Elektronenmikroskopische Untersuchungen am Herzmuskel der Ratte w�hrend der Entwicklung

Cardiomyocyte Proliferation from Fetal- to Adult- and from Normal- to Hypertrophy and Failing Hearts

Simple Summary

Death from injury to the heart from a variety of causes remains a major cause of mortality worldwide. The cardiomyocyte, the major contracting cell of the heart, is responsible for pumping blood to the rest of the body. During fetal development, these immature cardiomyocytes are small and rapidly divide to complete development of the heart by birth when they develop structural and functional characteristics of mature cells which prevent further division. All further growth of the heart after birth is due to an increase in the size of cardiomyocytes, hypertrophy. Following the loss of functional cardiomyocytes due to coronary artery occlusion or other causes, the heart is unable to replace the lost cells. One of the significant research goals has been to induce adult cardiomyocytes to reactivate the cell cycle and repair cardiac injury. This review explores the developmental, structural, and functional changes of the growing cardiomyocyte, and particularly the sarcomere, responsible for force generation, from the early fetal period of reproductive cell growth through the neonatal period and on to adulthood, as well as during pathological response to different forms of myocardial diseases or injury. Multiple issues relative to cardiomyocyte cell-cycle regulation in normal or diseased conditions are discussed.

Abstract

The cardiomyocyte undergoes dramatic changes in structure, metabolism, and function from the early fetal stage of hyperplastic cell growth, through birth and the conversion to hypertrophic cell growth, continuing to the adult stage and responding to various forms of stress on the myocardium, often leading to myocardial failure. The fetal cell with incompletely formed sarcomeres and other cellular and extracellular components is actively undergoing mitosis, organelle dispersion, and formation of daughter cells. In the first few days of neonatal life, the heart is able to repair fully from injury, but not after conversion to hypertrophic growth. Structural and metabolic changes occur following conversion to hypertrophic growth which forms a barrier to further cardiomyocyte division, though interstitial components continue dividing to keep pace with cardiac growth. Both intra- and extracellular structural changes occur in the stressed myocardium which together with hemodynamic alterations lead to metabolic and functional alterations of myocardial failure. This review probes some of the questions regarding conditions that regulate normal and pathologic growth of the heart.

Changes in Cardiomyocyte Cell Cycle and Hypertrophic Growth During Fetal to Adult in Mammals

The failure of adult cardiomyocytes to reproduce themselves to repair an injury results in the development of severe cardiac disability leading to death in many cases. The quest for an understanding of the inability of cardiac myocytes to repair an injury has been ongoing for decades with the identification of various factors which have a temporary effect on cell‐cycle activity. Fetal cardiac myocytes are continuously replicating until the time that the developing fetus reaches a stage of maturity sufficient for postnatal life around the time of birth. Recent reports of the ability for early neonatal mice and pigs to completely repair after the severe injury has stimulated further study of the regulators of the cardiomyocyte cell cycle to promote replication for the remuscularization of injured heart. In all mammals just before or after birth, single‐nucleated hyperplastically growing cardiomyocytes, 1X2N, undergo ≥1 additional DNA replications not followed by cytokinesis, resulting in cells with ≥2 nuclei or as in primates, multiple DNA replications (polyploidy) of 1 nucleus, 2X2(+)N or 1X4(+)N. All further growth of the heart is attributable to hypertrophy of cardiomyocytes. Animal studies ranging from zebrafish with 100% 1X2N cells in the adult to some strains of mice with up to 98% 2X2N cells in the adult and other species with variable ratios of 1X2N and 2X2N cells are reviewed relative to the time of conversion. Various structural, physiologic, metabolic, genetic, hormonal, oxygenation, and other factors that play a key role in the inability of post‐neonatal and adult myocytes to undergo additional cytokinesis are also reviewed.

