How are the cardiomyocytes aggregated together within the walls of the left ventricular cone?

Research output: Contribution to journalReview articlepeer-review


Colleges, School and Institutes

External organisations

  • Institute for Genetic Medicine, Newcastle University, and Newcastle Hospitals NHS Trust, Newcastle upon Tyne, United Kingdom.
  • Institute for Atmospheric and Climate Science; ETH Zurich; Zurich Switzerland
  • Department of Anatomy and Cell Biology, Faculty of Medicine, University of Extremadura, Badajoz, Spain.
  • Aarhus Universitet


The manner of packing together of the cardiomyocytes within the walls of the cardiac ventricles has now been investigated for over half a millennium. In 1669, Lower dissected the ventricular mass, likening the arrangement to skeletal musculature, in the form of a myocardial band extending between the right and left atrioventricular junctions. Pettigrew subsequently showed obvious helical arrangements to be evident within the ventricular walls, but emphasised that the cardiomyocytes were attached to each other, and could not justifiably be compared with skeletal cardiomyocytes. Torrent-Guasp then reactivated the notion that the ventricular mass was formed of a solitary band. Unlike Lower, he dissected the band as extending between the pulmonary to the aortic roots. Multiple investigations conducted using gross dissection and histology, and more recently diffusion tensor magnetic resonance imaging and computed tomographic analysis, have shown an absence of any anatomical boundaries within the walls that might permit the mass uniformly to be dissected so as to reveal the band. A response to a recent letter to the Journal, nonetheless, claimed that the dissections had been validated by clinicians interpreting the findings so as to provide an explanation for ventricular cardiodynamics, arguing that the findings provided a suitable anatomical model for this purpose. Anatomical models, however, are of no value unless they are anatomically correct. In this review, therefore, we summarise the evidence showing that the cardiomyocytes making up the ventricular walls, rather than forming a ventricular myocardial band, are instead aggregated together to form a three-dimensional myocardial mesh.

Bibliographic note

© 2019 Anatomical Society.


Original languageEnglish
Pages (from-to)697-705
Number of pages9
JournalJournal of Anatomy
Issue number4
Early online date17 Jun 2019
Publication statusPublished - Oct 2019


  • aggregated cardiomyocytes, fibrous matrix, helical heart, ventricular myocardial band