Morphology of the sinus node in human and mouse hearts with isomerism of the atrial appendages

S. Y. Ho, Jeong-Wook Seo, N. A. Brown, A. C. Cook, N. L.K. Fagg, R. H. Anderson

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44 Citations (Scopus)

Abstract

Background: The location of the sinus node is known to be at best abnormal, or at worst unknown, in patients with isomerism of the morphologically left atrial appendage. In contrast, the sinus node is known to be an excellent histological marker of the morphologically right appendage, being duplicated in those with right isomerism. The aim of the study was to investigate this condition further in fetal human and mouse hearts. Methods: Serial histological sections of the area anticipated to contain the sinus node were studied in hearts with isomerism of the atrial appendages taken from 14 human fetuses and 13 iv/iv mice, using 12 mouse hearts with normally arranged or mirror imaged atrial chambers for controls. Results: All hearts with isomerism of the right appendages (two human and four mouse) had bilateral sinus nodes. The cases with isomerism of the left appendages (12 human and nine mouse) showed absence of a recognisable sinus node except in four cases (19%) in which a small remnant of the node was found. In three of these cases, it was related postero-inferiorly to the superior cavoatrial junction. Conclusion: The concept of isomerism of the atrial appendages is endorsed by findings on the morphology of the sinus node, this being the most reliable histological criterion for existence of a morphologically right atrium. A small proportion of hearts with left isomerism had a structure resembling the sinus node, but it was hypoplastic and displaced postero-inferiorly, distant from expected position had the hearts possessed an incompletely formed morphologically right appendage.

Original languageEnglish
Pages (from-to)437-442
Number of pages6
JournalBritish Heart Journal
Volume74
Issue number4
StatePublished - 1 Jan 1995

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Isomerism
Atrial Appendage
Sinoatrial Node
Heart Atria
Fetus

Keywords

  • Conduction system
  • Isomerism of atrial appendages
  • Sinus node morphology
  • Situs inversus

Cite this

Ho, S. Y., Seo, J-W., Brown, N. A., Cook, A. C., Fagg, N. L. K., & Anderson, R. H. (1995). Morphology of the sinus node in human and mouse hearts with isomerism of the atrial appendages. British Heart Journal, 74(4), 437-442.
Ho, S. Y. ; Seo, Jeong-Wook ; Brown, N. A. ; Cook, A. C. ; Fagg, N. L.K. ; Anderson, R. H. / Morphology of the sinus node in human and mouse hearts with isomerism of the atrial appendages. In: British Heart Journal. 1995 ; Vol. 74, No. 4. pp. 437-442.
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Ho, SY, Seo, J-W, Brown, NA, Cook, AC, Fagg, NLK & Anderson, RH 1995, 'Morphology of the sinus node in human and mouse hearts with isomerism of the atrial appendages', British Heart Journal, vol. 74, no. 4, pp. 437-442.

Morphology of the sinus node in human and mouse hearts with isomerism of the atrial appendages. / Ho, S. Y.; Seo, Jeong-Wook; Brown, N. A.; Cook, A. C.; Fagg, N. L.K.; Anderson, R. H.

In: British Heart Journal, Vol. 74, No. 4, 01.01.1995, p. 437-442.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Morphology of the sinus node in human and mouse hearts with isomerism of the atrial appendages

AU - Ho, S. Y.

AU - Seo, Jeong-Wook

AU - Brown, N. A.

AU - Cook, A. C.

AU - Fagg, N. L.K.

AU - Anderson, R. H.

PY - 1995/1/1

Y1 - 1995/1/1

N2 - Background: The location of the sinus node is known to be at best abnormal, or at worst unknown, in patients with isomerism of the morphologically left atrial appendage. In contrast, the sinus node is known to be an excellent histological marker of the morphologically right appendage, being duplicated in those with right isomerism. The aim of the study was to investigate this condition further in fetal human and mouse hearts. Methods: Serial histological sections of the area anticipated to contain the sinus node were studied in hearts with isomerism of the atrial appendages taken from 14 human fetuses and 13 iv/iv mice, using 12 mouse hearts with normally arranged or mirror imaged atrial chambers for controls. Results: All hearts with isomerism of the right appendages (two human and four mouse) had bilateral sinus nodes. The cases with isomerism of the left appendages (12 human and nine mouse) showed absence of a recognisable sinus node except in four cases (19%) in which a small remnant of the node was found. In three of these cases, it was related postero-inferiorly to the superior cavoatrial junction. Conclusion: The concept of isomerism of the atrial appendages is endorsed by findings on the morphology of the sinus node, this being the most reliable histological criterion for existence of a morphologically right atrium. A small proportion of hearts with left isomerism had a structure resembling the sinus node, but it was hypoplastic and displaced postero-inferiorly, distant from expected position had the hearts possessed an incompletely formed morphologically right appendage.

AB - Background: The location of the sinus node is known to be at best abnormal, or at worst unknown, in patients with isomerism of the morphologically left atrial appendage. In contrast, the sinus node is known to be an excellent histological marker of the morphologically right appendage, being duplicated in those with right isomerism. The aim of the study was to investigate this condition further in fetal human and mouse hearts. Methods: Serial histological sections of the area anticipated to contain the sinus node were studied in hearts with isomerism of the atrial appendages taken from 14 human fetuses and 13 iv/iv mice, using 12 mouse hearts with normally arranged or mirror imaged atrial chambers for controls. Results: All hearts with isomerism of the right appendages (two human and four mouse) had bilateral sinus nodes. The cases with isomerism of the left appendages (12 human and nine mouse) showed absence of a recognisable sinus node except in four cases (19%) in which a small remnant of the node was found. In three of these cases, it was related postero-inferiorly to the superior cavoatrial junction. Conclusion: The concept of isomerism of the atrial appendages is endorsed by findings on the morphology of the sinus node, this being the most reliable histological criterion for existence of a morphologically right atrium. A small proportion of hearts with left isomerism had a structure resembling the sinus node, but it was hypoplastic and displaced postero-inferiorly, distant from expected position had the hearts possessed an incompletely formed morphologically right appendage.

KW - Conduction system

KW - Isomerism of atrial appendages

KW - Sinus node morphology

KW - Situs inversus

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