Document Detail

Development of the cardiac conduction tissue in human embryos using HNK-1 antigen expression: possible relevance for understanding of abnormal atrial automaticity.
MedLine Citation:
PMID:  9989966     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Abnormal atrial automaticity in young patients with structurally normal hearts is often located around the pulmonary veins and in sinus venosus-related parts of the right atrium. We hypothesize that these ectopic pacemaker sites correspond to areas of embryonic myocardium with an early phenotypic differentiation, as indicated by differences in antigen expression during normal cardiac development. METHODS AND RESULTS: In human embryos ranging in age from 42 to 54 days of gestation, the development of the cardiac conduction system was studied with the use of HNK-1 immunohistochemistry. HNK-1 stains the developing atrioventricular conduction system, ie, the bundle branches, His bundle, right atrioventricular ring, and retroaortic ring. In addition, the myocardium around the common pulmonary vein showed transient HNK-1 antigen expression. In the right atrium, 3 HNK-1-positive connections were demonstrated between the sinoatrial node and the right atrioventricular ring. An anterior tract through the septum spurium connects the sinoatrial node with the anterior right atrioventricular ring, and 2 posterior tracts connect the sinoatrial node with the posterior right atrioventricular ring through the right venous valve (future crista terminalis) and sinus septum, encircling the coronary sinus. The medioposterior part of the right atrioventricular ring connected to the His bundle and the medioanterior part form 2 node-like structures. CONCLUSIONS: In patients with abnormal atrial automaticity, the distribution of left and right atrial pacemaker foci correspond to areas of the embryonic myocardium that temporarily express the HNK-1 antigen.
N A Blom; A C Gittenberger-de Groot; M C DeRuiter; R E Poelmann; M M Mentink; J Ottenkamp
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  99     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1999 Feb 
Date Detail:
Created Date:  1999-03-04     Completed Date:  1999-03-04     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  800-6     Citation Subset:  AIM; IM    
Department of Pediatric Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
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MeSH Terms
Antigens, CD57 / analysis*,  biosynthesis*
Atrioventricular Node / chemistry*,  embryology*,  physiopathology
Biological Markers
Fetus / chemistry
Gestational Age
Heart Atria / chemistry,  embryology,  physiopathology
Image Processing, Computer-Assisted
Tachycardia, Supraventricular / physiopathology*
Reg. No./Substance:
0/Antigens, CD57; 0/Biological Markers
Erratum In:
Circulation. 2005 Jul 26;112(4):e71

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

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