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ResumenObjetivo: Exponer las características histológicas y funcionales que se presentan en el tejido muscular estriado cardíaco especializado en la conducción del estímulo eléctrico y sus implicaciones actuales en las arritmias cardíacas. Materiales y métodos: Se seleccionaron publicaciones en revistas indexadas en las bases PubMed, Wiley, Ovid-Medline y Science Direct. Los descriptores MESH utilizados para la búsqueda fueron cardiac myocytes, myocardium, heart conduction system. Se acoplaron los conceptos histology y arrhythmia. Se revisaron artículos publicados entre 1990 a 2014, originales, reportes de caso y revisiones, relacionados con los conceptos de desarrollo embrionario, diferenciación celular, morfología normal y alteración de los miocardiocitos conducentes ventriculares. Se revisó el resumen de 317 artículos, de los que se clasificaron 75 para lectura completa y de estos, 52 se seleccionaron para la redacción del presente artículo. Conclusión: Los estudios actuales se encaminan hacia las simulaciones del sistema de conducción para establecer otras causas de arritmia y opciones de tratamiento. La terapia con células indiferenciadas y las técnicas moleculares de modificación genética hacen parte de estos estudios, así como la implementación de terapias alternativas no invasivas en el tratamiento de las arritmias cardíacas. AbstractObjective: To expose the histological and functional characteristics that occur in heart striated muscle tissue specialized in the conduction of electrical stimulation and its current implications for cardiac arrhythmias. Materials and methods: Publications in indexed journals in PubMed, Wiley, Ovid-Medline and Science Direct databases were selected. The MESH descriptors used for the search were cardiac myocytes, myocardium and heart conduction system. The concepts of histology and arrhythmia were mated. Articles published from 1990 to 2014 were reviewed as well as the original ones, case reports and reviews related to the concepts of embryonic development, cell differentiation and normal morphology alteration of the leading ventricular cardiomyocytes. The summary of 317 articles were read, from which 75 were classified to complete reading and finally 52 were selected for the drafting of this article. Conclusion: Current studies are directed towards the driving system simulation to establish other causes of arrhythmia and its treatment options. Not only therapies with undifferentiated cells and molecular genetic modification techniques are part of these studies but also the implementation of alternative therapies that are not invasive in the treatment of cardiac arrhythmias.
ResumenObjetivo: Exponer las características histológicas y funcionales que se presentan en el tejido muscular estriado cardíaco especializado en la conducción del estímulo eléctrico y sus implicaciones actuales en las arritmias cardíacas. Materiales y métodos: Se seleccionaron publicaciones en revistas indexadas en las bases PubMed, Wiley, Ovid-Medline y Science Direct. Los descriptores MESH utilizados para la búsqueda fueron cardiac myocytes, myocardium, heart conduction system. Se acoplaron los conceptos histology y arrhythmia. Se revisaron artículos publicados entre 1990 a 2014, originales, reportes de caso y revisiones, relacionados con los conceptos de desarrollo embrionario, diferenciación celular, morfología normal y alteración de los miocardiocitos conducentes ventriculares. Se revisó el resumen de 317 artículos, de los que se clasificaron 75 para lectura completa y de estos, 52 se seleccionaron para la redacción del presente artículo. Conclusión: Los estudios actuales se encaminan hacia las simulaciones del sistema de conducción para establecer otras causas de arritmia y opciones de tratamiento. La terapia con células indiferenciadas y las técnicas moleculares de modificación genética hacen parte de estos estudios, así como la implementación de terapias alternativas no invasivas en el tratamiento de las arritmias cardíacas. AbstractObjective: To expose the histological and functional characteristics that occur in heart striated muscle tissue specialized in the conduction of electrical stimulation and its current implications for cardiac arrhythmias. Materials and methods: Publications in indexed journals in PubMed, Wiley, Ovid-Medline and Science Direct databases were selected. The MESH descriptors used for the search were cardiac myocytes, myocardium and heart conduction system. The concepts of histology and arrhythmia were mated. Articles published from 1990 to 2014 were reviewed as well as the original ones, case reports and reviews related to the concepts of embryonic development, cell differentiation and normal morphology alteration of the leading ventricular cardiomyocytes. The summary of 317 articles were read, from which 75 were classified to complete reading and finally 52 were selected for the drafting of this article. Conclusion: Current studies are directed towards the driving system simulation to establish other causes of arrhythmia and its treatment options. Not only therapies with undifferentiated cells and molecular genetic modification techniques are part of these studies but also the implementation of alternative therapies that are not invasive in the treatment of cardiac arrhythmias.
In mammals, the sinus node and atrioventricular node are defined as the heart's specific stimulus and conduction systems. The electrical stimulation that starts in the sinus node continues with the atrioventricular node, and the rhythmic stimulation occurs in this way. There are differences in the sinus and atrioventricular nodes' location, size, and cell structures between species. In this study, which was carried out to determine the morphological structures and locations of the sinus and atrioventricular nodes in Saanen goat hearts, nine hearts from healthy goats were used. After performing the routine tissue follow-up procedure for histological examinations, 5 μm-thick serial sections taken from paraffin-blocked samples were stained with Crossman Trichrome and Periodic Acid Schiff (PAS) and photographed. It was determined that the sinus node was in a subepicardial position near where the cranial vena cava opens up to the right atrium. The sinus node, with an average length of 8-10 mm was crescent-shaped. The atrioventricular node was located in the subendocardium layer in the right half of the interatrial and the interventricular septum, where the coronary sinus opened into the right atrium. An atrioventricular node with an average length of 4.5-5 mm was observed to be roughly oval. Two types of cells were identified in both nodes: cells with small, rounded with empty cytoplasm and rather large nuclei, and cells with thin, elongated structures and darker staining.
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