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Anatomy of the cardiac nervous system with clinical and comparative morphological implications

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Abstract

Unlike autonomic nervous preservation in other surgeries for improving patient quality of life, autonomic cardiac nervous system (ACNS) preservation has been neglected in cardiovascular surgery because of technical difficulties and other unsolved issues. Because such ACNS preservation in cardiovascular surgery is anticipated in the future, detailed anatomical investigation of the human ACNS is required. Therefore, we have conducted morphological studies of the ACNS from macroscopic, clinical, and evolutionary anatomical viewpoints. In this study, I review detailed anatomical studies of the human ACNS together with their clinical implications. In addition, the evolutionary comparative anatomical significance of primate ACNS is also summarized to help understand and translate the findings of functional experiments to humans. These integrated findings will be the subject of a future study unifying molecular embryological and anatomical findings to clarify cardiac functions based on functional animal experiments, clinical applications such as improving surgery techniques and individual order-made surgery in cardiac surgery, and for future evaluation in regenerative medicine.

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Abbreviations

AA:

Ascending aorta

AI:

Superior interventricular artery (anterior interventricular/descending branch of the coronary artery)

aMG:

Accessory middle cervical ganglion

Ao:

Aorta

Az:

Azygos vein

AV:

Anterior cardiac vein

BC:

Brachiocephalic trunk

BP:

Brachial plexus

Br-A:

Bronchial artery

CB:

Circumflex branch of the coronary artery

CC:

Common carotid artery

CT:

Cervicothoracic (stellate) ganglion

C1-8:

First to eighth cervical nerves

Es:

Esophagus

GV:

Great cardiac vein

IB:

Inferior (vagal) cardiac branch

IG:

Inferior cervical ganglion

IN:

Inferior cervical cardiac nerve

IVC:

Inferior caval vein

L:

Nerve branches to the lung

LA:

Left atrium

LC:

Left common carotid artery

LCA:

Left coronary artery

LS:

Left subclavian artery

LSVC:

Left superior vena cava

LV:

Left ventricle

MG:

Middle cervical ganglion

MN:

Middle cardiac nerve

NX:

Vagus nerve

OV:

Oblique vein of the left atrium

P:

Pectoral nerve

PA:

Pulmonary artery

PC:

Pericardium

Ph:

Phrenic nerve

PT:

Pulmonary trunk

PV:

Pulmonary vein

PVi:

Inferior pulmonary vein

PVs:

Superior pulmonary vein

RA:

Right atrium

RC:

Right common carotid artery

RCA:

Right coronary artery

RERSA:

Retroesophageal right subclavian artery

RL:

Recurrent laryngeal nerve of the vagus nerve

RS:

Right subclavian artery

RSVC:

Right superior vena cava

RV:

Right ventricle

SAN-B:

Sinuatrial nodal branch of the coronary artery

SB:

Superior (vagal) cardiac branch

SbC:

Nerve to the subclavian muscle

SG:

Superior cervical ganglion

SN:

Superior cardiac nerve

SVC:

Superior caval vein

TB:

Thoracic (vagal) cardiac branch

TN:

Thoracic cardiac nerve

T1-6:

First to sixth thoracic nerves

VA:

Vertebral artery

VG:

Vertebral ganglion

VN:

Vertebral nerve

X :

Vagus nerve

XI :

Accessory nerve

XII :

Hypogastric nerve

2TG–6TG:

Second to sixth thoracic ganglia

References

  • Aizawa Y, Isogai S, Izumiyama M, Horiguchi M (1999) Morphogenesis of the primary trunks of the forelimb in the rat embryo: the trunks originate from the lateral surface of the dorsal aorta independently of the intersegmental arteries. Anat Embryol 200:573–584

    Article  CAS  PubMed  Google Scholar 

  • Anderson RH, Loukas M (2009) The importance of attitudinally appropriate description of cardiac anatomy. Clin Anat 22:47–51

    Article  PubMed  Google Scholar 

  • Anderson RH, Razavi R, Taylor AM (2004) Cardiac anatomy revisited. J Anat 205:159–177

    Article  PubMed  Google Scholar 

  • Arnason U, Adegoke JA, Gullberg A, Harley EH, Janke A, Kullberg M (2008) Mitogenomic relationships of placental mammals and molecular estimates of their divergences. Gene 421:37–51

