Histology of Vascular Myocardial Wall of Left Atrial Body After Pulmonary Venous Incorporation

Douglas, Yvonne L.; Jongbloed, Monique R.M.; Groot, Adriana C. Gittenberger‐de; Evers, Dorothea; Dion, Robert; Voigt, Pieter; Bartelings, Margot M.; Schalij, Martin J.; Ebels, Tjark; DeRuiter, Marco C.

doi:10.1016/j.amjcard.2005.11.019

Cited by 91 publications

(66 citation statements)

References 17 publications

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“…During human development, a vascular lining comprising SMCs and an adventitia will evolve at the inside of the LA body that is lined on the outside by atrial myocardium (14). Findings in the current study show a similar phenomenon in the LA of wild-type mouse embryos.…”

Section: Discussionsupporting

confidence: 70%

“…In extracardiac tissues, podoplanin functions as a possible signaling molecule and is involved in the development of osteoblasts (10), intestinal and alveolar epithelium (11), podocytes and mesothelium of the visceral peritoneum (12), and lymphatic endothelium (13). During cardiac development, podoplanin is expressed specifically in the second heart field-derived myocardium and mesenchyme at the venous pole of the heart (7,8).Our previous study in humans (14) demonstrated that during incorporation of the PVs in the LA body, the inner lining of the LA body presents vessel wall tissue. The outer layer of the LA is formed by myocardium covered by epicardium.…”

mentioning

confidence: 99%

“…Our previous study in humans (14) demonstrated that during incorporation of the PVs in the LA body, the inner lining of the LA body presents vessel wall tissue. The outer layer of the LA is formed by myocardium covered by epicardium.…”

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confidence: 99%

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Pulmonary Vein, Dorsal Atrial Wall and Atrial Septum Abnormalities in Podoplanin Knockout Mice With Disturbed Posterior Heart Field Contribution

et al. 2009

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ABSTRACT:The developing sinus venosus myocardium, derived from the posterior heart field, contributes to the atrial septum, the posterior atrial wall, the sino-atrial node, and myocardium lining the pulmonary and cardinal veins, all expressing podoplanin, a coelomic and myocardial marker. We compared development and differentiation of the myocardium and vascular wall of the pulmonary veins (PV), left atrial dorsal wall, and atrial septum in wild type with podoplanin knockout mouse embryos (E10.5-E18.5) by 3D reconstruction and immunohistochemistry. Expression of Nkx2.5 in the pulmonary venous myocardium changes from mosaic to positive during development pointing out a high proliferative rate compared with Nkx2.5 negative myocardium of the sino-atrial node and cardinal veins. In mutants, myocardium of the PVs, dorsal atrial wall and atrial septum was hypoplastic. The atrial septum and right-sided wall of the PV almost lacked interposed mesenchyme. Extension of smooth muscle cells into the left atrial body was diminished. We conclude that myocardium of the PVs, dorsal atrial wall, and atrial septum, as well as the smooth muscle cells, are derived from the posterior heart field regulated by podoplanin. (Pediatr Res 65: 27-32, 2009) T he developmental origin and molecular mechanisms controlling the formation of the myocardium of the pulmonary veins (PV) and the smooth muscle cells (SMCs) of the PV media are a matter of debate. The PV myocardial sleeve develops by either migration of myocardial cells from the left atrium (LA) (1) or by recruitment of extracardiac mesenchymal cells, which differentiate into myocardial cells (2). Based on expression patterns of Nkx2.5, Islet1, and Pitx2c the LA and PV myocardium was suggested to be formed by the addition of myocardial cells from the second heart field at the venous pole (3).The second heart field, part of the splanchnic mesoderm, is involved in the addition of (myocardial) cells to the primary heart tube at both the arterial (the secondary and anterior heart field) and the venous pole (the posterior heart field) (4). Islet1, a marker of undifferentiated cardiac progenitor cells, is expressed throughout the second heart field (5). Myocardial cells can differentiate from second heart field derived mesenchymal cells, and SMCs may also differentiate from mesenchyme (6).The transmembrane glycoprotein podoplanin, a coelomic and myocardial marker expressed in the posterior heart field (7), has gained interest for its role in epithelial-tomesenchymal transformation (EMT) and in formation of the myocardium and coronary SMCs at the venous pole of the heart (8). It is found in the proepicardial organ, epicardium, and sinus venosus myocardium including the sino-atrial node, the PVs and cardinal veins, the dorsal atrial wall and the base of the atrial septum extending into the developing atrial and ventricular cardiac conduction system. Podoplanin promotes EMT by binding ezrin, radixin, moesin (ERM) proteins that activate RhoA, and by down-regulation of the cell-to-cell adhesion mo...

