The Atrioventricular Node, his Bundle and Bundle Branches-a New Histologic Technique

A technique for examination of the conducting system of the heart is described. A block of tissue embracing the ostium of the coronary sinus, the pars membranacea, the septal leaflet of the tricuspid valve, and appropriate amounts of interatrial and interventricular septum is flattened and fixed in a Kaiserling I solution. Blocks are subsequently cleared in methyl salicylate and trimmed. Sections are cut from the blocks after paraffin embedding beginning from the endocardial surfaces of the right heart chambers. The sections are mounted and stained on 35 mm unperforated leader film and covered with an acrylic preservative. For examination of the conducting system many fewer sections are required than with previous techniques.     

Quantitative electron microscopic research on the structure of the myocytes in the atrioventricular node and perinodal myocardium of the rat interatrial septum

A quantitative electron microscopical examination of specialized conducting myocytes of types II and III in the atrioventricular node and working myocytes in perinodal region was performed. The volume fractions of myofibrils, mitochondria, nuclei, sarcoplasmic reticulum, glycogen, atrial granules and "clear" cytoplasm were measured, in addition to the diameters of conducting and working myocytes. These data were compared with those for conducting myocytes of types I, II, and III from sinoatrial region and internodal tracts of the rat heart, and with evidence for atrioventricular node of other animals. Principles of an universal classification of conducting myocytes of the heart are discussed.     

Immunodetection of alpha1E voltage-gated Ca(2+) channel in chromogranin-positive muscle cells of rat heart, and in distal tubules of human kidney.

The calcium channel alpha1E subunit was originally cloned from mammalian brain. A new splice variant was recently identified in rat islets of Langerhans and in human kidney by the polymerase chain reaction. The same isoform of alpha1E was detected in rat and guinea pig heart by amplifying indicative cDNA fragments and by immunostaining using peptide-specific antibodies. The apparent molecular size of cardiac alpha1E was determined by SDS-PAGE and immunoblotting (218 +/- 6 kD; n = 3). Compared to alpha1E from stably transfected HEK-293 cells, this is smaller by 28 kD. The distribution of alpha1E in cardiac muscle cells of the conducting system and in the cardiomyoblast cell line H9c2 was compared to the distribution of chromogranin, a marker of neuroendocrine cells, and to the distribution of atrial natriuretic peptide (ANP). In serial sections from atrial and ventricular regions of rat heart, co-localization of alpha1E with ANP was detected in atrium and with chromogranin A/B in Purkinje fibers of the conducting system in both rat atrium and ventricle. The kidney is another organ in which natriuretic peptide hormones are secreted. The detection of alpha1E in the distal tubules of human kidney, where urodilatin is stored and secreted, led to the conclusion that the expression of alpha1E in rat heart and human kidney is linked to regions with endocrine functions and therefore is involved in the Ca(2+)-dependent secretion of peptide hormones such as ANP and urodilatin.     

Microquantitative determination of lactate dehydrogenase isoenzymes in the myocardium and the conducting system

Summary A newly developed technique was used for the electrophoretic separation of lactate dehydrogenase (LDH) isoenzymes from lyophilized tissue samples in the nanogram range. In this study portions of 10–200 ng from the myocardium and the conducting system of cattle, sheep, pig and man were microdissected and analysed.In the heart tissues of cattle, sheep and pig, the isoforms LDH1, LDH2 and LDH3 were detected in species-specific varying amounts. In all these animals, the conducting system is marked by high LDH1 activity, which is present at a ratio of about 2:1 compared with the myocardium. The values in man, however, differ from these values, but this might be due to post-mortem changes. The findings are discussed with respect to possible aerobic-anaerobic functions.     

Presence and co-localization of vasoactive intestinal polypeptide with neuronal nitric oxide synthase in cells and nerve fibers within guinea pig intrinsic cardiac ganglia and cardiac tissue

