New technology and old responsibilities

The heart's fibre alignment assessed by comparing two digitizing systems. Methodological investigation into the inclination angle towards wall thickness. Magnetic resonance myocardial fiber-orientation mapping with direct histological correlation. Influence of endocardial–epicardial crossover of muscle fibers on left ventricular wall mechanics. The purpose of placing this report of diffusion tensor imaging into a surgical journal is not clear. This is a time-consuming study that is technically well done to permit data accumulation.The acquisitions for a complete DTI data set usually take about 9 h, yielding about 200,000 helix angle measurements from each heart. There is extensive background for use of this MRI method in the literature, including histological evaluation by Scollan et al. and Chen et al. [1,2], and the central theme of each paper validates the suggestion of Streeter [3] about the oblique and helical configuration of the fiber orientation. Diffusion tensor imaging papers [4] provide clear eigenvector pixel images of orientation angulation going from epicardium to endocardium of around C60 to K608, yet the authors do not include this helical pattern in their data base and refer to this blueprint in only one sentence in their discussion. This paper amplifies the sustained effort from Lunkenheimer and Anderson to show that the ventricular band concept of Torrent-Guasp is wrong. The diffusion tensor method in dead hearts simply supports the suggestions of Streeter about the helical formation of the ventricle. In fact, each prior MRI paper defines the angle of inclination in the dead heart as the helical angle, with clockwise and counterclockwise fibers traversing the ven-tricular wall, through 0, to define the C60 and K608 inclination angle, as well as transverse dimensions. Similar examples also appear in studies by Hsu, Forder, Geerts (cited in their references), Costa et al [5] using strain, and many others that look at the helical configuration of fibers with diffusion tensor MRI methods. Unfortunately, this concept of helical inclination is completely missing from their results, with a description focus that is directed toward the circular middle portion. Architecture has a structure function counterpart, and the recognized oblique fiber orientation is consistent with the twisting action of torsion that is very evident by tagged MRI studies [6,7]. The authors focus upon the transverse orientation supports the constriction and dilation described by William Harvey [8], who also viewed the dead heart, and thus could not recognize the twisting elements of function that are so visible in the …