Initiation of apoptosis in the developing avian outflow tract myocardium.

Apoptosis occurs within the cardiac outflow tract (OFT) myocardium during normal development of chick hearts. This peak of apoptosis occurs at stage 30-31 and coincides with dramatic remodeling of the OFT, suggesting that apoptosis occurs to allow proper alignment of the great vessels over their respective ventricles. The signals that initiate apoptosis in this setting are unknown. The aim of this study was to characterize the cells undergoing apoptosis in the cardiac OFT myocardium and the cells that may influence this process. Two cell populations that may initiate apoptosis of the cardiomyocytes are the cardiac neural crest (CNC) cells and epicardial cells. We examined stage 30-31 chick embryos that had undergone removal of the CNC cells or had delayed epicardial growth for alterations of apoptosis. Removal of the CNC cells did not reduce the levels or pattern of apoptosis in the OFT myocardium. In contrast, impeding the growth of the epicardium over the OFT resulted in a 57% reduction in apoptotic cells in the OFT myocardium. Analysis of the apoptotic cells within the OFT myocardium showed that as many as 92% of them expressed cardiomyocyte markers. In the quail, the endothelial marker QH1 identified a component from the epicardium, endothelial cells, in regions where apoptosis is elevated in the OFT myocardium. These results suggest that a component from the epicardium, possibly endothelial cells, is required for the initiation of apoptosis in OFT cardiomyocytes.     

呼吸内胚层相关第二生心区与小鼠胚胎流出道远端的形态发生

目的探讨小鼠胚胎呼吸内胚层相关第二生心区(PSHF)发育与流出道远端形态发生的关系。方法用免疫蛋白印迹法检测抗胰岛因子-1(ISL-1)在80例胚龄10~14 d小鼠胚胎心脏标本的表达。另用抗ISL-1、抗α-平滑肌肌动蛋白(α-SMA)及抗心肌肌球蛋白重链(MHC)抗体,对36例胚龄11~13 d小鼠胚胎心连续石蜡切片进行免疫组织化学或免疫荧光染色。结果胚龄11~12 d是ISL-1蛋白在小鼠胚胎心脏表达的高峰时段。胚龄11 d,来自鳃弓或心包腔背侧壁等处PSHF的ISL-1阳性细胞延伸进入流出道远端管壁,流出道远端管壁则失去MHC表达,呈α-SMA阳性表达;来自PSHF的ISL-1阳性细胞则围绕呼吸内胚层呈对称性锥体结构分布,锥体顶端突入动脉囊腔呈ISL-1阳性突起。胚龄11.5 d,PSHF锥体顶端进入动脉囊头侧和尾侧管壁,形成流出道远端管壁上对称的ISL-1阳性柱结构;而动脉囊腔尚未分隔,流出道远端仍为单一管道。胚龄12 d,PSHF锥体突起失去ISL-1表达,呈较强的α-SMA表达。在PSHF锥体突起与流出道嵴融合前,两者之间出现主-肺动脉孔;两者融合后则形成α-SMA阳性的暂时性主-肺动脉隔,将动脉囊分隔成MHC阴性的心包内的主动脉和肺动脉。胚龄13 d,主-肺动脉隔逐渐消失,心包内主动脉和肺动脉分离。在MHC阴性的心包内大动脉管壁上出现了α-SMA阳性的平滑肌层,仍可见少量PSHF的ISL-1阳性细胞延伸进入心包内大动脉管壁。结论在小鼠胚胎发育11~13 d,PSHF将动脉囊分隔成心包内的主动脉和肺动脉,并参与心包内大动脉的侧面管壁和对侧面管壁的分化形成。     

Myosin light chain 2a and 2v identifies the embryonic outflow tract myocardium in the developing rodent heart