The presence of vasoactive intestinal polypeptide (VIP) has been analyzed in fibers and neurons within the guinea pig intrinsic cardiac ganglia and in fibers innervating cardiac tissues. In whole-mount preparations, VIP-immunoreactive (IR) fibers were present in about 70% of the cardiac ganglia. VIP was co-localized with neuronal nitric oxide synthase (nNOS) in fibers innervating the intrinsic ganglia but was not present in fibers immunoreactive for pituitary adenylate cyclase-activating polypeptide, choline acetyltransferase (ChAT), tyrosine hydroxylase, or substance P. A small number of the intrinsic ChAT-IR cardiac ganglia neurons (approximately 3%) exhibited VIP immunoreactivity. These few VIP-IR cardiac neurons also exhibited nNOS immunoreactivity. After explant culture for 72 h, the intraganglionic VIP-IR fibers degenerated, indicating that they were axons of neurons located outside the heart. In cardiac tissue sections, VIP-IR fibers were present primarily in the atria and in perivascular connective tissue, with the overall abundance being low. VIP-IR fibers were notably sparse in the sinus node and conducting system and generally absent in the ventricular myocardium. Virtually all VIP-IR fibers in tissue sections exhibited immunoreactivity to nNOS. A few VIP-IR fibers, primarily those located within the atrial myocardium, were immunoreactive for both nNOS and ChAT indicating they were derived from intrinsic cardiac neurons. We suggest that, in the guinea pig, the majority of intraganglionic and cardiac tissue VIP-IR fibers originate outside of the heart. These extrinsic VIP-IR fibers are also immunoreactive for nNOS and therefore most likely are a component of the afferent fibers derived from the vagal sensory ganglia. This work was supported by NIH grant HL65481 (R.L.P.) and HL54633 (D.B.H.). Use of the DeltaVision Restoration microscope was provided through the Imaging/Physiology Core supported by NIH Grant P20 RR16435 from the COBRE program of the National Center for Research Resources     

Gangliosides of the bovine heart impulse conducting system

The ganglioside analysis of the heart impulse conducting system was carried out, comparing it with that of ordinary myocardium. The heart impulse conducting system contained about 3-times more gangliosides than ordinary myocardium and showed a distinctly different ganglioside composition. These observations seemed to indicate that the differentiation between myoblasts and each type of cardiac muscle cell, impulse conducting system and ordinary myocardium cells, resulted in their characteristic ganglioside compositions.     

Enzyme histochemical studies on the Purkinje fibres of canine, bovine and porcine hearts

Synopsis Whereas in ungulates the Purkinje fibres of the atrioventricular conducting system are highly characteristic cells, those in the canine heart are poorly differentiated and accordingly they cannot always be readily identified in histological sections. Consequently in this paper the results of various histochemical tests on bovine and porcine hearts have been compared with the view of evaluating them as dependable methods for identifying Purkinje fibres that are microscopically poorly differentiated.It appeared that, histochemically, canine Purkinje fibres differ consistently in similar ways and as markedly from the common myocardial fibres as the morphologically typical conducting fibres in bovine and porcine hearts. The conducting fibres distinguish themselves from the myocardium proper in containing more glycogen and fewer lipids, in possessing higher activities of the enzymes -glucan phosphorylase,l-glycerol-3-phosphate:menadione oxidoreductase, myosin adenosine triphosphatase and monoamine oxidase, as well as in possessing lower activities of several dehydrogenases, cytochrome oxidase, peroxidase and mitochondrial adenosine triphosphatase. The relatively high activity of -glucan phosphorylase in particular is striking. As the activity of this enzyme persists during periods of up to 20 min after death, the staining method for this enzyme provides a valuable technique for identifying Purkinje fibres even if they are cytologically poorly differentiated.It is of interest in relation to electrophysiological data that the histochemical properties are similar in Purkinje fibres derived from widely differing levels of the conducting system. From the present histochemical findings it may be assumed that, as compared with the myocardium proper, the Purkinje fibres have a higher rate of anaerobic and a lower rate of aerobic metabolism. Furthermore, it is pointed out that histochemically the differences between Purkinje fibres and common myocardial cells on the one hand, and those between white (Type II) and red (Type I) striated muscle fibres on the other, are essentially similar.     

Enzyme histochemical studies on the conducting system of the human heart

Summary In this communication, the results of applying various histochemical techniques for the localization of oxidoreductases, transferases, hydrolases and isomerases in the human heart are presented. The Purkinje fibres of the atrioventricular conducting system of the human heart differ from the myocardium proper in containing a slightly higher activity of most of the glycolytic and gluconeogenetic enzymes investigated. The relatively higher activity of 6-phosphofructokinase, the key enzyme in anaerobic carbohydrate metabolism, is especially noteworthy. On the other hand, the activities of some of the enzymes that play a part in the aerobic energy metabolism is slightly less than those in the myocardium fibres.As for the activity of the NADPH regenerating enzymes, the activity of 6-phosphogluconate dehydrogenase and malate dehydrogenase (oxaloacetate-decarboxylating) is somewhat higher, and the activity of glucose-6-phosphate dehydrogenase similar, in the Purkinje fibres compared to that in the myocardial fibres. The activity of myosin ATPase is similar for both types of fibre. Likewise, the fibres of the conducting system and of the myocardium show a similar activity of acid phosphatase, -glucuronidase, non-specific naphthylesterase and peroxidase. The neurogenic function of the conducting system of the human heart was demonstrated by the high activity of acetylcholinesterase in the Purkinje fibres and in the atrioventricular node. All these histochemical findings in Purkinje fibres are similar at widely differing levels of the conducting system.     

