Abstract

The arterial roots are important transitional regions of the heart, connecting the intrapericardial components of the aortic and pulmonary trunks with their ventricular outlets. They house the arterial (semilunar) valves and, in the case of the aorta, are the points of coronary arterial attachment. Moreover, because of the semilunar attachments of the valve leaflets, the arterial roots span the anatomic ventriculo‐arterial junction. By virtue of this arrangement, the interleaflet triangles, despite being fibrous, are found on the ventricular aspect of the root and located within the left ventricular cavity. Malformations and diseases of the aortic root are common and serious. Despite the mouse being the animal model of choice for studying cardiac development, few studies have examined the structure of their arterial roots. As a consequence, our understanding of their formation and maturation is incomplete. We set out to clarify the anatomical and histological features of the mouse arterial roots, particularly focusing on their walls and the points of attachment of the valve leaflets. We then sought to determine the embryonic lineage relationships between these tissues, as a forerunner to understanding how they form and mature over time. Using histological stains and immunohistochemistry, we show that the walls of the mouse arterial roots show a gradual transition, with smooth muscle cells (SMC) forming the bulk of wall at the most distal points of attachments of the valve leaflets, while being entirely fibrous at their base. Although the interleaflet triangles lie within the ventricular chambers, we show that they are histologically indistinguishable from the arterial sinus walls until the end of gestation. Differences become apparent after birth, and are only completed by postnatal day 21. Using Cre‐lox‐based lineage tracing technology to label progenitor populations, we show that the SMC and fibrous tissue within the walls of the mature arterial roots share a common origin from the second heart field (SHF) and exclude trans‐differentiation of myocardium as a source for the interleaflet triangle fibrous tissues. Moreover, we show that the attachment points of the leaflets to the walls, like the leaflets themselves, are derived from the outflow cushions, having contributions from both SHF‐derived endothelial cells and neural crest cells. Our data thus show that the arterial roots in the mouse heart are similar to the features described in the human heart. They provide a framework for understanding complex lesions and diseases affecting the aortic root.

Highlights

  • The arterial roots connect the ventricular outflow tracts to the intrapericardial components of the ascending aorta and pulmonary trunk (Fig. 1)

  • Whereas the fibrous attachments of the valve leaflets are derivatives of the outflow cushions, and have contributions from both NCC and SHFderived endothelial cells, the fibroblasts in the walls of the valvar sinuses share a precursor with the smooth muscle cells (SMC) in this region

  • Histological analysis of the juvenile mouse heart at postnatal day (P) 21 demonstrated that the arterial valve leaflets formed the proximal boundary of the arterial components of the outflow tracts, they were supported proximally by the myocardial ventricular walls and associated septal structures (Figs 1B and 2A)

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Summary

Introduction

The arterial roots connect the ventricular outflow tracts to the intrapericardial components of the ascending aorta and pulmonary trunk (Fig. 1). They house the aortic and pulmonary valve complexes, and are an important site of congenital malformation and pathology in adult life. Dilation and calcification of the aortic root frequently accompany bicuspid aortic valve (Siu & Silversides, 2010), which represents one of the most common causes of cardiac intervention. Abnormalities in blood flow secondary to a bicuspid valve have been suggested to lead to aneurysm or calcification (Siu & Silversides, 2010). The late failure of the transposed pulmonary homograft after the Ross procedure, where the pulmonary root is grafted into the aortic position to treat severe aortic stenosis, may indicate a pathological process common to both arterial roots (David et al 2000)

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