    Article  CAS  PubMed  Google Scholar 

  • Axford MB (1927–1928) Some observation on the cervical sympathetic in man. J Anat 62:301–318

    Google Scholar 

  • Batulevicius D, Pauziene N, Pauza DH (2003) Topographic morphology and age-related analysis of the neuronal number of the rat intracardiac nerve plexus. Ann Anat 185:449–459

    Article  PubMed  Google Scholar 

  • Batulevicius D, Pauziene N, Pauza DH (2005) Architecture and age-related analysis of the neuronal number of the guinea pig intrinsic cardiac nerve plexus. Ann Anat 187:225–243

    Article  PubMed  Google Scholar 

  • Becker RF, Grunt JA (1957) The cervical sympathetic ganglia. Anat Rec 127:1–14

    Article  CAS  PubMed  Google Scholar 

  • Bengel FM, Ueberfuhr P, Ziegler SI, Nekolla S, Reichart B, Schwaiger M (1999) Serial assessment of sympathetic reinnervation after orthotopic heart transplantation. A longitudinal study using PET and C-11 hydroxyephedrine. Circulation 99:1866–1871

    CAS  PubMed  Google Scholar 

  • Bengel FM, Ueberfuhr P, Schiepel N, Nekolla SG, Reichart B, Schwaiger M (2001) Effect of sympathetic reinnervation on cardiac performance after heart transplantations. N Engl J Med 345:731–738

    Article  CAS  PubMed  Google Scholar 

  • Bengel FM, Ueberfuhr P, Hesse T, Schiepel N, Ziegler SI, Scholz S, Nekolla SG, Reichart B, Schwaiger M (2002) Clinical determinations of ventricular sympathetic reinnervation after orthotopic heart transplantation. Circulation 106:831–835

    Article  PubMed  Google Scholar 

  • Bergwerff M, DeRuiter MC, Hall S, Poelmann RE, Gittenberger-de Groot AC (1999) Unique vascular morphology of the fourth aortic arches: possible implications for pathogenesis of type-B aortic arch interruption and anomalous right subclavian artery. Cardiovasc Res 44:185–196

    Article  CAS  PubMed  Google Scholar 

  • Botar J (1932) Quelques observations sur l’anatomie du systéme sympathique du Gorille. Bull Soc Anthorop Paris 3:168–179

    Article  Google Scholar 

  • Botár J, Becker A (1939) Die Fasernstruktur der Herznerven beim Maki-Affen. Anat Anz 88:494–500

    Google Scholar 

  • Botár J, Világhi M, Sere D (1950) Die gemischten Rami communicantes beim Affen. Acta Anat 9:235–250

    Article  Google Scholar 

  • Chiba S, Suzuki T, Kasai T (1981) Two cases of the right subclavian artery as last branch of the aortic arch and review of previously reported cases. Hirosaki Med 33:465–474 (in Japanese with English abstract)

    Google Scholar 

  • De Marco T, Dae M, Yuen-Green MSF, Kumar S, Sudhir K, Keith F, Amidon TM, Rifkin C, Klinski C, Lau D, Botvinick EH, Chatterjee K (1995) Iodine-123 metaiodobenzylguanidine scintigraphic assessment of the transplanted human heart: evidence for late reinnervation. J Am Coll Cardiol 25:927–931

    Article  PubMed  Google Scholar 

  • Ellison JP, Williams TH (1962) Sympathetic nerve pathways to the human heart, and their variations. Am J Anat 124:149–162

    Article  Google Scholar 

  • Enomoto H, Crawford PA, Gorodinsky A, Heuckeroth RO, Johnson EM, Milbrandt J (2001) RET signaling is essential for migration, axonal growth and axon guidance of developing sympathetic neurons. Development 128:3963–3974

    CAS  PubMed  Google Scholar 

  • Freimark D, Silverman JM, Aleksic I, Crues JV, Blanche C, Trento A, Admon D, Queral CA, Harasty DA, Czer LSC (1995) Atrial emptying with orthotopic heart transplantation using bicaval and pulmonary venous anastomoses: a magnetic resonance imaging study. J Am Coll Cardiol 25:932–936