Blood supply and the atrioventricular conduction system of the dog heart

In 30 experiments in order to specify the blood supply and conducting system in the dog heart, coronal arteries were injected with a contrasting mass that was followed by roentgenography and preparation of the coronal arteries. The topography and blood supply of the atrioventricular conducting system with application of prevital blood supply, and the left coronal artery is the main source of blood supply for all the parts of the cardiac atrioventricular conducting system.     

A comparative enzyme histochemical study of glucose metabolism in the conduction system of mammalian hearts.

A histochemical study of some enzymes of glucose metabolism was performed on the heart conduction system of rat, dog, rabbit, pig, calf and lamb. Histochemical activities revealed a higher rate of anaerobic metabolism and a lower rate of aerobic metabolism in the conducting cells in comparison with the working myocardial fibres. An increase of the histochemical activities from the atrioventricular node to the distal portions of bundle branches was noted. The importance of the high glycogen content and the high phosphorylase activity in the heart conduction system was discussed.     

A rapid method for detecting malformations in rat fetuses

A rapid method for examining rat fetuses is presented. The technique consists of fixing the fetuses in Bouin's solution, serially sectioning the head, neck and lower trunk with a razor blade and doing sagittal sections of the heart after opening the thoracic cavity. Examples of sections from normal 20 day rat fetuses are given as well as some with the following abnormalities: cleft palate produced by chlorcyclizine and eye and heart malformations resulting from anti-adult rat kidney serum.     

Isolation of envelope membranes from bundle sheath chloroplasts of maize

Bundle sheath strands were isolated from maize (Zea mays L.) leaves treated with preparations of cellulase, hemicellulase, and pectinase. A three-phase discontinuous gradient yielded two fractions of envelope membranes from bundle sheath chloroplasts. Buoyant densities were 1.06 and 1.09 g cm⁻³. The lighter fraction contained membrane vesicles under light microscopy, but centrifugation produced a pellet that was too small and unstable for purposes of electron microscopy. The heavier fraction contained single and double membrane vesicles and was studied further. Enzymic, chemical, light microscopic, and electron microscopic examination showed less than 2% contamination by stromal contents, no contamination by microbial, microsomal, or mitochondrial membranes, and possible low levels of lamellar membrane contamination. Yields of 0.5 mg of envelope membrane protein were obtained from 56-g leaf sections. The Mg²⁺-dependent nonlatent ATPase activity, a marker enzyme for chloroplast envelope membranes, was 40 μmoles Pi released hr⁻¹ mg protein⁻¹, a value similar to that obtained with pure mesophyll chloroplast envelope membranes from other plants.     

New high-frequency catheter technique for His bundle ablation in dogs

A new method is presented for the production of complete atrioventricular heart block. It consists of a special catheter, which is inserted into the right atrium via a femoral vein and positioned in the region of the His bundle for His bundle potential recording. Production of heart block is achieved by a high frequency current pulse from an electrocautery unit.     

An extra atrioventricular node in an anomalous heart of a calf

An extra atrioventricular node in a double outlet ventricle with a quite normal inflow septum in a calf is described. The anomaly resembles the topography of the conducting system in the calf heart in the embryonic stages from 13.5 mm-90 mm.     

A Method for Histological Examination of Undecalcified Teeth

A method is presented for histological examination of undecalcified ground sections of tooth roots affected with periodontal disease. The roots were placed in Karnovsky's fixative overnight, postfixed in 2% buffered osmic acid, and dehydrated in an ascending series of ethanol. The specimens were then infiltrated with propylene-oxide and Epon-Araldite resin, embedded in Epon-Araldite, and sections were prepared using a cutting and grinding system. The resulting ground sections were 8-12 μm thick. The sections were allowed to air dry at room temperature. When thoroughly dried, a coverglass was applied using resinous mounting medium DPX. The specimens were examined by phase-contrast microscopy. The method is useful for simultaneous examination of mineralized dental tissue and bacterial morphotypes covering the root surface of teeth involved with periodontal disease.     

