心内膜 ENDO EC 　

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the membrane that lines the cavities of the heart and forms part of the heart valves

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/08/11 09:02:26」(JST)

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Illustration depicting the layers of the heart wall including the innermost endocardium.

The endocardium is the innermost layer of tissue that lines the chambers of the heart. Its cells are embryologically and biologically similar to the endothelial cells that line blood vessels. The endocardium also provides protection to the valves and heart chambers.

The endocardium underlies the much more voluminous myocardium, the muscular tissue responsible for the contraction of the heart. The outer layer of the heart is termed epicardium and the heart is surrounded by a small amount of fluid enclosed by a fibrous sac called the pericardium.

Function

Recently, it has become evident that the endocardium, which is primarily made up of endothelial cells, controls myocardial function. This modulating role is separate from the homeometric and heterometric regulatory mechanisms that control myocardial contractility. Moreover, the endothelium of the myocardial (heart muscle) capillaries, which is also closely appositioned to the cardiomyocytes (heart muscle cells) is involved in this modulatory role. Thus, the cardiac endothelium (both the endocardial endothelium and the endothelium of the myocardial capillaries) controls the development of the heart in the embryo as well as in the adult, for example during hypertrophy. Additionally, the contractility and electrophysiological environment of the cardiomyocyte are regulated by the cardiac endothelium.

The endocardial endothelium may also act as a kind of blood-heart barrier (analogous to the blood–brain barrier), thus controlling the ionic composition of the extracellular fluid in which the cardiomyocytes bathe.

Clinical significance

In myocardial infarction, ischemia of the myocardium can extend to the endocardium, disrupting the inner lining of the heart ("transmural" infarction). Less extensive infarctions are often "subendocardial" and do not affect the epicardium. In the acute setting, subendocardial infarctions are more dangerous than transmural infarctions because they create an area of dead tissue surrounded by a boundary region of damaged myocytes. This damaged region will conduct impulses more slowly, resulting in irregular rhythms. The damaged region may enlarge or extend and become more life-threatening. In the chronic setting, transmural infarctions are more dangerous due to the greater amount of muscular damage and the development of scar tissue leading to impaired systolic contractility, impaired diastolic relaxation, and increased risk for rupture and thrombus formation.

During depolarization the impulse is carried from endocardium to epicardium, and during repolarization the impulse moves from epicardium to endocardium. In infective endocarditis, the endocardium (especially the endocardium lining the heart valves) is affected by bacteria.

History

External links

Histology image: 64_06 at the University of Oklahoma Health Sciences Center - "Heart and AV valve" (atrial endocardium)
Histology image: 64_07 at the University of Oklahoma Health Sciences Center - "Heart and AV valve" (ventricular endocardium)

UpToDate Contents

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English Journal

Progenitor Cells Identified by PDGFR-Alpha Expression in the Developing and Diseased Human Heart.

Chong JJ, Reinecke H, Iwata M, Torok-Storb B, Stempien-Otero A, Murry CE.Source1 Center for Cardiovascular Biology, University of Washington , Seattle, Washington.
Stem cells and development.Stem Cells Dev.2013 Jul 1;22(13):1932-43. doi: 10.1089/scd.2012.0542. Epub 2013 Mar 26.
Platelet-derived growth factors (PDGFs) and their tyrosine kinase receptors play instrumental roles in embryonic organogenesis and diseases of adult organs. In particular, platelet-derived growth factor receptor-alpha (PDGFRα) is expressed by multipotent cardiovascular progenitors in mouse and huma
PMID 23391309

The effect of microvascular obstruction and intramyocardial hemorrhage on contractile recovery in reperfused myocardial infarction: insights from cardiovascular magnetic resonance.

Kidambi A, Mather AN, Motwani M, Swoboda P, Uddin A, Greenwood JP, Plein S.AbstractBACKGROUND: Following acute myocardial infarction (AMI), microvascular obstruction (MO) and intramyocardial hemorrhage (IMH) adversely affect left ventricular remodeling and prognosis independently of infarct size. Whether this is due to infarct zone remodeling, changes in remote myocardium or other factors is unknown. We investigated the role of MO and IMH in recovery of contractility in infarct and remote myocardium.
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance.J Cardiovasc Magn Reson.2013 Jun 27;15(1):58. [Epub ahead of print]
BACKGROUND: Following acute myocardial infarction (AMI), microvascular obstruction (MO) and intramyocardial hemorrhage (IMH) adversely affect left ventricular remodeling and prognosis independently of infarct size. Whether this is due to infarct zone remodeling, changes in remote myocardium or other
PMID 23806080

In vivo cardiac reprogramming contributes to zebrafish heart regeneration.

Zhang R, Han P, Yang H, Ouyang K, Lee D, Lin YF, Ocorr K, Kang G, Chen J, Stainier DY, Yelon D, Chi NC.SourceDepartment of Medicine, Division of Cardiology, University of California, San Diego, La Jolla, California 92093, USA.
Nature.Nature.2013 Jun 27;498(7455):497-501. doi: 10.1038/nature12322. Epub 2013 Jun 19.
Despite current treatment regimens, heart failure remains the leading cause of morbidity and mortality in the developed world due to the limited capacity of adult mammalian ventricular cardiomyocytes to divide and replace ventricular myocardium lost from ischaemia-induced infarct. Hence there is gre
PMID 23783515

Japanese Journal

Antiarrhythmic Peptide AAP10 Prevents Arrhythmias Induced by Protein Kinase C Activation in Rabbit Left Ventricular Wedges

Ni Mingke,Ruan Lei,Zhang Cuntai
International Heart Journal advpub(0), 2015
… Transmural ECG as well as action potentials from both endocardium and epicardium were simultaneously recorded throughout all experiments. …
NAID 130004941347

Antiarrhythmic Peptide AAP10 Prevents Arrhythmias Induced by Protein Kinase C Activation in Rabbit Left Ventricular Wedges

Ni Mingke,Ruan Lei,Zhang Cuntai
International Heart Journal 56(2), 234-238, 2015
… Transmural ECG as well as action potentials from both endocardium and epicardium were simultaneously recorded throughout all experiments. …
NAID 130004941315

特発性好酸球増加症候群にLöffler心内膜心筋炎を合併し多発脳梗塞を発症した1例

石井淳子,山本司郎,吉村元,藤堂謙一,川本未知,幸原伸夫
臨床神経学 55(3), 165-170, 2015
症例は82歳女性．呼吸困難で入院し，白血球17,700/μl，好酸球52％（9,204/μl），好酸球増多をおこす基礎疾患をみとめず，特発性好酸球増加症候群（hypereosinophilic syndrome; HES）と診断した．第6病日に左上下肢麻痺が出現し，頭部MRIで両側大脳半球分水嶺領域・小脳に散在性多発微小脳梗塞をみとめた．心エコーで左室壁全周性に血栓をみとめ，Löffler心内膜心 …
NAID 130004921323

Related Pictures

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