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“形式追随功能”:心脏心房的发育形态学

"Form follows function": the developmental morphology of the cardiac atria.

作者信息

Neradilova C, Gregorovicova M, Kovanda J, Kvasilova A, Melenovsky V, Nanka O, Sedmera D

机构信息

Children's Heart Center, Second Faculty of Medicine, Charles University and Motol University Hospital, Praha, Czech Republic.

出版信息

Physiol Res. 2024 Dec 31;73(S3):S697-S714. doi: 10.33549/physiolres.935503.

Abstract

Although the heart atria have a lesser functional importance than the ventricles, atria play an important role in the pathophysiology of heart failure and supraventricular arrhythmias, particularly atrial fibrillation. In addition, knowledge of atrial morphology recently became more relevant as cardiac electrophysiology and interventional procedures in the atria gained an increasingly significant role in the clinical management of patients with heart disease. The atrial chambers are thin-walled, and several vessels enter at the level of the atria. The left and right atrium have different structures and shape. In general, both atrial chambers have the venous part, the appendage, and the vestibule; different aspects of each part allow us to distinguish morphologically between the left and right atrium. The human atrial conduction system consists of the sinus node and the atrioventricular node with no histologically specialized conduction pathways in the atrial chamber and an interatrial connection. The data show that the propagation of the impulse depends mainly on the myocardial architecture in the atria and the orientation of the myocytes plays a significant role in conduction. To complete the picture, it is also important to know how the atria develop and what is the embryonic origin of its different structures, as this may play a role in the development of some pathological conditions such as atrial fibrillation or certain types of congenital heart defects. Functional impairment of the atria can in some situations severely compromise heart pumping function, and conversely, can support it if other areas are damaged, balancing the blood flow to the body for some time. Key words Morphology of atrial chambers, Pectinate muscles, Atrial function.

摘要

虽然心房的功能重要性低于心室,但心房在心力衰竭和室上性心律失常(尤其是心房颤动)的病理生理学中发挥着重要作用。此外,随着心脏电生理学和心房介入手术在心脏病患者临床管理中的作用日益显著,心房形态学知识最近变得更加重要。心房腔壁薄,有几条血管在心房水平进入。左心房和右心房结构和形状不同。一般来说,两个心房腔都有静脉部分、心耳和前庭;每个部分的不同方面使我们能够在形态上区分左心房和右心房。人类心房传导系统由窦房结和房室结组成,心房腔内没有组织学上专门的传导通路以及房间连接。数据表明,冲动的传播主要取决于心房中的心肌结构,心肌细胞的取向在传导中起重要作用。为了全面了解情况,了解心房如何发育以及其不同结构的胚胎起源也很重要,因为这可能在某些病理状况(如心房颤动或某些类型的先天性心脏缺陷)的发展中起作用。在某些情况下,心房功能受损会严重损害心脏泵血功能,反之,如果其他区域受损,心房功能可以起到支持作用,在一段时间内平衡流向身体的血流。关键词心房腔形态学、梳状肌、心房功能

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