Cardiovascular System - Heart Rate Development: Difference between revisions
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* '''Conversion of human cardiac progenitor cells into cardiac pacemaker-like cells'''{{#pmid:31678351|PMID31678351}} "We used a screening strategy to test for reprogramming factors for the conversion of human cardiac progenitor cells (CPCs) into Pacemaker-like cells. Human transcription factors S{{HOX}}2, {{TBX}}3, {{TBX}}5, {{TBX}}18, and the channel protein HCN2, were transiently induced as single factors and in trio combinations into CPCs, first transduced with the connexin 30.2 (CX30.2) mCherry reporter. Following screens for reporter CX30.2 mCherry gene activation and FACS enrichment, we observed the definitive expression of many pacemaker specific genes; including, CX30.2, KCNN4, HCN4, HCN3, HCN1, and SCN3b. These findings suggest that the SHOX2, HCN2, and TBX5 (SHT5) combination of transcription factors is a much better candidate in driving the CPCs into Pacemaker-like cells than other combinations and single transcription factors. Additionally, single-cell RNA sequencing of SHT5 mCherry+ cells revealed cellular enrichment of pacemaker specific genes including TBX3, KCNN4, CX30.2, and BMP2, as well as pacemaker specific potassium and calcium channels (KCND2, KCNK2, and CACNB1). In addition, similar to human and mouse sinoatrial node (SAN) studies, we also observed the down-regulation of NKX2.5. Patch-clamp recordings of the converted Pacemaker-like cells exhibited HCN currents demonstrated the functional characteristic of pacemaker cells. These studies will facilitate the development of an optimal Pacemaker-like cell-based therapy within failing hearts through the recovery of SAN dysfunction." | |||
* '''Non-invasive fetal electrocardiography for the detection of fetal arrhythmias'''{{#pmid:30602066|PMID30602066}} "A total of 500 echocardiography and NI-FECG recordings were collected from pregnant women during a routine medical visit in this multicenter study. All the cases with fetal arrhythmias (n = 12) and a matching number of control (n = 14) were used. Two perinatal cardiologists analyzed the extracted NI-FECG while blinded to the echocardiography. The NI-FECG based diagnosis was compared to the reference fetal echocardiography diagnosis....It is possible to diagnose fetal arrhythmias using the NI-FECG technique. However, this study identifies that improvement in algorithms for reconstructing the P-wave is critical to systematically resolve the mechanisms underlying the arrhythmias. The elaboration of a NI-FECG Holter device will offer new opportunities for fetal diagnosis and remote monitoring of problematic pregnancies because of its low-cost, non-invasiveness, portability and minimal set-up requirements." | * '''Non-invasive fetal electrocardiography for the detection of fetal arrhythmias'''{{#pmid:30602066|PMID30602066}} "A total of 500 echocardiography and NI-FECG recordings were collected from pregnant women during a routine medical visit in this multicenter study. All the cases with fetal arrhythmias (n = 12) and a matching number of control (n = 14) were used. Two perinatal cardiologists analyzed the extracted NI-FECG while blinded to the echocardiography. The NI-FECG based diagnosis was compared to the reference fetal echocardiography diagnosis....It is possible to diagnose fetal arrhythmias using the NI-FECG technique. However, this study identifies that improvement in algorithms for reconstructing the P-wave is critical to systematically resolve the mechanisms underlying the arrhythmias. The elaboration of a NI-FECG Holter device will offer new opportunities for fetal diagnosis and remote monitoring of problematic pregnancies because of its low-cost, non-invasiveness, portability and minimal set-up requirements." | ||
Revision as of 05:37, 10 December 2019
Embryology - 15 Jun 2024 Expand to Translate |
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Introduction
Some Recent Findings
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More recent papers |
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This table allows an automated computer search of the external PubMed database using the listed "Search term" text link.
More? References | Discussion Page | Journal Searches | 2019 References | 2020 References Search term: Fetal Heart Rate | Fetal Electrocardiogram | Fetal Heart Ultrasound | Sinoatrial Node Development | Atrioventricular Node Development | Cardiovascular Development | | Cardiovascular Embryology |
Older papers |
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These papers originally appeared in the Some Recent Findings table, but as that list grew in length have now been shuffled down to this collapsible table.
