The quantitative anatomy of the normal human heart in fetal and perinatal life

Álvarez, Luis; Aránega, Amelia; Saucedo, Roberto; Contreras, JoséA.

doi:10.1016/0167-5273(87)90033-7

Cited by 26 publications

(39 citation statements)

References 5 publications

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“…It is particularly noteworthy that such progress has occurred despite a vacuum in anatomic details concerning the fetal heart and correlation of this information to prenatal echocardiographic data (De la Cruz et al, 1960;Schulz and Giordano, 1962;Van Meurs et al, 1977;Allan et al, 1980Allan et al, , 1984Allan et al, , 1997Alvarez et al, 1987Alvarez et al, , 1990Alvarez et al, , 1991Sun et al, 1999). It was this knowledge gap that led us to perform the present study using fetal hearts between the 13th and 20th weeks of gestation.…”

Section: Discussionmentioning

confidence: 81%

“…At present, there are only a few published studies that report direct morphometric data on the fetal heart and these are rather incomplete (De la Cruz et al, 1960;Sinha et al, 1969;Van Meurs et al, 1977;Alvarez et al, 1987Alvarez et al, , 1990Alvarez et al, , 1991. In light of the current state of knowledge in this field, it seemed of scientific interest to perform a quantitative analysis of normal fetal hearts to improve our knowledge and understanding of heart anatomy during prenatal development and to provide accurate reference information for fetal echocardiography.…”

Section: Introductionmentioning

confidence: 95%

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Morphometric study of the human fetal heart I. Arterial segment

et al. 2005

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This study measured the dimensions of the great arteries of normal human fetal hearts at an early fetal stage (between 13-20 weeks post-fertilization) in 103 fetuses obtained by necropsy. Different segments of the aorta and the pulmonary artery were dissected and their external diameters measured under stereoscopic magnification. All segments showed linear growth during this period of fetal development. Ranges in median values of external diameters associated with the pulmonary artery were: 2.1-4.2 mm for the valve ring; 2.2-4.2 mm for the main pulmonary trunk; 1.2-2.5 mm for the right pulmonary artery; 0.9-2.18 mm for the left pulmonary artery; and 4.0-8.0 mm for the length of the main pulmonary trunk. Similarly, in the aorta, median diameters were: 2.1-4.2 mm for the ascending aorta; 1.92-3.8 mm for the aortic arch; 1.45-3.0 mm for the aortic isthmus; and 1.75 -3.35 mm for the descending aorta. The diameter of the ductus arteriosus ranged between 1.2-2.45 mm. The growth rates of the pulmonary artery and the aorta were similar. The diameter of the ascending aorta was found to be greater than that of the descending aorta and the right pulmonary artery was wider than the left pulmonary artery. In addition, the magnitude of growth in the various aortic segments was different and the ratios obtained between the aortic isthmus and the ascending and descending aortae, ranged between 0.66-0.93. This study provides important morphometric reference information concerning the dimensions and growth of the great arteries of the fetal heart and has clinical application in pediatric cardiac surgery and echocardiography.

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Section: Discussionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 95%

Morphometric study of the human fetal heart I. Arterial segment

et al. 2005

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“…The statistical power was Ͼ85% for all cases with nonsignificant differences in Tables 2 and 3 (aortic diameters and aortic distensibility in descending aorta and PWV) using effect size estimates, representative of the age-related progression of subclinical disease. 21 …”

Section: Distensibility Pwv and Rv Functionmentioning

confidence: 99%

“…Reasons for dilatation of the neoaorta in patients with HLHS after surgery can be attributed to the following constraints. First, the diameter of the pulmonary root, which is used to create the neoaortic root, is larger than the aortic root of healthy subjects 21,22 and determines the size of the neoaortic root. Second, the increased diameters of the ascending aorta and transverse aortic arch are a consequence of surgical implantation of the aortic patch to compensate for underdevelopment of these vascular structures.…”

