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. 2024 Oct 14;11:1410859. doi: 10.3389/fcvm.2024.1410859

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© 2024 Zheng, Huang, Ahmed, Pat, Lloyd, Sharifov, Denney and Dell'Italia.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Importance of mid LV remodeling in PMR. (A) CMR images of a normal subject and PMR patient demonstrate LV wall thinning and decrease in sphericity index (green lines length/width). (B) Color-coded LV maps demonstrating decrease in endocardial curvature (bluer) at mid LV (blue dot marks interventricular septum). (C) TEM of endomyocardial biopsies from mid LV lateral wall (green arrow in A) depicting extensive myofibrillar lysis, and breakdown of sarcomere structure with disorganized and damaged mitochondria. (D) CMR LVESD measurement as the sum of 32 radially directed vectors measured at the tips of the papillary muscles in the mid LV near measurement of mid LV circumferential strain rate.