Computer Three-Dimensional Anatomical Reconstruction of the Human Sinus Node and a Novel Paranodal Area
Computer Three-Dimensional Anatomical Reconstruction of the Human Sinus Node and a Novel Paranodal Area
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DOI：
10.1002/ar.21379
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发表时间：
2011-06-01
影响因子：
2
通讯作者：
Dobrzynski, Halina
中科院分区：
文献类型：
--
作者：
Chandler, Natalie;Aslanidi, Oleg V.;Dobrzynski, Halina
我们之前在兔子的实验中发现，心脏起搏器（窦结）分布广泛，与右心房内主要起搏器部位的广泛分布相匹配。然而，人类心脏起搏器的精确位置及其与周围右心房肌的空间关系尚不确定。因此，本研究的目的是研究一系列健康人类心脏的窦结组织分布，并为其中一个心脏构建窦结的计算机三维解剖模型，包括肌细胞可能的取向。采用扩散张量磁共振成像（DT-MRI）、组织学、免疫组织化学、图像处理和计算机建模等综合实验技术。我们的数据显示，窦结比以前的研究更大，最重要的是，我们发现了一个以前未知的区域，沿着窦结运行（“旁窦区”），它甚至比窦结更广泛。该区域具有结性和心房组织的特性，可能在起搏中起作用。例如，它可以解释人类右心房主要起搏器部位的广泛分布，这种现象在临床上被称为游离起搏器。总之，一种新的三维解剖重建呈现了人类右心房结细胞分布的新图像。中国生物医学工程学报，2011,29(4):970-979。(C) 2011 Wiley-Liss, Inc。
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.