Why do T cell-rich foci prefer the front of the heart? We conducted 3D vascular analysis & found that T cell-rich immune foci tended to occupy highly vascularized regions. Do T cells extravasate to the front by virtue of anatomic vasculature or does pathology play a bigger role?

For the first time, we can see how T Cells & Macrophages (MФ) are distributed throughout myocarditis hearts. Intriguingly we show that T cell-rich foci are more concentrated in the front of the heart while MФ-rich foci accumulate in the back. This is confirmed by both flow & PCR.

Endomyocardial biopsies (EMBs) have sensitivities that range 20%-80% for myocarditis. 3D compartment analysis showed that immune foci are mostly found in myocardial regions of the Left Ventricle. This further favors a multimodal EMB approach over a blinded endocardial septal one.

Focusing on the ventricles, we 3D reconstructed immune foci (purple) and blood vessels (red). We showed that myocarditis was mostly made of large branching elongated immune foci that followed vasculature.

For long, we have studied Myocarditis, but have you ever considered how ventricular Myocarditis actually looks like in 3D? To address this question, we performed the first-of-its-kind whole-heart 3D reconstruction of mouse viral myocarditis at the phenotypic and immune levels.