Computer Three-Dimensional Anatomical Reconstruction of the Human Sinus Node and a Novel Paranodal Area

被引:77
作者
Chandler, Natalie
Aslanidi, Oleg V.
Buckley, David [2 ]
Inada, Shin
Birchall, Steven
Atkinson, Andrew
Kirk, Danielle
Monfredi, Oliver
Molenaar, Peter [3 ]
Anderson, Robert
Sharma, Vinod [4 ]
Sigg, Daniel [4 ]
Zhang, Henggui
Boyett, Mark
Dobrzynski, Halina [1 ]
机构
[1] Univ Manchester, Core Technol Facil, Fac Med & Human Sci, Manchester M13 9NT, Lancs, England
[2] Univ Leeds, Div Med Phys, Leeds, W Yorkshire, England
[3] Univ Queensland, Queensland Univ Technol, Brisbane, Qld, Australia
[4] Medtronic Inc, Minneapolis, MN USA
来源
ANATOMICAL RECORD-ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY | 2011年 / 294卷 / 06期
关键词
sinus node; pacemaking; 3D anatomical model; arrhythmias; PACEMAKER FUNCTION; INSIGHTS; ORIGIN;
D O I
10.1002/ar.21379
中图分类号
R602 [外科病理学、解剖学]; R32 [人体形态学];
学科分类号
100101 ;
摘要
We have previously shown in rabbit that the pacemaker of the heart (the sinus node) is widespread and matches the wide distribution of the leading pacemaker site within the right atrium. There is, however, uncertainty about the precise location of the pacemaker in human heart, and its spatial relationships with the surrounding right atrial muscle. Therefore, the aim of the current study was to investigate the distribution of the sinus node tissue in a series of healthy human hearts and, for one of the hearts to construct a computer three-dimensional anatomical model of the sinus node, including the likely orientation of myocytes. A combination of experimental techniques-diffusion tensor magnetic resonance imaging (DT-MRI), histology, immunohistochemistry, image processing and computer modelling-was used. Our data show that the sinus node was larger than in previous studies and, most importantly, we identified a previously unknown area running alongside the sinus node (the "paranodal area"), which is even more extensive than the sinus node. This area possesses properties of both nodal and atrial tissues and may have a role in pacemaking. For example, it could explain the wide spread distribution of the leading pacemaker site in human right atrium, a phenomenon known as the wandering pacemaker observed in clinics. In summary, a novel 3D anatomical reconstruction presents a new picture of the distribution of nodal cells within the human right atrium. Anat Rec, 294:970-979, 2011. (C) 2011 Wiley-Liss, Inc.
引用
收藏
页码:970 / 979
页数:10
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