    Article  CAS  PubMed  Google Scholar 

  • Fukuyama U (1982) Macroscopic anatomy of the extrinsic nerves in human heart. Acta Anat Nippon 57:357–380

    CAS  PubMed  Google Scholar 

  • Gomez H (1958) The development of the innervation of the heart in the rat embryo. Anat Rec 130:53–71

    Article  CAS  PubMed  Google Scholar 

  • Grande AM, Rinaldi M, D’Armini AM, Campana C, Traversi E, Pederzolli C, Abbiate N, Klersy C, Vigano M (2000) Orthotopic heart transplantations: standard versus bicaval technique. Am J Cardiol 85:1329–1333

    Article  CAS  PubMed  Google Scholar 

  • Harman NB (1900) The anterior limit of the cervico-thoracic visceral efferent nerves in man. J Anat Physiol 34:359–391

    CAS  PubMed  Google Scholar 

  • Hausman E (1956) Über die Anatomie der Herznerven. Z Anat Entwickl 119:263–279

    Article  Google Scholar 

  • Hedges SB, Kumar S (2003) Genomic clocks and evolutionary timescales. Trends Genet 19(4):200–206

    Article  Google Scholar 

  • Hildreth V, Anderson RH, Henderson DJ (2009) Autonomic innervation of the developing heart: origin and function. Clin Anat 22:36–46

    Article  PubMed  Google Scholar 

  • Hiruma T, Nakajima Y, Nakamura H (2002) Development of pharyngeal arch arteries in early mouse embryo. J Anat 201:15–29

    Article  PubMed  Google Scholar 

  • Hoffman HH (1957) An analysis of the sympathetic trunk and rami in the cervical and upper thoracic regions in man. Ann Surg 145:94–103

    Article  CAS  PubMed  Google Scholar 

  • Horiguchi M, Yamada T, Uchiyama Y (1982) A case of retroesophageal right subclavian artery with special reference to the morphology of cardiac nerves (in Japanese with English abstract). Acta Anat Nippon 57:1–8

    CAS  PubMed  Google Scholar 

  • Jakubowicz M, Ratajczak W, Nowik M (2002) Aberrant left subclavian artery. Folia Morphol 61:53–56

    Google Scholar 

  • Jamieson RW, Smith DB, Anson BJ (1952) The cervical sympathetic ganglia- an anatomical study of 100 cervico-thoracic dissections. Q Bull Northwest Univ Med Sch 26:219–227

    CAS  PubMed  Google Scholar 

  • Janecka JE, Miller W, Pringle TH, Wiens F, Zitzmann A, Helgen KM, Springer MS, Murphy WJ (2007) Molecular and genomic data identify the closest living relative of primates. Science 318:792–794

    Article  CAS  PubMed  Google Scholar 

  • Janes RD, Brandys JC, Hopkins DA, Johnstone DE, Murphy DA, Armour JA (1986) Anatomy of human extrinsic cardiac nerve and ganglia. Am J Cardiol 57:299–309

    Article  CAS  PubMed  Google Scholar 

  • Kasai T (1962) Topographic changes of the surrounding structures of the arch of aorta in various anomalies of aorta in man. Acta Anat Nippon 37:275–292

    Google Scholar 

  • Kawano H, Okada R, Yano K (2003) Histological study on the distribution of autonomic nerves in the human heart. Heart Vessel 18:32–39

    Article  Google Scholar 

  • Kawashima T (2005) Autonomic nervous system of the human heart with special reference to the origin, course, and peripheral distribution of the nerve. Anat Embryol 209:425–438

    Article  PubMed  Google Scholar 

  • Kawashima T, Sasaki H (2005) Topological changes of the human autonomic cardiac nervous system in individuals with a retroesophageal right subclavian artery: two case reports and a brief review. Anat Embryol 210:327–334

    Article  PubMed  Google Scholar 

  • Kawashima T, Sasaki H (2007) Morphological comparison of the cardiac autonomic nervous system between normal and abnormal great arterial branching pattern with a brief review of the literature. Auton Neurosci 132:37–43

    Article  PubMed  Google Scholar 

  • Kawashima T, Sasaki H (2008) Evolutionary morphology of the autonomic cardiac nervous system in non-human primates and humans. In: Endo H, Frey R (eds) Anatomical imaging: towards a new morphology. Springer, Tokyo, pp 89–102