The embryonic heart consists of five segments comprising the fast‐conducting atrial and ventricular segments flanked by slow‐conducting segments, i.e. inflow tract, atrioventricular canal and outflow tract. Although the incorporation of the flanking segments into the definitive atrial and ventricular chambers with development is generally accepted now, the contribution of the outflow tract myocardium to the definitive ventricles remained controversial mainly due to the lack of appropriate markers. For that reason we performed a detailed study of the pattern of expression of myosin light chain (MLC) 2a and 2v by in situ hybridization and immunohistochemistry during rat and mouse heart development. Expression of MLC2a mRNA displays a postero‐anterior gradient in the tubular heart. In the embryonic heart it is down‐regulated in the ventricular compartment and remains high in the outflow tract, atrioventricular canal, atria and inflow tract myocardium. MLC2v is strongly expressed in the ventricular myocardium and distinctly lower in the outflow tract and atrioventricular canal. The co‐expression of MLC2a and MLC2v in the outflow tract and atrioventricular canal, together with the single expression in the atrial (MLC2a) and ventricular (MLC2v) myocardium, permits the delineation of their boundaries. With development, myocardial cells are observed in the lower endocardial ridges that share MLC2a and MLC2v expression with the myocardial cells of the outflow tract. In neonates, MLC2a continues to be expressed around both right and left semilunar valves, the outlet septum and the non‐trabeculated right ventricular outlet. These findings demonstrate the contribution of the outflow tract to the definitive ventricles and demonstrate that the outlet septum is derived from outflow tract myocardium. Anat Rec 254:135–146, 1999. © 1999 Wiley‐Liss, Inc.     

Septation and separation within the outflow tract of the developing heart

The developmental anatomy of the ventricular outlets and intrapericardial arterial trunks is a source of considerable confusion. First, major problems exist because of the multiple names and definitions used to describe this region of the heart as it develops. Second, there is no agreement on the boundaries of the described components, nor on the number of ridges or cushions to be found dividing the outflow tract, and the pattern of their fusion. Evidence is also lacking concerning the role of the fused cushions relative to that of the so-called aortopulmonary septum in separating the intrapericardial components of the great arterial trunks. In this review, we discuss the existing problems, as we see them, in the context of developmental and postnatal morphology. We concentrate, in particular, on the changes in the nature of the wall of the outflow tract, which is initially myocardial throughout its length. Key features that, thus far, do not seem to have received appropriate attention are the origin, and mode of separation, of the intrapericardial portions of the arterial trunks, and the formation of the walls of the aortic and pulmonary valvar sinuses. Also as yet undetermined is the formation of the free-standing muscular subpulmonary infundibulum, the mechanism of its separation from the aortic valvar sinuses, and its differentiation, if any, from the muscular ventricular outlet septum.     

AgNORs in the myocardium in ischaemic heart disease complicated by heart failure: a postmortem study.

AIM: To evaluate the interphase ribosomal RNA cistron activity of cardiomyocytes in case with ischaemic heart disease complicated by heart failure. METHODS: Nucleoli were investigated in postmortem myocardium samples from 31 cases with ischaemic heart disease (mean (SEM), 57.4 (6.5) years) with or without severe heart failure (18 and 13, respectively) and from eight healthy people who died in accidents (mean (SEM) 25.3 (4.0) years). Myocardium obtained within one hour after death was frozen in liquid nitrogen. Silver staining for nucleolar organiser regions (AgNOR) was performed with a standard procedure and the mean score obtained. On the basis of these data, the average number of AgNORs per nucleus was determined. The Student's t test was used to compare groups. RESULTS: Compared with controls, the mean numbers of AgNORs per nucleus in cardiomyocytes from ischaemic heart disease patients not complicated with severe heart failure were higher (8.0 v 9.9; p < 0.05), but cases with severe heart failure had a progressive decrease in cardiomyocyte AgNORs. A difference in AgNOR numbers between cases with different ischaemic heart disease courses was found when cases with the same New York Heart Association (NYHA) functional stage III of heart failure were studied. CONCLUSIONS: The significant decrease of AgNORs in cardiomyocytes from cases with severe ischaemic heart disease complicated by heart failure seems to be connected with cardiomyocyte adaptation (a variant of hibernation) to a diminished circulation that, hypothetically, may affect the level of ribosomal RNA synthesis.     

小鼠胚胎心流出道近段心室化形成右心室小梁部

目的探讨小鼠胚胎心流出道快速缩短及右心室形成机制。方法用抗α-横纹肌肌动蛋白(SCA)、抗肌球蛋白重链(MHC)抗体标记心肌,抗GATA-4抗体标记心肌及其前体细胞,抗α-平滑肌肌动蛋白(SMA)抗体标记早期心肌细胞,抗增殖细胞核抗原(PCNA)抗体显示增殖细胞,抗人/鼠活性Caspase-3(CAS-3)抗体检测凋亡早期细胞,对胚龄9d(E9)~E12(不同胚龄胚胎各取3~5只)小鼠胚胎心连续切片行免疫组织化学染色。结果E11时动脉囊及流出道远端心肌界退却至心包腔内,GATA-4、SCA、SMA染色示第二生心区前体细胞不断分化为心肌细胞添加在心动脉端使流出道延长。小鼠胚胎心流出道于E12缩短,缩短前及缩短过程中全长未检测到CAS-3阳性细胞。E10~12时右心室及流出道近段心肌不断增生形成小梁并侵入邻近的流出道嵴内,流出道近端嵴逐渐小梁状心肌化改建为右心室壁;E12时近段间充质性流出道嵴内出现散在的SCA、SMA阳性心肌细胞及与流出道心肌相延续的SCA、SMA弱阳性心肌细胞流,这些结果表明近段流出道心肌小梁化、流出道嵴小梁状肌化形成了右心室小梁部。结论小鼠胚胎流出道近段心室化致右心室小梁部形成及流出道快速缩短,心肌细胞凋亡及转分化对流出道快速缩短的作用甚微。     

