Myokardiale

Myokardiale is an adjective that denotes relation to the myocardium, the muscular middle layer of the heart wall. The myocardium consists of cardiac muscle cells (cardiomyocytes) that contract rhythmically to pump blood. It forms the thick muscular portion of the heart and lies between the endocardium (inner surface) and the epicardium (outer layer); its thickness is greatest in the left ventricle.

Cardiomyocytes are branched, striated cells connected by intercalated discs, which contain gap junctions and desmosomes. These connections enable rapid electrical propagation and synchronized contraction, essential for the heart’s pumping action. The myocardium relies on a dense coronary circulation, with the left and right coronary arteries delivering oxygenated blood; capillaries permeate the tissue to meet metabolic needs.

Physiology and control: contraction is initiated by electrical impulses that trigger calcium release from the sarcoplasmic reticulum and calcium entry through L-type channels, enabling actin–myosin interaction. The heart’s activity is modulated by the autonomic nervous system and by circulating hormones as needed.

Clinical relevance: diseases of the myocardiale affect heart function. Myocardial infarction (ischemic necrosis) results from reduced blood flow. Myocarditis denotes inflammation of the tissue. Cardiomyopathies—dilated, hypertrophic, and restrictive—describe chronic abnormalities in structure or function. Myokardiale pathology can lead to heart failure, arrhythmias, and reduced exercise capacity.

Diagnosis and imaging: evaluation uses troponin biomarkers, ECG, echocardiography, and advanced imaging such as cardiac MRI or perfusion studies to assess anatomy, function, and tissue integrity.