    Google Scholar 

  • Kawashima T, Sato K (2000) Morphological analysis of sympathetic cardiac nerves in the Japanese monkey and man (in Japanese with English abstract). J Auton Nerv Syst 37:521–531

    Google Scholar 

  • Kawashima T, Sato K, Sasaki H (2001) An anomalous case of the thoracic cardiac nerve in the Japanese monkey (in Japanese with English abstract). Acta Anat Nippon 76:399–406

    CAS  PubMed  Google Scholar 

  • Kawashima T, Sato K, Akita K, Sasaki H (2005) Comparative anatomical study of the autonomic cardiac nervous system in macaque monkeys. J Morphol 266:112–124

    Article  PubMed  Google Scholar 

  • Kawashima T, Akita K, Sato K, Sasaki H (2007) Evolutionary and comparative anatomical investigation of the autonomic cardiac nervous system in the African Cercopithecidae. J Morphol 268:771–790

    Article  PubMed  Google Scholar 

  • Kawashima T, Thorington RW Jr, Kunimatsu Y, Whatton JF (2008) Systematic morphology and evolutionary anatomy of the autonomic cardiac nervous system in the lessor apes, gibbons (Hylobatidae). Anat Rec 291:939–959

    Article  Google Scholar 

  • Kawashima T, Thorington RW Jr, Whatton JF (2009) Comparative anatomy and evolution of the cardiac innervation in New World monkeys (Platyrrhini, E. Geoffroy, 1812). Anat Rec 292:670–691

    Article  Google Scholar 

  • Kaye DM, Esler M, Kingwell B, McPherson G, Esmore D, Jennings G (1993) Functional and neurochemical evidence for partial cardiac sympathetic reinnervation after cardiac transplantation in humans. Circulation 88:1110–1118

    CAS  PubMed  Google Scholar 

  • Kirby ML, McKenzie JW, Weidman TA (1980) Developing innervation of the chicken heart: a histofluorescence and light microscopic study of sympathetic innervation. Anat Rec 196:333–340

    Article  CAS  PubMed  Google Scholar 

  • Kitamura S, Nakatani T, Bando K, Sasako Y, Kobayashi J, Yagihara T (2001) Modification of bicaval anastomosis technique for orthotopic heart transplantation. Ann Thorac Surg 72:1405–1406

    Article  CAS  PubMed  Google Scholar 

  • Kolesnikov VV (1935) The relation between the truncs and the cardiac branches of the jugular section of the sympathicus and vagus in some apes (in Russian with English abstract). Arkh Biol Nauk 39:405–419

    Google Scholar 

  • Kumaki K (1980) Anatomical practice data. Second Department of Anatomy, School of Medicine, Kanazawa University, Kanazawa (in Japanese)

  • Kuntz A (1946) The autonomic nervous system, 3rd edn. Bailliere, Tindall & Cox, London

    Google Scholar 

  • Kuntz A, Morehouse A (1930) Thoracic cardiac nerves in man. Arch Surg 20:607–613

    Google Scholar 

  • Kuratani S (2004) Evolutionary morphology: Bauplan and embryonic development of vertebrates. University of Tokyo Press, Tokyo, pp 123–127

    Google Scholar 

  • Kuratani S, Tanaka S (1990) Peripheral development of the avian vagus nerve with special reference to the morphological innervation of heart and lung. Anat Embryol 182:435–445

    Article  CAS  PubMed  Google Scholar 

  • Kuratani SC, Miyagawa-Tomita S, Kirby M (1991) Development of cranial nerves in the chick embryo with special reference to the alterations of cardiac branches after ablation of the cardiac neural crest. Anat Embryol 183:501–514

    Article  CAS  PubMed  Google Scholar 

  • Kurt MA, Ari I, Ikiz I (1997) A case with coincidence of aberrant right subclavian artery and common origin of the carotid arteries. Ann Anat 179:175–176

    CAS  PubMed  Google Scholar 

  • Loukas M, Giannikopoulos P, Fudalej M, Dimopoulos C, Wagner T (2004) A retroesophageal right subclavian artery originating from the left aortic arch—a case report and review of the literature. Folia Morphol 63:141–145