Deficiency of the Wnt receptor Ryk causes multiple cardiac and outflow tract defects

Ryk is a member of the receptor tyrosine kinase (RTK) family of proteins that control and regulate cellular processes. It is distinguished by binding Wnt ligands and having no detectable intrinsic protein tyrosine kinase activity suggesting Ryk is a pseudokinase. Here, we show an essential role for Ryk in directing morphogenetic events required for normal cardiac development through the examination of Ryk-deficient mice. We employed vascular corrosion casting, vascular perfusion with contrast dye, and immunohistochemistry to characterize cardiovascular and pharyngeal defects in Ryk^?/? embryos. Ryk^?/? mice exhibit a variety of malformations of the heart and outflow tract that resemble human congenital heart defects. This included stenosis and interruption of the aortic arch, ventriculoarterial malalignment, ventricular septal defects and abnormal pharyngeal arch artery remodelling. This study therefore defines a key intersection between a subset of growth factor receptors involved in planar cell polarity signalling, the Wnt family and mammalian cardiovascular development.     

Septation and valvar formation in the outflow tract of the embryonic chick heart

There is no agreement, in the chick, about the number of the endocardial cushions within the outflow tract or their pattern of fusion. Also, little is known of their relative contributions to the formation of the arterial valves, the subpulmonary infundibulum, and the arterial valvar sinuses. As the chick heart is an important model for studying septation of the outflow tract, our objective was to clarify these issues. Normal septation of the outflow tract was studied in a series of 60 staged chick hearts, by using stained whole-mount preparations, serial sections, and scanning electron microscopy. A further six hearts were examined subsequent to hatching. At stage 21, two pairs of endocardial cushions were seen within the developing outflow tract. One pair was positioned proximally, with the other pair located distally. By stage 25, a third distal cushion had developed. This finding was before the appearance of two further, intercalated, endocardial cushions, also distally positioned, which were first seen at stage 29. In the arterial segment, the aortic and pulmonary channels were separated by the structure known as the aortopulmonary septum. The dorsal limb of this septum penetrated the distal dorsal cushion, whereas the ventral limb grew between the remaining two distal cushions, both of which were positioned ventrally. The three distal endocardial cushions, and the two intercalated endocardial cushions, contributed to the formation of the leaflets and sinuses of the arterial roots. The two proximal cushions gave rise to a transient septum, which later became transformed into the muscular component of the subpulmonary infundibulum. Concomitant with these changes, an extracardiac tissue plane was formed which separated this newly formed structure from the sinuses of the aortic root. Our study confirms that three endocardial cushions are positioned distally, and two proximally, within the developing outflow tract of the chick. The pattern of the distal cushions, and the position of the ventral limb of the aortopulmonary septum, differs significantly from that seen in mammals.     

The reaction of the vascular pattern of the hypertrophied myocardium to increased cardiac volume load. A microangiographical study.

Myocardial stereo-microangiography was performed on 30 rats after swimming exercise for one or two periods with and without a previous operation for production of aortic stenosis. In 8 rats with aortic stenosis no swimming exercise followed, and 10 more rats served as normal controls. Swimming exercise resulted in a higher degree of cardiac hypertrophy than aortic stenosis. Both types of cardiac hypertrophy resulted in vascular adaptive reactions in the myocardium. The adaptive reaction to swimming exercise was found to be persistent, at least to some extent, and to be of use if the exercise was resumed. The adaptive alterations in aortic stenosis were further modified by a superimposed period of exercise, although the nutritive capillary vasculature only showed a slight and focal increase in density.     

