Embriologi Jantung

By
dr. Abdul Malik Setiawan, M.Infect.Dis.
Objective

1. Pembentukan tabung jantung

2. Pembentukan rongga jantung
3. Pembentukan sekat jantung
4. Pembentukan katup jantung
Introduction

• Human heart starts to develop during the 3rd week of embryonic life.
• Cardiogenesis in humans is associated with complex morphogenetic
events
Cardiac development

Early development
• Formation of the trilaminar embryo
• Origin of cardiogenic cells
• Formation of bilateral heart fields
• Formation of the heart tube
• Folding of the heart tube
• Looping of the heart tube
• Day 0 : Fertilisation forming zygote initiating embryogenesis
• Week 1 : implantation ( as a blastocyst)
• Week 2 : bilaminar stage (epiblast, hypoblast)
• Week 3 : Gastrulation ; primitive streak, notochord and neural plate
begin to form
• Week 4: heart begins to form and beats
Week 1 – beginning of development
• Day 1-Fertilisation and formation of zygote
• Day 2 – 2 cell blastula
• Day 3 – 4 cell blastula
• Day 4 – morula ( 32 cell stage)
• Day 5 – blastocyst ( inner cell mass of embryoblast and outer cell
mass called trophoblast)
• Day 6 - implantation
Week 1
Week 2-Implantation

• After the initial rounds of cellular divisions, the embryo must implant
into the endometrium of the uterus.
• The syncytiotrophoblast becomes continuous with the uterus
• Maternal blood vessels (known as sinusoids) invade the spaces within
the syncytiotrophoblast (known as lacunae).
• At this point, uteroplacental circulation has begun; and further
embryonic development can occur.
• 2 germ layers (epiblast and hypoblast) and 2 cavities (amniotic cavity
and yolk sac)
Week 3 - Gastrulation

• Gastrulation means the formation of gut (Greek, gastrula = belly), but

has now a more broad sense to to describe the formation of the
trilaminar embryo.
• During this process, the two cell layers become three germ cell layers,
and the bodily axes observed in the mature adult are created.
• The epiblast layer, consisting of totipotent cells, derives all 3 embryo
layers: endoderm, mesoderm and ectoderm.
Week 3 - Gastrulation

Cells of the epiblast layer break off and migrate and penetrate through
the epiblast layer to form three new germ cell layers:
• Endoderm – formed by epiblast cells that migrate through the primitive
pit and displace the hypoblast cells.
• Mesoderm – formed by epiblast cells that migrate through the
primitive pit and lie between the epiblast layer and the newly created
endoderm.
• Ectoderm – formed by the epiblast cells that remain in position.

“3 germ layers ( gastrula) : ectoderm,mesoderm and endoderm”

Week 3 – End of Gastrulation

Mesoderm :
1. Paraxial mesoderm
2. Intermediate mesoderm
3. Lateral Mesoderm :
• Somatic mesoderm Neurulation process
• Splanchnic mesoderm
• Extra embryonic
mesoderm
Cardiac Embryogenesis

Steps in the embryology of the vascular system

• Establishment Of The Cardiogenic Field
• Formation And Position Of The Heart Tube
• Formation Of The Cardiac Loop
• Molecular Regulation Of Cardiac Development
• Development Of The Sinus Venosus
• Formation Of The Cardiac Septae
• Formation Of The Conducting System Of The Heart
• Vascular Development
STEP 1. Establishment Of The Cardiogenic Field
• Progenitor heart cells lie in the epiblast migrate into the splanchnic
layer of lateral plate mesoderm shown as Blood Island
• Migrating progenitor heart cells form a horseshoe-shaped cluster of
cells called the primary heart field (PHF)
• The heart fields are patterned into primary and secondary heart
fields:
• Primary heart field will develop into left and right atria and the left ventricle
• The secondary heart field will become the right ventricle and outflow tract
 angiogenic cell clusters
The cardiogenic field (angioblasts/hemangioblasts)

is established in the
(right endocardial tube)
mesoderm just after
(right dorsal aorta)
gastrulation (~18-19
days) and develops
into a fully functional,
multi-chambered
heart by the 8th week blood islands
(developing blood vessels)
pericardial cavity

cardiogenic field
STEP 2. FORMATION AND POSITION OF THE HEART TUBE

Processes responsible for positioning of the heart

1. Cranio-caudal folding swings the heart tube into a position just ventral
to the foregut pocket in the neck of the embryo with the inflow
oriented toward the tail of the embryo and outflow oriented toward
the head.
2. Lateral folding brings the forming heart tubes to the midline to fuse
into a single tube
3. Differential growth of the embryo causes the heart to be displaced
toward the tail of the embryo such that the heart ends up in the chest.
Cranio-caudal folding