Excitation-contraction coupling of the developing rat heart

Postnatal maturation of rat heart is characterized by increases in force production, velocity of shortening and heart rate. Simultaneously with the enhanced cardiac power production the size of ventricular myocytes markedly increases. Parallel increase in cardiac rate functions and cells size would be expected to require reorganization of cardiac Ca regulation so that adequate rate of Ca release and uptake can be maintained. In accordance with this the source of activator Ca shifts from extracellular space to intracellular stores within the first four or five weeks of postnatal life. Calcium handling of sarcoplasmic reticulum and sarcolemma change in complementary manner so that diminishing sarcolemmal Ca transport is compensated with enhanced Ca release and sequestration by the sarcoplasmic reticulum during the early postnatal development of rat heart. These functional changes are partly due to reciprocal alterations in surface area of sarcolemma and sarcoplasmic reticulum, partly due to age-dependent changes in the expression of different transport systems and their kinetic properties.

Morphological development of the rat heart growing in oculo in the absence of hemodynamic work load

We evaluated cardiac muscle development in the absence of hemodynamic work load but in the presence of host factors including blood vessels, nerves, and circulating neurohumoral agents by transplanting 12-day fetal rat ventricle into the anterior eye chamber of adult host rats. Implants were studied by electron microscopy at intervals from 1 to 14 weeks in oculo. For comparison with myocardium developing in oculo, 12-day fetal tissue and 3-, 8-, and 28-day-old normally growing rats were also studied. At 1 week in oculo, myofibrils were laterally located and more frequent than in the 12-day fetus. Fibrils had clear Z bands and H bands, but no M bands. At 10 days in oculo (comparable to birth in normally growing animals), myocyte mitoses were present and tritiated thymidine autoradiography revealed many labeled myocyte nuclei. By 5 weeks in oculo, cells were filled with mature myofibrils with clear M bands and lateral connections between adjacent Z bands. However, myofibril bundles sometimes coursed at sharp angles to each other within single cells. Except for the relative lack of fibrillar polarization and small cell size, ultrastructure of myocytes developing in oculo for 5 or more weeks appeared very similar to myocytes developing in normally growing rats. By 10 weeks in oculo, when in situ growing hearts are clearly in a hypertrophic phase of growth, no mitoses or tritiated thymidine-labeled nuclei were present in myocytes, although labeled nonmyocyte nuclei were present. Morphometric evaluation revealed no change in myocyte diameter or nuclear-to-cytoplasmic ratio from 1 to 3 weeks in oculo, consistent with continued hyperplastic growth. Binucleated cells were present by 3 weeks in oculo and later, and the cytoplasm per nucleus increased fourfold between 3 and 5 weeks in oculo, suggesting conversion to hypertrophic cell growth. We concluded that cells proliferated and differentiated in the absence of a hemodynamic load, but that polarized alignment of myocytes and myofibrils was incomplete.

Sarcolemmal ATPase activities of the rat heart ventricle--dependence on age and sodium ion

Na-K-ATPase activity of the rat heart was similar throughout the postnatal growth when measured from crude unpurified fraction. Instead in the cardiac sarcolemmal fraction, isolated by hypotonic shock LiBr-treatment method, the activity was over two times higher in 10-day old neonates than in adult rats. The conflicting results are partly explained by different effects of the isolation procedure on neonatal and adult tissues. Na concentration for half-maximal activity of the Na-K-ATPase was similar in neonates (7.0 mM) and adults (6.4 mM). Ca-ATPase activity was not affected by Na concentration (2-100 mM) in the two age-groups studied.

Postnatal changes in the inotropic effect of ouabain on the rat heart ventricle

The concentration-dependent effects of ouabain on the contractility of postnatally developing rat heart ventricles were studied. Ouabain caused a positive inotropic effect in right ventricular strips of neonatal rats up to the age of about 30 days but a negative inotropic effect in the adult cardiac tissue. When extracellular Ca concentration was lowered from 2.5 to 1.0 mmol/l and the rate of stimulation was simultaneously elevated from 0.2 to 1.0 Hz a clear positive inotropic effect was also generated in the adult rat heart. The positive inotropic effect of ouabain showed a biphasic developmental pattern: the contractile force first grew from birth to about 15 days of age but steeply declined near to the adult level during the 3rd postnatal week. The force response to ouabain occurred within two distinct dose-ranges. In the newborn only the high-dose (above 3 X 10(-6) mol/l) effect was seen but in rats older than 5 days a mixed low-dose (below 3 X 10(-6) mole/l)/high-dose effect was apparent. In both ranges the positive inotropic effect of ouabain seemed to be dependent on caffeine sensitive Ca store, perhaps the sarcoplasmic reticulum. It is suggested that during the 3rd postnatal week a transition from extracellular to intracellular Ca stores occurs in the rat heart, which is reflected as a changing inotropic effect of ouabain on the developing cardiac tissue.

