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Citation:
Feger J, Myocardial fibre disarray. Reference article, Radiopaedia.org (Accessed on 27 Apr 2024) https://doi.org/10.53347/rID-88745
Myocardial disarray, myocardial fibre disarray or cardiac myocyte disarray refers to bizarre disorganisation and texture of cardiac myocyte bundles, individual cardiomyocytes and contractile elements within the sarcomeres. It is an important histological feature of hypertrophic cardiomyopathy where typically >10% of the myocardium is involved 2.
The cardiac myocytes show a loss of their parallel alignment and show a haphazard frequently oblique or perpendicular arrangement to each other resulting in a whorling or swirling appearance of the myocardial architecture 1-3.
Radiographic features
MRI
There is promising research concerning a cardiac MRI based assessment utilising diffusion tensor imaging where decreased fractional anisotropy might represent myocardial disarray if accounting for myocardial fibrosis 4,5.
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1. Marian A & Braunwald E. Hypertrophic Cardiomyopathy: Genetics, Pathogenesis, Clinical Manifestations, Diagnosis, and Therapy. Circ Res. 2017;121(7):749-70. doi:10.1161/CIRCRESAHA.117.311059 - Pubmed
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2. Becker A & Caruso G. Myocardial Disarray. A Critical Review. Heart. 1982;47(6):527-38. doi:10.1136/hrt.47.6.527 - Pubmed
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3. Kocovski L & Fernandes J. Sudden Cardiac Death: A Modern Pathology Approach to Hypertrophic Cardiomyopathy. Archives of Pathology & Laboratory Medicine. 2015;139(3):413-6. doi:10.5858/arpa.2013-0489-rs - Pubmed
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4. Ariga R, Tunnicliffe E, Manohar S et al. Identification of Myocardial Disarray In Patients With Hypertrophic Cardiomyopathy and Ventricular Arrhythmias. J Am Coll Cardiol. 2019;73(20):2493-502. doi:10.1016/j.jacc.2019.02.065 - Pubmed
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5. Moon J, Reed E, Sheppard M et al. The Histologic Basis of Late Gadolinium Enhancement Cardiovascular Magnetic Resonance in Hypertrophic Cardiomyopathy. J Am Coll Cardiol. 2004;43(12):2260-4. doi:10.1016/j.jacc.2004.03.035 - Pubmed
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