18 Days

22 Days
Lateral Folding

18
Days

22
Days
 Cranial folding

Cranial folding rotates moves it ventrally and Orients heart tube and
cardiogenic area caudally pericardial cavity

Moore & Persaud fig 13-9

 Lateral folding

• Lateral folding
apposes paired heart
tube primordia
• Brings dorsal aortae to
midline
• Heart primordia fuse
to form tubular heart
Moore & Persaud fig 13-8
 Fusion of Heart Tubulars

Fusion of Heart Tubulars happen during week 3, and the hearth starts beating in week 4
Heart tube and dorsal aortae in place
How do you get from this…

22 days 30 days
…to this?
STEP 3. FORMATION OF THE CARDIAC LOOP
Bulbus cordis
Primitive ventricle
The primitive atrium and sinus venosus
 Folding and rotation of heart tube
aortic roots

truncus arteriosus

bulbus cordis

ventricle

atrium

sinus venosus

22 days 23 days 24 days

• The Primitive atrium and sinus venosus
• Ventricle moves ventrally move superiorly and posteriorly
and to right • The primitive ventricle moves to the
embryo’s left side
• Atrium moves dorsally • The bulbus cordis moves interiorly and to
and to left the embryo’s right
Folding and rotation of heart tube
STEP 3. FORMATION OF THE CARDIAC SEPTAE

The major septae are formed between the 27th and 37th days of
development

It is a simultanuous process if the following areas

• Septum formation in the common atrium

• Septum formation in the atrioventricular canal
• Septum formation in the truncus arteriosus and conus cordis
• Septum formation in the ventricles
Septum formation in the common atria
At the end of the fourth week, a sickle-shaped crest grows from the roof of the
common atrium into the lumen. This crest is the first portion of the septum
primum

A. 30 days (6 mm).
B. Same stage as A, viewed from the right.
Septum formation of the common atria (2)
When the lumen of the right atrium expands as a result of incorporation of the
sinus horn, a new crescent-shaped fold appears. This new fold, the septum
secundum never forms a complete partion in the atrial cavity

C. 33 days (9 mm). D. Same stage as

C, viewed from the right
Septum formation of the common atria(3)
When the upper part of the septum primum gradually disappears, the
remaining part becomes the valve of the oval foramen.

E. 37 days (14 mm)

F. Newborn.
G. The atrial septum from the right; same stage as F.
Further differentiation of the atria

Coronal sections through the heart to show development of the smoothwalled

portions of the right and left atrium. Both the wall of the right sinus horn (blue)
and the pulmonary veins (red) are incorporated into the heart to form the smooth-walled
parts of the atria.
Septum formation of the atrioventricular canal
• At the end of the fourth week, The Atrioventricular endocardial cushions appear
at the superior and inferior borders of the atrioventricular canal.
• Two additional lateral cushions appear at the left and right borders.
• At the end of the fifth week there is complete fusion of the superior and
inferior cushions with complete division of the canal into left and right orifices.
Atrioventricular valves

Formation of the atrioventricular valves and chordae tendineae. The valves

are hollowed out from the ventricular side but remain attached to the
ventricular wall by the chordae tendineae.
 Septum formation of the truncus arteriosus and conus cordis

Fifth week, pairs of

opposing ridges appear
in the truncus and conus
cordis
 Septum formation of the truncus arteriosus
and conus cordis
Proliferations of the right and left conus
cushions, combined with proliferation of
the inferior endocardial cushion, close
the interventricular foramen and form
the membranous portion of the
interventricular septum.

A. 6 weeks (12 mm).

B. Beginning of the 7th week (14.5 mm).
C. End of the 7th week (20 mm).
 Septum formation of the ventricles

End of the fourth week the

two primitive ventricles start
to expand.
The medial walls of the
expanding ventricles become
apposed and gradually
merge, forming the muscular
interventricular septum
Semilunar valves
When partitioning of the truncus is almost complete, primordia of the
semilunar valves become visible as small tubercles found on the main
truncus swellings.

•One of each pair is assigned to the pulmonary and aortic channels,

respectively

•A third tubercle appears in both channels opposite the fused truncus

swellings.

•Gradually the tubercles hollow out at their upper surface, forming the
semilunar valves.
Longitudinal section through the semilunar valves

6 weeks seven weeks 9 weeks

Refferences :
Langman’s Medical embryology
Thank You