The transverse tubular system of rat myocardium: its morphology and morphometry in the developing and adult animal

The three dimensional arrangements of the T system in the developing and adult animal were investigated by means of high voltage electron microscope stereoscopy using Golgi treated materials. The rat myocardial T system was composed of three major group elements: the transverse tubules, longitudinal tubules and flattened cisternae, which were classified according to their orientation and to their morphological features. It was found, as the growth of the rats proceeded, that the longitudinal tubules increased in number and that the transverse tubules were arranged more regularly and densely at the level of the z band. The flattened cisternae transiently increased in number during the 2-9 weeks, and then decreased gradually. Electron microscopy also revealed that all the transverse, longitudinal tubules and flattened cisternae of the T system had the chance of forming a coupling with the sarcoplasmic reticulum irrespective of its morphology and orientation to the myofibrils. Quantitative analysis of the rat T system from the stereo images indicated that the surface area (0.299 micron2/micron3) was considerably greater than previously reported.

Ontogenetic differences in cardiac sensitivity to verapamil in rats

The degree of a negative inotropic response of the isolated right ventricle to verapamil as well as the mortality rate were studied in rats during their postnatal development. Male Wistar rats aged 3, 15, 30, and 90 days were used. The isolated right ventricle was incubated in a glucose-free solution with a mixture of 95% O2 and 5% CO2 and electrically stimulated. The amplitude of isotonic contractions (AIC) was registered. In 90-day-old rats, AIC was 74.1 +/- 6.2% of initial amplitude 45 min after administration of verapamil; in 30-day-old, 41.1 +/- 6.4%; in 15-day-old, 38.2 +/- 4.1%; and in 3-day-old rats, only 2.6 +/- 1.5. The difference between the 3-day-old rats and all older groups was statistically highly significant. The mortality rate of verapamil-treated rats increased with decreasing age of animals. It is concluded that the sensitivity of the rat myocardium to verapamil is age dependent: the negative inotropic effect of this drug increases with decreasing age of the animal. This indicates a possible risk in the therapeutic use of verapamil when given to newborns and infants.

Activation of contractility and occurrence of aftercontractions in Ca2+ and Sr2+-solutions during the postnatal development of the rat heart

Activation of isometric contractile force and induction of aftercontractions by different extracellular Ca- and Sr-concentrations during the early postnatal development of the rat heart were studied. In the neonatal (1-15 days) rat heart activation of contractility by [Ca]0 and [Sr]0 were similar when a dose-response curve for Ca was determined before Sr, but if the experiment was performed in the reverse order of the dose-response curve for Sr was shifted to the left. In either case the maximal developed tension was about the same. In the adult (3-5 months) rat heart [Ca]0 higher than 4 mM was inhibitory, whereas contractile force increased up to 16 mM [Sr]0 without any signs of force depression. The dose-response curve for Sr was shifted to the right compared to that of Ca and the maximal developed tension was clearly higher in Sr-solution than in Ca-solution. Aftercontractions appeared for the first time on the 13th and 24th postnatal days for 16 mM [Ca]0 and [Sr]0, respectively. In the adult rat ventricle lower Ca concentrations were needed to induce aftercontractions compared to Sr. Based upon these observations it is suggested that the appearance of aftercontractions during the third postnatal week of rat heart development is due to the maturation of intracellular Ca stores which become available for contractile activation by the development of the T-system. The absence of a negative inotropic effect in elevated Sr concentrations may be due to the slowing down of the transport processes of the sarcoplasmic reticulum (SR) by Sr and to the greater ability of the SR to store Sr over Ca.