Section: Aortic Dimensionsmentioning

confidence: 99%

Maladaptive Aortic Properties in Children After Palliation of Hypoplastic Left Heart Syndrome Assessed by Cardiovascular Magnetic Resonance Imaging

et al. 2010

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Background-The status of the reconstructed aorta in hypoplastic left heart syndrome is considered an important determinant of long-term prognosis. Therefore, we assessed the anatomy, elastic properties, and viability of the aorta and right ventricular function in patients with hypoplastic left heart syndrome by cardiovascular magnetic resonance imaging. Methods and Results-Cardiovascular magnetic resonance imaging was performed in 40 patients with hypoplastic left heart syndrome (age, 6.0Ϯ2.2 years) and 13 control subjects (age, 6.6Ϯ2.2 years). Aortic dimensions and distensibility were calculated at different locations of the aorta using gradient-echo cine imaging at 3.0 T. Additionally, pulse-wave velocity, right ventricular ejection fraction, and aortic late gadolinium enhancement for viability assessment were measured. Compared with control subjects, patients with hypoplastic left heart syndrome had increased axial diameters of the aortic root (36.0Ϯ5. 01).Pulse-wave velocity trended higher in patients (Pϭ0.06). Reduced distensibility in the ascending aorta correlated with the amount of late gadolinium enhancement in a volume that included the aortic root and the ascending aorta (rϭϪ0.72, PϽ0.01), and both parameters correlated with decreased right ventricular ejection fraction. Conclusions-Adverse aortic properties post palliation of hypoplastic left heart syndrome manifest themselves by aortic dilatation, decreased distensibility, and increased volume of nonviable aortic wall tissue. The negative association between aortic late gadolinium enhancement and right ventricular ejection fraction suggests unfavorable aortic-ventricular coupling. The potential impact of these findings on long-term right ventricular function should be evaluated in future studies.

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“…The heart grows with negative allometry during the embryonic period and with isometry during the 2nd and 3rd trimes ters together. The anatomogeometric configuration for each ventricle was described analyzing the human heart in fetal and perinatal life (Granada collection) in fetuses of up to 2,700 g in body weight: ventricular wall thickness was greater in the right than in the left ventricle, although the opposite was true in fetuses weighing above this weight [21].…”

Section: Introductionmentioning

confidence: 99%

Growth Allometry of the Myocardium in Human Embryos (from Stages 15 to 23)

Mandarim-de-Lacerda¹

1991

Cells Tissues Organs

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The relative growth of the myocardium was studied in 27 staged human embryos (Carnegie stages). The volume of the myocardium was determined for each embryo according to Cavalieri’s principle (by using point-counting planimetry to determine the area of the profiles of the myocardium). The volume of the myocardium (variable Y) was correlated to embryonic crown-rump length (variable X in millimeters) and age (in days). The bivariate allometric equation was used as Y = aX^b. The scatterplot was discontinuous, presenting two trends during the postsomitic period. The first part was composed of embryos staged from stages 15 to 20, and the second part by embryos staged from stages 21 to 23. The breakpoint between these different trends was found at the level of stage 20 (embryo of 22 mm in crown-rump length and age nearly of 52 days). From stages 15 to 20, the growth rate of the myocardium was allometrically negative. On the other hand, from stages 21 to 23 this growth rate was moderately allometrically positive. These differences in growth of the myocardium were analyzed and, at least partially, might be due to the functional circulatory increase in the peripheral vascular bed in correlation to the cardiac hemodynamic demand required at the end of the embryonic period proper.

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The quantitative anatomy of the normal human heart in fetal and perinatal life

Cited by 26 publications

References 5 publications

Morphometric study of the human fetal heart I. Arterial segment

Morphometric study of the human fetal heart I. Arterial segment

Maladaptive Aortic Properties in Children After Palliation of Hypoplastic Left Heart Syndrome Assessed by Cardiovascular Magnetic Resonance Imaging

Growth Allometry of the Myocardium in Human Embryos (from Stages 15 to 23)

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