Circulation, Vol 85, 2176-2184, Copyright © 1992 by American Heart Association
I Shiraishi, T Takamatsu, T Minamikawa, Z Onouchi and S Fujita
BACKGROUND. Fibrosis or fatty infiltration of the human sinoatrial (SA)
node is generally believed to represent replacement of the SA nodal cells
by connective tissue. Quantitative analysis, however, has not been
performed precisely to validate the interpretation of such histological
changes. METHODS AND RESULTS. The actual volume of the SA node and its
components were calculated according to the sum of the pixel number
representing the colors of SA nodal cells and connective tissue in serial
sections using a digital color image analyzer. Average volume occupied by
the total SA nodal cells in adolescents and adults (n = 7) was 3.55 +/-
0.45 mm3, which was 2.4 times greater than that in infants (n = 3). The
rate of increase was smaller than that of the total SA node (4.2 times,
16.68 +/- 2.56 mm3 in adolescents and adults). The considerable discrepancy
in the growth ratio between the SA nodal cells and the total SA node
resulted from an increase in the volume of connective tissue (7.4 times).
In the elderly (n = 9), the volume of total SA node and SA nodal cells
actually decreased (13.10 +/- 1.85 mm3 and 2.18 +/- 0.44 mm3), whereas that
of fibrous connective tissue remained unchanged. Constant DNA ploidy
patterns of SA nodal cells determined by cytofluorometry indicated that SA
nodal cells never synthesize DNA during growth. CONCLUSIONS. Until
adulthood, the actual volume of SA nodal cells does not decrease, although
the increase in volume ratio of the interstitial tissue to the total SA
node has merely given a false impression of involution of SA nodal cells.
Atrophy of SA nodal cells, however, occurs during aging together with
reduction of the SA node and/or infiltration of fatty tissue.
ARTICLES
Quantitative histological analysis of the human sinoatrial node during growth and aging
Department of Pathology, Children's Research Hospital, Kyoto, Japan.
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