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Functional Morphology of the Heart

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The Heart and Circulation

Abstract

As mentioned in Chap. 1 , the embryonic heart is a modifi ed blood vessel which in the process of looping transforms from a straight tube to a complex, four-chambered organ. However, unlike in the lower vertebrates, e.g., fi sh and amphibians, where the muscular elements within the myocardial walls are ring shaped [ 1 , 2 ], the threedimensional structure of mammalian hearts is characterized by spiral arrangement of muscle fibers. Resemblance between helical forms and flows in nature and the myocardial structure was already known to the Renaissance anatomists and has been a subject of fascination to researchers ever since. Leonardo da Vinci believed that the heart is a “vessel made of dense muscle” and proposed that closure of the aortic valves results from vortical flow in the sinuses of Valsalva [ 3 ]. Leonardo may have been the first to describe the difference between the rotational and irrotational vortex, a key concept of circulation in hydrodynamics [ 4 ]. 1 Richard Lower published the first detailed drawings of the separate myocardial muscular layers–overlapping much like rings of an onion – and drew attention to the fact that the endocardium and epicardium meet directly at the apex which is free of muscular elements [ 5 ]. In 1728, Senac demonstrated that the myocardial fibers are organized in spiral, three-dimensional arrangement, a fi nding repeatedly confi rmed by investigators over the next 200 years. (For review, see [ 6–8 ].)

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Notes

  1. 1.

    Leonardo correctly observed that the velocity of movement in swirling water draining from a tub, or hitting a stationary object, is faster towards the axis of rotation, where the product of tangential velocity and radius is invariant (constant). An object caught in such a “free” or irrotational vortex, e.g., a seed of grass, always points in the same direction as it circles around the center. Irrotational vortices occur in the sinuses of Valsalva, as observed by Leonardo, and also in the ventricles [4]. When, on the other hand, the fluid is impelled into movement by spinning its container, a vortex is formed in which the tangential velocity is proportional to its distance from the center of rotation. In addition to rotating around the center of the container, the seed of grass floating on the surface of such a vortex will also spin around its own axis; hence, the vortex is said to be rotational.

  2. 2.

    See Markl et al. [40] for time-resolved three-dimensional MRI video of intracardiac flow paths (Ref. [38]).

  3. 3.

    In a novel technique of minimally invasive (i.e., without resorting to open-heart surgery and cardiopulmonary bypass) aortic valve replacement know as TAVI (transcatheter aortic valve implantation), the aortic valve is deployed into the aortic root through the heart’s apex, without apparent disruption of left ventricular integrity.

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Authors and Affiliations

  1. Department of Anesthesiology, Albany Medical College, Albany, NY, USA

    Branko Furst MD, FFARCSI (Associate Professor)

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  1. Branko Furst MD, FFARCSI
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Furst, B. (2014). Functional Morphology of the Heart. In: The Heart and Circulation. Springer, London. https://doi.org/10.1007/978-1-4471-5277-4_13

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  • DOI: https://doi.org/10.1007/978-1-4471-5277-4_13

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