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Section: Discussionsupporting

confidence: 70%

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confidence: 99%

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Pulmonary Vein, Dorsal Atrial Wall and Atrial Septum Abnormalities in Podoplanin Knockout Mice With Disturbed Posterior Heart Field Contribution

et al. 2009

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“…Each LA image was divided into portions by embryological origin as follows: the venous LA (posterior LA including the antrum and posterior wall), anterior LA (excluding the LAA and venous LA), and LAA. 16 Although both the LAA and anterior LA are of embryological primordial atrial origin, they differ in geometry, myocardial fiber orientation, and the distribution of autonomic innervation. Therefore, we divided the LAA and anterior LA, and referenced them to points of inflection and separated the venous LA and anterior LA along the anterior border of both antral ablation lines, roof line, and posterior inferior line on the 3D spiral CT image (Figures 2A,D).…”

Section: Volumetric and Curvilinear Lengths Analyses Of 3d Spiral Ct mentioning

confidence: 99%

Characteristics of Complex Fractionated Atrial Electrogram in the Electroanatomically Remodeled Left Atrium of Patients With Atrial Fibrillation

Park

Kim

et al. 2010

Circ J

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Background: Complex fractionated atrial electrogram (CFAE) guided ablation is effective in some patients with persistent atrial fibrillation (PeAF), but the pattern of CFAE may be different in the remodeled left atrium (LA). Methods and Results:In 100 AF patients (83 males, 55.0±10.6 years old) with AF (51 paroxysmal AF (PAF), 49 PeAF) who underwent catheter ablation, CFAE cycle length (CL) and distribution (NavX 3D map) were compared according to the LA volume (3D-CT) and endocardial voltage (during high right atrial pacing 500-ms (VolPACE) and AF (VolAF; NavX). The mean CFAE-CL was longer (P=0.003) and the % area CFAE was smaller (P=0.006) in patients with LA ≥125 ml than those with <125 ml. The mean CFAE-CL was longer in patients with VolPACE <1.7 mV than those with ≥1.7 mV (P=0.002) and in VolAF <0.7 mV than ≥0.7 mV (P<0.001). The % area CFAE was smaller in patients with VolPACE <1.7 mV than those with ≥1.7 mV (P=0.006). The incidence of septal CFAE was consistently high, regardless of the degree of LA remodeling. Conclusions:In the AF patients with an electroanatomically remodeled LA, the % area of CFAE was smaller and mean CFAE-CL was longer than in those with a less remodeled LA. However, the majority of CFAE are consistently positioned on the septum in the remodeled LA. (Circ J 2010; 74: 1557 - 1563

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“…The LAA plays a role in volume homeostasis secreting ANP and in autonomic innervation due to the presence of ganglia along the groove between the left superior PV and the LAA [1][2][3][4][5][6][7][8][9].…”

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confidence: 99%

To “isolate” or “not to isolate,” the left atrial appendage, “that is the question”

Biase

2016

J Interv Card Electrophysiol

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Histology of Vascular Myocardial Wall of Left Atrial Body After Pulmonary Venous Incorporation

Cited by 91 publications

References 17 publications

Pulmonary Vein, Dorsal Atrial Wall and Atrial Septum Abnormalities in Podoplanin Knockout Mice With Disturbed Posterior Heart Field Contribution

Pulmonary Vein, Dorsal Atrial Wall and Atrial Septum Abnormalities in Podoplanin Knockout Mice With Disturbed Posterior Heart Field Contribution

Characteristics of Complex Fractionated Atrial Electrogram in the Electroanatomically Remodeled Left Atrium of Patients With Atrial Fibrillation

To “isolate” or “not to isolate,” the left atrial appendage, “that is the question”

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