The Anatomy, Development, and Evolution of the Atrioventricular Conduction Axis

Anderson, Robert H.; Mori, Shigeo; Spicer, Diane E.; Sánchez‐Quintana, Damián; Jensen, Bjarke

doi:10.3390/jcdd5030044

Cited by 19 publications

(17 citation statements)

References 95 publications

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“…Furthermore, abnormal thickening of the aortic-tomitral continuity showed that the inflammation was propagating beneath the aortic valve toward the left ventricular outflow tract. This observation warned us of the risk of complete atrioventricular block development, as the proximal part of the atrioventricular conduction is closely associated with the membranous septum, which is located at the septal part of the left ventricular outflow tract (15). Although an endomyocardial biopsy was not performed during surgery, the elevated serum Troponin I levels at admission and their prompt improvement after the administration of prednisolone despite the rapid exacerbation of congestive heart failure supported a diagnosis of myocardial inflammation involving the left ventricular outflow tract owing to ANCA-associated vasculitis.…”

Section: Discussionmentioning

confidence: 99%

Predominant Involvement of the Aortic Root in a Patient with Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis: Congestive Heart Failure due to Subacute Severe Aortic Regurgitation and Reversible Conduction Disturbance

et al. 2020

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A 72-year-old woman was referred to our institution with decompensated congestive heart failure owing to subacute severe aortic regurgitation and mitral regurgitation. Her blood sample tested positive for myeloperoxidase anti-neutrophil cytoplasmic antibody (ANCA). Cardiac computed tomography revealed abnormal thickening and shortening of the aortic valvar leaflets as well as wall thickening of the sinuses of Valsalva. Based on the diagnosis of ANCA-associated vasculitis, predominantly involving the aortic root, prednisolone administration was initiated, which failed to improve the valvar dysfunction. The patient underwent aortic root replacement and mitral annuloplasty. Histopathology confirmed severe inflammation involving both the aortic valvar sinuses and leaflets.

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Section: Discussionmentioning

confidence: 99%

Predominant Involvement of the Aortic Root in a Patient with Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis: Congestive Heart Failure due to Subacute Severe Aortic Regurgitation and Reversible Conduction Disturbance

et al. 2020

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“…Instead, this variation is known to be related to the variation in the position of the entirety of the membranous septum relative to the virtual basal ring (Mori et al, ). The inferior margin of the membranous septum reflects, in turn, the location of the atrioventricular conduction axis relative to the virtual basal ring (Anderson et al, ). This metric is important for both the surgeon and interventionalist if iatrogenic damage to the axis is to be avoided.…”

Section: Discussionmentioning

confidence: 99%

“…The latter metric serves as a surrogate for the location of the atrioventricular conduction axis. This feature is of great significance for those performing transcatheter insertion of prosthetic aortic valves (Anderson et al, ; Piazza et al, ).…”

Section: Introductionmentioning

confidence: 99%

The rotational position of the aortic root related to its underlying ventricular support

et al. 2019

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We aimed to assess the relationship of the rotational position of the aortic root to its underlying ventricular support, and to the position of the inferior margin of the membranous septum, which serves as a surrogate of the atrioventricular conduction axis. We analyzed 40 normal heart specimens (19 children, 21 adults). The inferior margin of the membranous septum was measured relative to the virtual basal ring. The rotational position of the aortic root was determined by assessing the relationship of the aortic leaflet of the mitral valve to the interleaflet triangle between the non-and left coronary leaflets. The extent of supporting fibrous versus myocardial tissues was measured. We also performed a similar investigation of 30 adult computed tomographic data sets. The median age was 0.25 years (44% male) for children, and 64 years (33% male) for adults. The aortic root was positioned centrally in 22 specimens (55%), rotated counterclockwise in 6 (15%), and clockwise in 12 (30%). In the setting of counterclockwise rotation, 53.4% (median) of the supporting circumference was myocardial, as opposed to 41.4% (median) in those with centrally positioned roots, and 31.9% (median) in those with clockwise rotation (P < 0.0001). The position of the inferior margin of the membranous septum was not associated with the rotational position. Analysis of the 30 adult computed tomographic data sets (median age 66.5 years, 57% male) confirmed the positive relationship between clockwise rotation of the aortic root and an increase in the extent of fibrous as opposed to myocardial support. The rotational position of the aortic root correlates with variation in the extent of its fibrous as opposed to myocardial ventricular support, but not with the position of the inferior margin of the membranous septum relative to the virtual basal ring.

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“…5;Mines 1913;Jensen et al 2012;Gregorovicova et al 2018). HNK-1, a marker of the atrioventricular conduction axis in human, chicken, and quail, also identifies the atrioventricular conduction axis in crocodilians (Wessels et al 1992;Anderson et al 2018;Kvasilova et al 2019). Crocodilians appear to lack the equivalent of mammalian bundle branches and Purkinje system and the ventricular activation is long like it is in other reptiles (Fig.…”

Section: Septation Of the Reptile Heartmentioning

confidence: 99%

Reptiles as a Model System to Study Heart Development

Jensen

Christoffels

2019

Cold Spring Harb Perspect Biol

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A chambered heart is common to all vertebrates, but reptiles show unparalleled variation in ventricular septation, ranging from almost absent in tuataras to full in crocodilians. Because mammals and birds evolved independently from reptile lineages, studies on reptile development may yield insight into the evolution and development of the full ventricular septum. Compared with reptiles, mammals and birds have evolved several other adaptations, including compact chamber walls and a specialized conduction system. These adaptations appear to have evolved from precursor structures that can be studied in present-day reptiles. The increase in the number of studies on reptile heart development has been greatly facilitated by sequencing of several genomes and the availability of good staging systems. Here, we place reptiles in their phylogenetic context with a focus on features that are primitive when compared with the homologous features of mammals. Further, an outline of major developmental events is given, and variation between reptile species is discussed.

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The Anatomy, Development, and Evolution of the Atrioventricular Conduction Axis

Cited by 19 publications

References 95 publications

Predominant Involvement of the Aortic Root in a Patient with Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis: Congestive Heart Failure due to Subacute Severe Aortic Regurgitation and Reversible Conduction Disturbance

Predominant Involvement of the Aortic Root in a Patient with Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis: Congestive Heart Failure due to Subacute Severe Aortic Regurgitation and Reversible Conduction Disturbance

The rotational position of the aortic root related to its underlying ventricular support

Reptiles as a Model System to Study Heart Development

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