左心室重建术:从解剖到临床

Left Ventricular Reconstruction:from Anatomy to Surgery

以冠心病的流行病学作为开端,首先对心肌梗死后的心脏进行了病理解剖学和病理生理学分析,然后对心肌的基本解剖学,即心脏心肌纤维的解剖基础理论的形成与发展过程作了历史性回顾,主要阐述了螺旋心肌带理论,内容还涵盖了心脏结构的系统进化生物学、发育生物学、现代影像学证据,以及心脏的结构及功能的生理学内在联系。用螺旋心肌带理论解释了心脏几何形态与功能的内在联系。然后再回到临床问题,介绍左心室重建术的形成及发展,螺旋心肌带理论对左心室重建术的发展演化现状的影响;并对左心室重建术的现状以及存在的争议作了客观陈述,最后对左心室重建术的未来发展方向作了前景展望。

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 modem 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.