Activation and release of degradative proteinases within the myocardium are the trigger for ventricular remodeling in chronic heart failure

Our conceptual framework of chronic heart failure is based upon the neurohormonal model. In this construct, neurohormonal systems that provide short-term homeostasis remain activated after a myocardial injury, producing progressive ventricular dysfunction and worsening heart failure. However, this model fails to explain several aspects of the pathophysiology of heart failure, including the mechanisms that trigger neurohoromone release and those that lead to ventricular dysfunction in the absence of a large myocardial infarction. These gaps in our understanding can be explained by an expanded model of heart failure, which focuses on myocardial matrix events as the triggers for disease progression. This model embraces the neurohormonal model, and integrates the roles of the immune system and the myocardial fibroblast, within the matrix, to more fully describe the initiation and progression of the disease.     

Epicardial-like cells on the distal arterial end of the cardiac outflow tract do not derive from the proepicardium but are derivatives of the cephalic pericardium.

A series of recent studies strongly suggests that the myocardium of the cardiac distal outflow tract (d-OFT) does not derive from the original precardiac mesoderm but, instead, differentiates from a so-called anterior heart field. Similar findings were also reported for the endocardium of the d-OFT. However, very little information is available on the origin of the epicardium of the OFT. To address this issue, we have performed a study in which we have combined experimental in vivo and in vitro techniques (construction of proepicardial chimeras, proepicardial ablation, OFT insertion of eggshell membrane pieces, and culture on collagen gels) with molecular characterization techniques to determine this origin and define the properties of d-OFT epicardium compared with proepicardially derived epicardium. Our results demonstrate that the coelomic/pericardial epithelium in the vicinity of the aortic sac (and not the proepicardium) is the origin of d-OFT epicardium. This "pericardially" derived epicardium and the proepicardially derived epicardial tissues differ in their morphologic appearance, gene-expression profile, and in their ability to undergo epithelial-to-mesenchymal transformation. We conclude that the heterogeneity in the epicardial cell population of the OFT could be a factor in the complex developmental remodeling events at the arterial pole of the heart.     

Left ventricular volume and cardiac output of the canine heart

This paper describes a mathematical model of some of the circulatory properties of the heart, and it is demonstrated how information about the volume of the ventricle can be retrieved from dye dilution curves using the value of the volume flow rate, the time for maximum dye concentration to appear at the sampling site, and the mean transit time of the dye. A nomograph has been developed in order to eliminate the need for mathematical calculations. The validity of the model described is assessed in seven dog experiments by comparing results obtained using the dye dilution technique with results from cineangiocardiographic films taken almost simultaneously of dispersed radiographic contrast fluid. The flow measurements have been checked using a new method employing a suspension of radio-opaque particles.     

Baroreflex inhibition of cardiac sympathetic outflow is attenuated by angiotensin II in the nucleus of the solitary tract

Homeostatic regulation of arterial pressure is maintained by arterial baroreceptors. Activation of these receptors results in an inhibition of sympathetic activity to the heart. It is known that angiotensin II in the nucleus tractus solitarii attenuates the baroreceptor reflex-evoked vagal bradycardia. Here, we determined whether the cardiac sympathetic component of the baroreceptor reflex could be modulated by angiotensin II in the nucleus of the solitary tract. An in situ, arterially perfused working heart--brainstem preparation of rat was employed and the sympathetic inferior cardiac nerve recorded. Increases in perfusion pressure caused a reflex bradycardia and inhibition of inferior cardiac nerve activity. Microinjection of angiotensin II (500 fmol) in the nucleus of the solitary tract attenuated significantly both the reflex bradycardia and inhibition of inferior cardiac nerve activity (P<0.01). The latter was reversible and sensitive to losartan, an angiotensin II type 1 receptor antagonist. In contrast, the peripheral chemoreceptor reflex evoked an increase in inferior cardiac nerve activity that was not affected by angiotensin II applied exogenously in the nucleus of the solitary tract. We conclude that within the nucleus of the solitary tract angiotensin II exerts a powerful and specific inhibitory modulation of the baroreceptor reflex control of sympathetic nerve activity destined for the heart. We suggest that our data may have clinical implications relating to hypertension, a condition when angiotensin II activity is heightened in the brain and the efficacy of the baroreflex is reduced.     