Temporal appearance and distribution of the Ca2+ + Mg2+ ATPase of the sarcoplasmic reticulum in developing chick myocardium as determined by immunofluorescence labeling

The temporal appearance and distribution of the Ca2+ + Mg2+ ATPase of the sarcoplasmic reticulum were determined in the developing chick heart (stage 9 to stage 16) by indirect immunofluorescence labeling. The results obtained showed that the Ca2+ + Mg2+ ATPase was first observed in the bulbus ventricular region of the single tubular heart at stage 9 to 10 of development, when these myocardial cells first contract. As the atrial and later the sinus venosus tissues became incorporated into the single tubular heart the Ca2+ + Mg2+ ATPase was also observed in these regions, however, the highest density of Ca2+ + Mg2+ ATPase labeling was generally observed in the region of the heart most recently incorporated. These results suggest that the sarcoplasmic reticulum is present and perhaps functional in the regulation of the cytoplasmic Ca2+ concentration and thereby the contraction-relaxation cycle in myocardial cells when the first contraction occurs, as well as throughout all subsequent stages of development. Furthermore comparison between the relative density and intensity of the Ca2+ + Mg2+ ATPase labeling and the intrinsic rate of contraction of the myocardial cells in the various regions of the heart (A. Barry, 1942, J. Exp. Zool. 91, 119-130) supports the possibility that a positive correlation exists between these two characteristics of the myocardial cells.

Activation of contractility and sarcolemmal Ca2+-ATPase by Ca2+ during postnatal development of the rat heart

The effects of 0.25-16.0 mM Ca2+ on the contractile force of isolated ventricular strips and sarcolemmal Ca2+-ATPase activity during postnatal development of the rat heart were studied. The half maximal concentrations for contractile activation of ventricular strips were 0.76 and 5.59 mM Ca2+ for adult and 3-day-old rats, respectively. The sensitivity towards Ca2+ began to change from newborn type to that of adult rat 2 weeks after birth and was almost completed after 4 weeks. No significant differences were found in half maximal activation of Ca2+-ATPase by Ca2+ between different age groups. Activation of contractility and Ca2+-ATPase by Ca2+ were linearly related in 30-day-old and adult rats but not in 3- and 10-day-old rats. The observed sensitivity change towards extracellular Ca2+ for contractile activation is suggested to be due to the development of transverse tubular system and sarcoplasmic reticulum during the first 4 weeks of postnatal development.

Effects of caffeine on the mechanical properties of developing rat heart ventricles

The effects of caffeine on isometric contractions of right-ventricular strips during the postnatal development of the rat heart were studied. Caffeine (2-10 mM) had a positive inotropic effect on ventricular strips of 3-15-days-old rats but a negative inotropic effect on the muscles of rats older than 22 days. Rest-twitch potentiation was most prominent in the muscles of 3-15-days-old rats but weakened clearly after that age. The potentiation was eliminated by 5 and 10 mM caffeine. An abrupt increase in frequency from 0.2 to 2 Hz caused a positive tension-staircase in 3-15-days-old rats but a negative staircase in older rats, the latter effect being eliminated by caffeine. It is suggested that the observed changes during the third postnatal week are due to a shift from extracellular to intracellular Ca2+ as the main source of this cation.

Development of dyadic junctional complexes between sarcoplasmic reticulum and plasmalemma in rabbit left ventricular myocardial cells. Morphometric analysis

Dyadic junctional couplings between cardiac sarcoplasmic reticulum (SR) and plasma membrane presumably are implicated in release of Ca2+ from terminal cisterns of SR during excitation-contraction coupling. We measured the areas of SR and plasma membrane involved in such couplings in late embryonic and neonatal rabbit left ventricles during a developmental period characterized by rapid cell growth and rapid accumulation of myofibrils. By morphometric methods previously applied to adult hearts, it could be shown that from the inception of the nascent T-system the surface density of dyadic couplings at T-tubular plasmalemma exceeds by about four-fold that at the external plasmalemmal envelope. Before the development of a T-system (similar to or approximately 10 days after birth) surface density of dyads, as well as total dyad areas per unit cell volume and per unit myofibrillar volume, increase progressively during embryonic life until they approach constancy at near adult values one day after birth. Constancy of total dyadic membrane area per unit myofibrillar volume during neonatal cell growth confirms that the membrane area of the activating system and the volume of myofibrils to be activated accumulate in a constant proportion.