Widespread epithelioid angiosarcoma with ventricular wall involvement in a dog

This paper reports on a canine angiosarcoma, presenting as an "undifferentiated metastasizing tumor". A 14-year-old female Cocker Spaniel was referred to the University of Extremadura Veterinary Clinic for clinical examination after suffering rapid deterioration, with chronic cough, anorexia and cachexia. One week after clinical examination, the dog died of right congestive heart failure and ventricular arrhythmia. Blood counts revealed lymphopenia and platelet depletion. The biochemistry profile was within normal limits, except for a drop in blood urea nitrogen. Cytological evaluation of liver and spleen biopsies revealed clustered anaplastic cells that lacked convincing tissue differentiation. Major findings at necropsy were enlarged spleen and multiple, beige to dark-red nodules ranging from 0.5 to 3 cm in diameter in the heart, lung, liver and spleen. At histological examination, multiple nests of anaplastic epithelioid cells were found in sections from all affected organs. Immunohistochemistry revealed widespread expression of CD31 and Factor VIII-related antigen. The neoplastic cells were negative for CD 18. The diagnosis of epithelioid angiosarcoma, localized in the myocardium, lung, liver and spleen was made. The primary site of the neoplasm could not be determined.     

A Method for Histological Examination of Undecalcified Teeth

A method is presented for histological examination of undecalcified ground sections of tooth roots affected with periodontal disease. The roots were placed in Karnovsky's fixative overnight, postfixed in 2% buffered osmic acid, and dehydrated in an ascending series of ethanol. The specimens were then infiltrated with propylene-oxide and Epon-Araldite resin, embedded in Epon-Araldite, and sections were prepared using a cutting and grinding system. The resulting ground sections were 8-12 μm thick. The sections were allowed to air dry at room temperature. When thoroughly dried, a coverglass was applied using resinous mounting medium DPX. The specimens were examined by phase-contrast microscopy. The method is useful for simultaneous examination of mineralized dental tissue and bacterial morphotypes covering the root surface of teeth involved with periodontal disease.     

Embryonic histogenesis of the atrioventricular segment of the heart conduction system of swine (Sus porcus L.)]

Histological, histochemical and neurochemical methods were used in order to study the features of the histogenesis of structures of the atrioventricular area of the conducting system of the heart and the formation of their cholinergic innervation in the postnatal period of the hog. Under study were 175 hearts of embryos of the hog at the age of 3, 4, 5, 6, 8, 10, 12, 14 and 15 weeks and 22 hearts of adult hogs. The formation of different areas of this system was shown to be asynchronous. The atrioventricular fascicle is formed during the 4th week, the atrioventricular node -- during the 6th week and the conducting muscle fibres--during the 8th week of embryogenesis. The fascicle and the node have a complicated structure and different cellular composition. In the process of prenatal ontogenesis the increased amount of glycogen and increased activity of phosphorylase were noted in the cytoplasm of myocytes of the atrioventricular area of the conducting system of the heart. The cholinergic nerve fibres grow up to the structures of the atrioventricular area of the conducting system of the heart during the 6th week of embryogenesis, and by the end of the prenatal development they form a thick network in all its structures.     

Myocardial and vascular lesions in the LA/N-corpulent rat

The LA/N-corpulent (LA/N-cp) rat is a normotensive strain derived from Koltesky's original mutant strain of the spontaneously hypertensive rat (SHR). When homozygous for the cp gene (cp/cp), the rats are hyperphagous, hyperlipidemic, hyperinsulinemic, and obese. The rats have been shown, by scanning electron microscope observation of the arterial system, to develop arterial lesions and occasional occlusive thrombi. These are significantly more frequent in the corpulent rats. Histological examination of the heart has shown the presence of four distinguishable types of lesions: type A, muscle scar or cell dropout with pigment deposition and inflammatory cell accumulation; type B, necrosis of a small number of myocytes with reactive inflammatory cells; type C, nodule of chronic inflammatory cells; type D, muscle scar without chronic inflammatory cells. Complete transverse sections of three regions of the heart were examined from rats 3, 6, and 9 months of age. Rats that were homozygous normal (+/+) showed an absence of all types of cardiac lesions. Male corpulent rats showed frequent lesions of all types with the frequency rising consistently with age. Female corpulent rats showed a similar incidence of types C and D lesions to males, but no type B lesions were found. Type A lesions, the most common in corpulent males, were found at a greatly reduced relative frequency. In some instances, we have found occlusive thrombi in a coronary artery of corpulent rats. The disease process in these animals occurs with a normal low fat, virtually cholesterol-free diet and no experimental manipulation.