Document Detail


Development of the cardiac conduction system in atrioventricular septal defect in human trisomy 21.
MedLine Citation:
PMID:  16148066     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In patients with atrioventricular septal defect (AVSD), the occurrence of nonsurgical AV block has been reported. We have looked for an explanation in the development of the AV conduction system. Human embryos with AVSD and trisomy 21 and normal embryos were examined (age 5-16 wk gestation). Antibodies to human natural killer cell-1 (HNK-1), muscle actin (HHF-35), and collagen VI were used to delineate the conduction system. As in normal hearts, HNK-1 transiently stains the AV conduction system, the sinoatrial node, and parts of the sinus venosus in AVSD. A large distance is present between the superior and inferior node-like part of the right AV ring bundle, comparable to 6-wk-old normal hearts. The definitive inferior AV node remains in dorsal position from 7 wk onward and does not appose to the superior node-like part as seen in normal hearts. Furthermore, in AVSD, a transient third HNK-1-positive "middle bundle" branch that is continuous with the retroaortic root branch and the superior node-like part can be identified, and thus the AV conduction system forms a figure-of-eight loop. At later stages, the AV node remains in dorsal position close to the coronary sinus ostium with a long nonbranching bundle that runs through thin fibrous tissue toward the ventricular septum. The formation of the AV node and the ventricular conduction system in AVSD and Down syndrome differs from normal development, which can be a causative factor in the development of AV conduction disturbances.
Authors:
Nico A Blom; Jaap Ottenkamp; Marco C Deruiter; Arnold C G Wenink; Adriana C Gittenberger-de Groot
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric research     Volume:  58     ISSN:  0031-3998     ISO Abbreviation:  Pediatr. Res.     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-09-08     Completed Date:  2006-01-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  516-20     Citation Subset:  IM    
Affiliation:
Department of Pediatric Cardiology, Leiden University Medical Center, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Down Syndrome*
Heart Conduction System / embryology*
Heart Septal Defects / genetics,  physiopathology*
Humans

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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