Ultrastructural studies on the formation of myoflilaments and myofibrils in the human embryonic and adult hypertrophied heart

The myofibrillogenesis in the human embryonic heart is described. The synthesis of thin filaments, which are the first to appear, takes place in close proximity to smooth surfaced SR tubules. Z-band material is closely related to the thin filaments and appears first as irregularly distributed patches in the filamenteous mass. Further cellular differentiation includes an organization of the thin filaments/Z-band material. The synthesis of thick filaments, which follows that of the thin filaments, takes place in ribosome rich areas of the cell. They are rapidly incorporated into the strings of organized thin filaments/Z-band material. The periodic binding sites on both kinds of filaments are believed to play an important role in the precise ordering of the filaments. The formation of myofilaments in the adult hypertrophied human heart is also described. The similarities between this process and that observed in the embryonic heart are striking, and we believe it to be the same process.

Loss of differentiation features in trypsin separated heart muscle cells

Loss of maturation features is demonstrated for 8-day-old chick embryo heart myocytes, once they have been completely dissociated by trypsin. In support of this statement a total of 65 sections of six isolated cells, fixed while still spherical or during early flattening, were examined under the electron microscope. Trypsin-separated heart muscle cells, even though originating from already differentiated embryonic heart tissue, can therefore in principle be used for differentiation experiments in culture. However, the same cell suspensions also yielded an appreciable quantity of nonisolated cells. In such cell complexes, one can find areas showing well-ordered fibrils and intercalated disks. From 27 sections of a cell pair incidentally transferred into culture undissociated and then fixed while still in the globular state, the fourth and fifth sections, starting from the substrate side of the culture, showed an intercalated disk. Because of its small diameter, this cell complex would hardly have been retainable by a gauze with meshes likely to allow passage of only single cells. Thus the availability of differentiation experiments in culture, starting with already differentiated heart tissue, is restricted to cases where, in a selected territory, each cell has been established without doubt as isolated.

An electron microscopic study of early developmental stages, myogenesis, oogenesis and cnidogenesis in the anthomedusa, Podocoryne carnea M. Sars

This descriptive electron microscopic study of the blastogenetic medusa development of Podocoryne carnea focuses on the earliest stages of primordium formation, myogenesis, oogenesis and cnidogenesis. The events which take place at the cellular level prior to the formation of stage 1 (Frey, '68), which are characterized by ecto- and entodermal accumulations of undifferentiated I-cells and the beginning of transdifferentiation of epithelial cells, have been subdivided into four distinct stages (U1-U4). The genealogy of cells participating in medusa differentiation indicates that some cell types of the medusa are derived by transdifferentiation from the polyp's epithelial cells, while others originate by differentiation from I-cells. The myogenesis of the subumbrellar muscle cells resembles vertebrate myocardiac differentiation in many respects.

Pre- and post-natal development of lipoprotein lipase and hepatic triglyceride hydrolase activity in rat tissues

The ontogenic development of lipoprotein lipase and liver triglyceride hydrolase was studied in the rat. The enzyme activity measured in extrahepatic tissues fulfilled the criteria of lipoprotein lipase from the onset of measurable activity, i.e. it was inhibited by protamine and 1 M NaCl and showed requirement for serum and heparin for optimal activity. In the liver, measurable amounts of triglyceride hydrolase, active at pH 8.6 were detected 6 days prior to birth. However, till the fourth postnatal day about 50% of this activity was inhibited by NaCl and its sensitivity towards protamine was also higher than that of the enzyme in adult liver. Three patterns of development of enzymic activity were observed in extrahepatic tissues. In the lung, the lipoprotein activity reached the adult values one day prior to birth, while in the kidney only 30% of adult activity were found at birth. A linear increase of enzyme activity was observed in the heart; only 25% of adult activity were detected at birth and 100% were reached only 20 days after birth. The increase in lipoprotein lipase activity in the heart was accompanied by morphological differentiation of cardiocytes and by a progressive development of the capillary bed, which might be related to the pattern of development of enzyme activity in this organ. Adipose tissue lipoprotein lipase activity in inguinal fat fell from values 15 times than adult values between the 4th and 40th postnatal days. The enzyme activity in epididymal fat increased steeply between day 10 and 40, at which time it exceeded the adult values very considerably. These findings indicate that the regulation of the development of lipoprotein lipase activity in extrahepatic tissues is governed by local factors, which can differ even in the same type of tissue, as exemplified by the difference between inguinal and epididymal fat.

