Stereological estimates of nuclear number in human ventricular cardiomyocytes before and after birth obtained using physical disectors

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Abstract
Design‐based stereology is employed to estimate total numbers of myocyte nuclei and mean myocyte volume per nucleus in ventricles of fetal and early postnatal human hearts. Organs were collected postmortem from subjects varying in age from 16 gestational wk to 40 postnatal wk. Numbers of myocyte nuclei per unit volume of ventricle were estimated using physical disectors (parallel pairs of sections). Absolute numbers were calculated by multiplying nuclear packing densities by ventricular volumes estimated from ventricular mass and tissue density. Volumes per nucleus were obtained via estimates of the combined volumes of all myocytes (or of the myocardium as a whole) and the numbers of myocyte nuclei. The findings showed that numbers of myocyte nuclei increase linearly from 16 wk towards term. They were also consistent with the notion that hyperplasia ceases abruptly at birth or soon afterwards. The net rate of production of myocyte nuclei was about 38×107/wk (2.3 million nuclei/h). The total volume of myocytes continued to expand in the same way from 16 wk to at least 35 wk of gestation. Published studies on the incidence of binucleate myocytes during early postnatal growth of the ventricles of rats suggest that the volume of a myocyte doubles prior to nuclear division. Prenatal growth in the human heart is consistent with this mechanism. Myocardial hypertrophy after birth must occur by cellular hypertrophy without karyokinesis.