See also the Discussion Page for other references listed by year and References on this current page.
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Textbooks
- Human Embryology (2nd ed.) Larson Ch7 p151-188 Heart
- The Developing Human: Clinically Oriented Embryology (6th ed.) Moore and Persaud Ch14: p304-349
- Before we Are Born (5th ed.) Moore and Persaud Ch12; p241-254
- Essentials of Human Embryology Larson Ch7 p97-122 Heart
- Human Embryology Fitzgerald and Fitzgerald Ch13-17: p77-111
Embryonic Heart Rate
In a 1996 study normal successful human gestations were defined by EHR criteria at different early embryonic (34-56 days from last menstrual period) developmental stages (at the earliest stages when embryo length is difficult to measure gestational sac diameters are included).[9]
- Stage 9 - 10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
- Stage 11 - 12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
- Stage 16 10 mm embryo EHR at least 120 beats / minute
- Stage 18 15 mm embryo EHR at least 130 beats / minute
Fetal Heart Rate
Week 15 (GA week 17) Fetal Heart Rate audio recording of human embryo heart sounds .
<html5media>File:Week17 fetal heart rate.mp3</html5media>
Ultrasound Measurement
This movie is a realtime ultrasound recording of the week 12 fetus. The bottom window shows doppler analysis to measure the fetal heart rate.
<html5media height="560" width="680">File:Week12_fetal_heart_rate.mp4</html5media>
Click Here to play on mobile device
Electrocardiogram
Electrocardiogram (ECG) with a normal ECG on the left and an ECG showing T-wave inversion on the right.
The T-waves represents the recovery/repolarisation of the ventricles. Inversion of T-waves relate to repolarisation abnormalities which may indicate a problem with the ventricles (in the recovery beat).
Heart Innervation
The 1976 study by Gardner and O'Rahilly[10], summarised below, described the developmental innervation of the heart at the end of the embryonic period (Week 8, Carnegie stage 23).
Left side | Right Side | |
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from cervical sympathetic and from cervical and thoracic vagal (CN X) filaments. | from cervical sympathetic and from cervical and thoracic vagal (CN X) filaments. | |
Form several descending, ganglionated, vagosympathetic filaments that descended to the right of the arch of the aorta and entered the aorticopulmonary ganglion.
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Interconnexions form vagoxympathetic nerves that:
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- The thoracic vagal filaments descended to the left of the arch of the aorta and supplied chiefly the arterial end of the heart.
- No thoracic sympathetic cardiac filaments were found.
Sinu-Atrial Node
- began as a crescentic mass in front of the lower part of the superior vena cava.
- gradually extended on each side of the superior vena cava
- came to form its posterior wall at a more caudal level.
- atrial myocardium that formed the septum spurium, venous valves, and interatrial septum could be traced from the sinu-atrial to the atrioventricular node.
- Myocardium also encircled the atrial aspects of the atrioventricular orifices, and could be traced caudally to the atrioventricular node.
Atrioventricular Node
- was a mass in the anterior and lower part of the interatrial septum
- from which a defined bundle left to enter the interventricular septum.
- Right and left limbs were observed
- Right limb forms a rounded bundle that passed immediately in front of the root of the aorta.
References
- ↑ Raghunathan S, Islas JF, Mistretta B, Iyer D, Shi L, Gunaratne PH, Ko G, Schwartz RJ & McConnell BK. (2019). Conversion of human cardiac progenitor cells into cardiac pacemaker-like cells. J. Mol. Cell. Cardiol. , 138, 12-22. PMID: 31678351 DOI.
- ↑ Behar JA, Bonnemains L, Shulgin V, Oster J, Ostras O & Lakhno I. (2019). Non-invasive fetal electrocardiography for the detection of fetal arrhythmias. Prenat. Diagn. , , . PMID: 30602066 DOI.
- ↑ 3.0 3.1 Fotiadou E, van Laar JOEH, Oei SG & Vullings R. (2018). Enhancement of low-quality fetal electrocardiogram based on time-sequenced adaptive filtering. Med Biol Eng Comput , , . PMID: 29938302 DOI.