Development of the outflow tract and closure of the interventricular septum in the normal human heart

The majority of congenital heart malformations in humans involve defects in the atrioventricular valves, the crest of the interventricular septum, and/or the outflow tract, but the position and timing of these structures during cardiac development is controversial. We examined all 622 staged, serially sectioned normal human embryos and fetuses in the Carnegie Embryological Collection, and obtained a statistical tabulation of the appearance of the endocardial cushion components and surrounding structures for 382 embryos in good condition between stages 9 and 23 inclusive, when the heart normally develops. Accurately scaled drawings of ventral and lateral views of the hearts of seven embryos from stage 13 through 22 were prepared from graphic reconstructions in order to visualize the relationships of the structures under consideration. We found that development of the outflow tract septum follows the apparent functional separation of both the left and right ventricles and the blood streams leaving them. Elevations of the endocardial cushion material are continuous throughout the outflow tract and develop as a consequence of the elliptical configuration imposed on the circular cross section of the outflow tract. The membranous interventricular septum is formed of cushion material in the space bounded by the outflow tract septum, interventricular septum, and the fused AV cushion and right outflow tract cushion. The results of this study are consistent with the assertion that functional separation of the aortic and pulmonary outflow tracts precedes anatomic septation, and that anatomic septation is brought about by mechanical modeling of developing myocardium and endocardial cushion material.     

Rotation of the junction of the outflow tract and great arteries in the embryonic human heart

The factors which give rise to the normal relationship between the great arteries and their respective ventricles are unknown. The developmental anatomy of this region was studied by using frontal, sagittal, or transverse serial histologic sections of 17 normal human embryos of Carnegie stages 15-19 from the Carnegie Embryological Collection. Distances and angles between major anatomic landmarks were determined by using computer reconstructions of the serially sectioned embryos, three-dimensional analytic geometry, and Euclidean distance formulas. The findings show that between stages 15 and 19 there is a marked rotation of the axis of the semilunar valves: frontal 121 degrees counterclockwise, sagittal 196 degrees counterclockwise, and transverse 240 degrees clockwise. Simultaneously the great arteries lengthen at a faster rate than the rest of the heart; and there is also an increase in the caliber and wall thickness of the great arteries. These results suggest that the changing rate of growth between the great arteries and the heart is necessary to align the great arteries, the semilunar valves, and the muscular outflow tract septum appropriately with respect to the interventricular septum. Reductions in the rate of growth of the great arteries relative to the heart could, by causing changes in the rotation of great arteries and outflow tract septum, have a role in the pathogenesis of cardiovascular malformations such as tetralogy of Fallot and transposition of the great arteries.     

Intraoperative damage to the myocardium and heart failure upon radical correction of the tetralogy of Fallot]

The ultrastructure of contractile myocardium at the stages of anoxia and after switching in the coronary circulation was studied on the material of 128 biopsies of the myocardium from 51 patients with Fallot's tetrad operated radically under conditions of artificial circulation and anoxic cardiac arrest. Heterogeneity of cell organelles damage made it difficult to evaluate myocardial injury on the whole. To make morphological data more objective, a geometric method of quantitative analysis was used which permitted to distinguish two groups of damage and to correlate them with the pattern of cardiac activity restoration and the course of the postoperational period. The results indicate some relationship between changes in the ultrastructure of mitochondria and the development of cardiac insufficiency in patients with Fallot's tetrad.     

骨形态发生蛋白-2在小鼠胚胎心流出道发育中的作用

目的 探讨骨形态发生蛋白-2(BMP-2)在小鼠胚胎心流出道发育过程中的作用。 方法 对胚龄9d(E9) ～E15（各胚龄取3～7只）小鼠心连续石蜡切片,用抗α-横纹肌肌动蛋白(α-SCA)抗体、抗胰岛素增强子结合蛋白(ISL-1)抗体、抗增殖细胞核抗原(PCNA)抗体、抗BMP-2抗体进行免疫组织化学染色。结果 E9,流出道心胶质内无细胞,心肌增殖活性低,BMP-2弱表达于流出道心肌、心内膜及心包腔背侧壁。E9～11,流出道增长,心包腔背侧壁ISL-1阳性细胞至流出道远端分化为心肌细胞后增殖逐渐减弱。E10～11,流出道嵴内间充质细胞逐渐增加,可见BMP-2、PCNA阳性细胞;流出道BMP-2表达逐渐增强达高峰,向两端延伸逐渐减弱,动脉端可及心包反折处。E12,流出道缩短,BMP-2表达减弱。E13～15,流出道隔逐渐肌化,BMP-2在心脏近大血管部心肌呈较弱表达。E10～13,流出道远段心肌呈低增殖活性,近段及右心室心肌增殖成小梁致右心室形成及扩大。结论 BMP-2诱导第二生心区(SHF)细胞分化为心肌细胞添加至心动脉端,参与心流出道嵴的发育。BMP-2抑制流出道心肌增殖,流出道近段BMP 2表达减弱重启了心肌细胞增殖,致右心室形成及流出道缩短。低水平的BMP 2可能诱导流出道隔间充质细胞向心肌分化。