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Organisation tri-dimensionnelle des cellules myocardiques au cours du développement ventriculaire fœtal et postnatal

Abstract : The 3D architecture of the ventricular mass is poorly known, although in vivo imaging techniques show the physiological inhomogeneity of transmural myocardial mechanics. Polarized light imaging makes it possible to quantitatively analyse the myocardial cell orientation to study the regional isotropy of myosin filaments (a new parameter) and to provide virtual dissection (a new tool) of the myocardial ventricular mesh. This deep inside is complementary of superficial anatomical description.Sixteen normal hearts of human term stillbirths, newborns and infants were studied. During the first months of postnatal age, the median regional isotropy values decreased in the ventricular three-dimensional mesh. There was a progressive appearance of a particularly inhomogeneous secondary arrangement of myocardial cells with alternation of thick low-RI and thin high-RI areas. The topology of Torrent-Guasp' cleavage plans and intercalated high RI areas were identical. The outlet septum was constantly identified.Eleven malformed hearts were studied. The deep components of the ventriculo-infundibular fold, the outlet septum and the latitudinal fibres of the ventricular walls were described and 3 different patterns could be portrayed : 1) a normal aligned pattern ; 2) a parallel pattern of the ventriculo-infundibular fold and the outlet septum in Tetralogy of Fallot ; 3) a V pattern of the ventriculo-infundibular fold in heart with mitro-arterial muscular discontinuity.To conclude, we uncover new elements to understand the onset of the myocardial architecture in normal and pathological hearts. However, this new data need to be statistically consolidated by studying a greater numbers of cases. As a perspective, these observations will be confronted to physiological data provided by functional imaging technique.
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Ba Luu Truong. Organisation tri-dimensionnelle des cellules myocardiques au cours du développement ventriculaire fœtal et postnatal. Biologie du développement. Université Grenoble Alpes, 2017. Français. ⟨NNT : 2017GREAS011⟩. ⟨tel-01693647⟩

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