Myocardial fiber disarray

Myocardial disarray, myocardial fiber disarray or cardiac myocyte disarray refers to bizarre disorganization 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 utilizing diffusion tensor imaging where decreased fractional anisotropy might represent myocardial disarray if accounting for myocardial fibrosis ^4,5.