between Clip Device and the Mitral Valve Apparatus in the Human Heart.

Intermediate Accessory Papillary Muscle: An Anatomic Variant of Interest for Transcatheter Edge-to-Edge Mitral Valve Repair.

The coronary circulation plays a crucial role in balancing myocardial perfusion and oxygen demand to prevent myocardial ischemia. Extravascular compressive forces, coronary perfusion pressure, and microvascular resistance are involved to regulate coronary blood flow throughout the cardiac cycle. Autoregulation of the coronary blood flow through dynamic adjustment of microvascular resistance is maintained by complex interactions among mechanical, endothelial, metabolic, neural, and hormonal mechanisms. This review focuses on the neural mechanism. Anatomy and physiology of the coronary arterial innervation have been extensively investigated using animal models. However, findings in the animal heart have limited applicability to the human heart as cardiac innervation is generally highly variable among species. So far, limited data are available on the human coronary artery innervation, rendering multiple questions unresolved. Recently, the clinical entity of ischemia with non-obstructive coronary arteries has been proposed, characterized by microvascular dysfunction involving abnormal vasoconstriction and impaired vasodilation. Thus, measurement of microvascular resistance has become a standard diagnostic for patients without significant stenosis in the epicardial coronary arteries. Neural mechanism is likely to play a pivotal role, supported by the efficacy of cardiac sympathetic denervation to control symptoms in patients with angina. Therefore, understanding the coronary artery innervation and control of microvascular resistance of the human heart is increasingly important for cardiologists for diagnosis and to select appropriate therapeutic options. Advancement in this field can lead to innovations in diagnostic and therapeutic approaches for coronary artery diseases.

Article	Year
Photogrammetry of Perfusion-Fixed Heart: Innovative Approach to Study 3-Dimensional Cardiac Anatomy. JACC. Clinical electrophysiology\| PubMed ID: 37516938	2023
Photogrammetry of Perfusion-Fixed Heart: Innovative Approach to Study 3-Dimensional Cardiac Anatomy. JACC. Case reports\| PubMed ID: 37719294	2023
Insights Into Interaction Between Clip Device and the Mitral Valve Apparatus in the Human Heart. JACC. Case reports\| PubMed ID: 37790766	2023
Intermediate Accessory Papillary Muscle: An Anatomic Variant of Interest for Transcatheter Edge-to-Edge Mitral Valve Repair. Circulation. Cardiovascular imaging\| PubMed ID: 37847764	2023
Innervation of the coronary arteries and its role in controlling microvascular resistance. Journal of cardiology\| PubMed ID: 38346669	2024
Understanding Cardiac Anatomy and Imaging to Improve Safety of Procedures: The Interleaflet Triangle. JACC. Clinical electrophysiology\| PubMed ID: 38430089	2024
Underexpansion and Neoleaflet Bending Caused by Transcatheter Valve-in-Valve Mismatch. JACC. Cardiovascular interventions\| PubMed ID: 38703148	2024

Takanori Sato

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