Pregnant pause: MRI looks at fetal heart formation

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  • Published: Oct 1, 2017
  • Author: David Bradley
  • Channels: MRI Spectroscopy
thumbnail image: Pregnant pause: MRI looks at fetal heart formation

Making a good heart

This is an image of the fetal heart at the end of the 4 days when cardiac tissue is organised into the helix shape of the heart. Credit: Eleftheria Pervolaraki

A new magnetic resonance imaging (MRI) study reveals that the major structures of a baby's heart take just four days to form, according to scientists at the University of Leeds, UK. New insights from MRI into the development of the heart could lead to better ways to monitor the unborn baby during critical phases of gestation. There is also the long-term possibility that an improved understanding of hearth development might ultimately allow congenital defects, such as Tetralogy of Fallot, to be identified earlier so that preparations for remedial surgery might be made ahead of the birth. Or, perhaps even to identify ways to preclude the emergence of such problems. Lead researcher Eleftheria Pervolaraki certainly hopes the findings will mean that doctors would be able to intervene when a baby's heart fails to grow properly.

"We have identified a critical time of development of the human heart in pregnancy," she says. "We now have a map that we can use to interpret problems during development and look at ways of trying to resolve those problems." The team's work involved the imaging of 23 fetal hearts with a gestational age range of 95 to 143 days in the womb. The researchers published details in the journal Scientific Reports.

Modelling the developing heart

3D modelling software applied to the scans revealed that remarkable changes occur over a short four-day period 124 days into gestation. Within this short period, the researchers explain, the muscle tissues of the heart rapidly organise. Cardiac fibres are laid down to form the essentially helical shape of the heart within which the four chambers then arise, the two atria and the two ventricles. The team points out that without this essential architecture in place at such an early stage, the fetus cannot survive outside the womb. Indeed, one in ten miscarriages is believed to be caused by the failure of the heart to form normally. Pervolaraki says that there is a remarkable consistency around that fact that this phase of the heart's development starts between the 16 and 17 week of the pregnancy. This is thus a critical developmental point.

Connexin connection

The research team, which includes researchers from the Universities of Durham and Edinburgh, also looked at a possible mechanism involved in the development of the heart. During the critical four day period identified from the MRI study, they saw increased levels of two proteins: connexin 40 and connexin 43. Durham's James Dachtler explains that, "The expression of connexin 40 and connexin 43 helps cells in the heart to communicate with each other." As concentrations of these proteins rise, so intercellular communication becomes more effective. "This is why we believe we observed this structural development of the heart," he adds.

Of course, there are many developmental points that remain to be elucidated. The researchers concede that the development timeline of the human heart remains elusive because of the difficulties of measuring development in the womb. At the moment, clinicians can only monitor a baby's heart effectively after about 20 weeks into the pregnancy. As the present study shows, this is long after any developmental problems have arisen that may subsequently be difficult to resolve. The team suggests that the imaging techniques they used in their research could readily be adapted for use in the hospital and so allow obstetricians sight of whether the baby's heart is forming properly where risk factors for congenital heart problems are known.

Related Links

Sci Rep 2017, online: "Ventricular myocardium development and the role of connexins in the human fetal heart"

Article by David Bradley

The views represented in this article are solely those of the author and do not necessarily represent those of John Wiley and Sons, Ltd.

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