- ↑ Lopes-Pereira J, Costa A, Ayres-de-Campos D, Costa-Santos C, Amaral J & Bernardes J. (2018). Computerized analysis of cardiotocograms and ST signals is associated with significant reductions in hypoxic-ischemic encephalopathy and cesarean delivery: an observational study in 38 466 deliveries. Am. J. Obstet. Gynecol. , , . PMID: 30594567 DOI.
- ↑ Gu X, Zhu H, Zhang Y, Han J, Zhang H, Liu Y, Wang A, Liu B, Xue J, Sun B, Weng Z, Ge S & He Y. (2018). Quantile Score: A New Reference System for Quantitative Fetal Echocardiography Based on a Large Multicenter Study. J Am Soc Echocardiogr , , . PMID: 30591282 DOI.
- ↑ Li SF, Wang Y, Li GF, Zhao YY, Chen L & Zhang S. (2018). [Diurnal rhythm of fetal heart rate in third trimester of pregnancy]. Zhonghua Fu Chan Ke Za Zhi , 53, 849-854. PMID: 30585024
- ↑ Grivell RM, Alfirevic Z, Gyte GM & Devane D. (2012). Antenatal cardiotocography for fetal assessment. Cochrane Database Syst Rev , 12, CD007863. PMID: 23235650 DOI.
- ↑ Papaioannou GI, Syngelaki A, Poon LC, Ross JA & Nicolaides KH. (2010). Normal ranges of embryonic length, embryonic heart rate, gestational sac diameter and yolk sac diameter at 6-10 weeks. Fetal. Diagn. Ther. , 28, 207-19. PMID: 20847544 DOI.
- ↑ Coulam CB, Britten S & Soenksen DM. (1996). Early (34-56 days from last menstrual period) ultrasonographic measurements in normal pregnancies. Hum. Reprod. , 11, 1771-4. PMID: 8921130
- ↑ Gardner E & O'Rahilly R. (1976). The nerve supply and conducting system of the human heart at the end of the embryonic period proper. J. Anat. , 121, 571-87. PMID: 1018009
Reviews
Strasburger JF & Wakai RT. (2010). Fetal cardiac arrhythmia detection and in utero therapy. Nat Rev Cardiol , 7, 277-90. PMID: 20418904 DOI.
Bennet L & Gunn AJ. (2009). The fetal heart rate response to hypoxia: insights from animal models. Clin Perinatol , 36, 655-72. PMID: 19732619 DOI.
Butcher JT & Markwald RR. (2007). Valvulogenesis: the moving target. Philos. Trans. R. Soc. Lond., B, Biol. Sci. , 362, 1489-503. PMID: 17569640 DOI.
Articles
Hashima JN, Frias AE, Bernard L, Spindel ER, Hobbs TR & Rasanen J. (2010). Fetal ventricular diastolic filling characteristics in a primate model: the role of fetal heart rate and pulmonary vascular impedance. Reprod Sci , 17, 760-6. PMID: 20595708 DOI.
Park YS, Koh SK, Hoh JK & Park MI. (2010). Difference of fetal heart rate accelerations based on 10 and 15 beats per minute. J. Obstet. Gynaecol. Res. , 36, 291-5. PMID: 20492379 DOI.
Lunshof S, Boer K, Wolf H, van Hoffen G, Bayram N & Mirmiran M. (1998). Fetal and maternal diurnal rhythms during the third trimester of normal pregnancy: outcomes of computerized analysis of continuous twenty-four-hour fetal heart rate recordings. Am. J. Obstet. Gynecol. , 178, 247-54. PMID: 9500482
Mandarim-de-Lacerda CA, Le Floch-Prigent P & Hureau J. (1985). [Study of atrial conduction tissue in the 17 mm V-C human embryo. Morphological contribution to the pathogenesis of sinoauricular node dysfunction]. Arch Mal Coeur Vaiss , 78, 1504-9. PMID: 3938216
Gardner E & O'Rahilly R. (1976). The nerve supply and conducting system of the human heart at the end of the embryonic period proper. J. Anat. , 121, 571-87. PMID: 1018009
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Cite this page: Hill, M.A. (2024, June 15) Embryology Cardiovascular System - Heart Rate Development. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Cardiovascular_System_-_Heart_Rate_Development
- © Dr Mark Hill 2024, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G