The presence of transverse and axial tubules in the ventricular myocardium of embryonic and neonatal guinea pigs

Developing transverse (T) tubules are found in embryonic guinea pig ventricular myocardium after approximately eight weeks of gestation. By the time of birth (nine weeks total gestation); longitudinally-oriented axial tubules connected to the T tubules also have formed, and the majority of cells closely resemble those of the adult. The form taken by the developing T and axial tubules suggests that they are generated in a manner similar to that for T tubules in chick and rat skeletal muscle, namely by repeated formation of caveolae.

Correlation of the glycoside response, the force staircase, and the action potential configuration in the neonatal rat heart

The rat heart demonstrates marked alterations in its responses to ouabain and increased frequencies of stimulation and in the duration of its action potential during the initial 21 days of life. At an age of 6.2 days 5 times 10- minus 5M ouabain produced a 158.2% increase in dP/dt compared with a 17.2% increase at 21.1 days (P less than 0.001). At 6.2 days dP/dt increased by 53.4% when the heart rate was accelerated from 30 to 90 beats/min compared with an increase of 12.2% at 21.1 days (P less than 0.005). The positive glycoside and staircase responses at the younger age were virtually eliminated when the hearts were perfused with a solution containing 50% [Na+]o and 25% [Ca-2+]o ([Ca-2+]o/[Na+]o-2 maintained constant). The duration of the ventricular action potential progressively decreased from 350-400 msec at birth to 100-150 msec at 21 days of life. This decrease was due to a shortening and a decrease in the potential level of the plateau phase. The prominent plateau typical of the early neonatal period was significantly diminished by perfusion with 50% [Na+]o. The results suggest that Na+ flux through a slow membrane channel plays a significant role in the positive staircase and glycoside responses of the early neonatal rat heart. As the heart matures and becomes functionally anomalous relative to other mammalian species, the slow channel progressively closes.

Relations between development of the capillary wall and myoarchitecture of the rat heart

The type of the blood supply to the myocardium appears to be closely related to its structural arrangement. The heart of adult poikilotherm animals is either entirely spongious, supplied from the ventricular cavity or its spongious musculature is covered by an outer compact layer with vascular supply. The size of the compact layer increases with increasing heart weight. The changes in the heart size during the ontogenetic development of honoiotherms are accompanied by the gradual transformation of the vascularless spongious musculature into a compact myocardium supplied thrugh coronary vessels. Up to the development of coronary arteries (in the rat up to the 17th day of embryonic life - ed) the myocardium is entirely spongious and supplied from mentricular cavity. Two types of primitive vascular bed are characteristic for this period: a) intertrabecular spaces, which penetrate deep into the ventricular wall as direct continuation of the endocardium, and b) intramyocardial clefts without endothelial lining. During further development of the terminal mascular bed, the outgrowth of endothelial cells into the myocardial clefts is important. The first capillaries with closed endothelial wall can be observed on the 18th ed. At this time various developmental stages o the terminal blood bed can be observed simultaneously. Within the following period (20-21 ed) the thick capillary walls become narrow and pericytes occur. The process of differentiation spreads in both ventricles and in septum from the base to the cardiac apex and is practically finished by the 14th day of postnatal life. The longitudinal orientations of myofibres starts between the 20th and 22nd ed. The final arrangement of muscle cells and capillaries into three layers (outer and inner longitudinal, central circular) is terminated during the second postnatal week.