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(Circulation Research. 2001;88:395.)
© 2001 American Heart Association, Inc.

Integrative Physiology

Development of the Myocardium of the Atrioventricular Canal and the Vestibular Spine in the Human Heart

Jung-Sun Kim, Szabolcs Virágh, Antoon F. M. Moorman, Robert H. Anderson, Wouter H. Lamers

From the Department of Anatomy & Embryology (J.-S.K., A.F.M.M., W.H.L.), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Pathology (S.V.), Semmelweis University Faculty of Health Sciences, Budapest, Hungary; and Cardiac Unit (R.H.A.), Institute of Child Health, University College London, London, UK.

Correspondence to Wouter H. Lamers, MD, PhD, Department of Anatomy & Embryology, Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands. E-mail w.h.lamers{at}amc.uva.nl

Abstract—To establish the morphogenetic mechanisms underlying formation and separation of the atrioventricular connections, we studied the remodeling of the myocardium of the atrioventricular canal and the extracardiac mesenchymal tissue of the vestibular spine in human embryonic hearts from 4.5 to 10 weeks of development. Septation of the atrioventricular junction is brought about by downgrowth of the primary atrial septum, fusion of the endocardial cushions, and forward expansion of the vestibular spine between atrial septum and cushions. The vestibular spine subsequently myocardializes to form the ventral rim of the oval fossa. The connection of the atrioventricular canal with the atria expands evenly. In contrast, the expression patterns of creatine kinase M and GlN2, markers for the atrioventricular and interventricular junctions, respectively, show that the junction of the canal with the right ventricle forms by local growth in the inner curvature of the heart. Growth of the caudal portion of the muscular ventricular septum to make contact with the inferior endocardial cushion occurs only after the canal has expanded rightward. The atrioventricular node develops from that part of the canal myocardium that retains its continuity with the ventricular myocardium.

Key Words: atrioventricular junction • atrial vestibule • vestibular spine • tendon of Todaro • atrioventricular node

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