    Google Scholar 

  • Mitchell GAG (1953) Anatomy of the autonomic nervous system. Livingstone, London

    Google Scholar 

  • Mizeres NJ (1955) The course of left cardio-inhibitory fibers in the dog. Am J Anat 96:285–318

    Article  CAS  PubMed  Google Scholar 

  • Mizeres NJ (1958) The origin and course of the cardio-accelerator fiber in the dog. Anat Rec 132:261–278

    Article  CAS  PubMed  Google Scholar 

  • Mizeres NJ (1963) The cardiac plexus in man. Am J Anat 112:141–152

    Article  Google Scholar 

  • Molin DGM, DeRuiter MC, Wisse LJ, Azher M, Doetschman T, Poelmann RE, Gittenberger-de Groot AC (2002) Altered apoptosis pattern during pharyngeal arch artery remodeling is associated with aortic arch malformation in Tgfbeta2 knock-out mice. Cardiovasc Res 56:312–322

    Article  CAS  PubMed  Google Scholar 

  • Mukouyama YS, Shin D, Britsch S, Taniguchi M, Anderson DJ (2002) Sensory nerves determine the pattern of arterial differentiation and blood vessel branching in the skin. Cell 109:693–705

    Article  CAS  PubMed  Google Scholar 

  • Mukouyama YS, Gerber HP, Ferrara N, Gu C, Anderson DJ (2005) Peripheral nerve-derived VEGF promotes arterial differentiation via neuropilin 1-mediated positive feedback. Development 132:941–952

    Article  CAS  PubMed  Google Scholar 

  • Nakatani T, Tanaka S, Mizukami S, Okamoto K, Shiraishi Y, Nakamura T (1996) Retroesophageal right subclavian artery originating from the aortic arch distal and dorsal to the left subclavian artery. Ann Anat 178:269–271

    CAS  PubMed  Google Scholar 

  • Nonidez JF (1939) Studies on the innervation of the heart. Am J Anat 65:361–413

    Article  Google Scholar 

  • Pauza DH, Pauziene N, Tamasauskas KA, Storopus R (1997) Hilum of the heart. Anat Rec 248:322–324

    Article  CAS  PubMed  Google Scholar 

  • Pauza DH, Skripka V, Pauziene N, Stropus R (2000) Morphology, distribution, and variability of the epicardiac neural ganglionated subplexuses in the human heart. Anat Rec 259:353–382

    Article  CAS  PubMed  Google Scholar 

  • Pauza DH, Skripka V, Pauziene N (2002) Morphology of the intrinsic cardiac nervous system in the dog: a whole-mount study employing histochemical staining with acetylcholinesterase. Cell Tissues Organs 172:297–320

    Article  Google Scholar 

  • Pick J (1970) The autonomic nervous system: morphological, comparative, clinical and surgical aspects. Lippincott, Philadelphia, pp 265–275

    Google Scholar 

  • Pick J, Sheehan D (1946) Sympathetic rami in man. J Anat 80:12–20

    Google Scholar 

  • Raczak G, La Roverre MT, Mortara A, Assandri J, Prpa A, Pinna GD, Maestri R, D’Armini AM, Viganó M, Cobelli F (1999) Arterial baroreflex modulation of heart rate in patients early after heart transplantation: lack of parasympathetic reinnervation. J Heart Lung Transplant 18:399–406

    Article  CAS  PubMed  Google Scholar 

  • Riegele HL (1925–1926) Die Innervation des Herzmuskels bei Affen. SB Ges Morphol Physiol 37:57–59

  • Riegele HL (1926) Über die Innervation der Halz- und Brustorgane bei einegem Affen. Z Anat Entwickl 80:777–858

    Article  Google Scholar 

  • Roberts LA (1991) Morphological innervation pattern of the developing rabbit heart. Am J Anat 190:370–384

    Article  CAS  PubMed  Google Scholar 

  • Saburkina I, Rysevaite K, Pauziene N, Mischke K, Schauerte P, Jalife J, Pauza DH (2010) Epicardial neural ganglionated plexus of ovine heart: anatomic basis for experimental cardiac electrophysiology and nerve protective cardiac surgery. Heart Rhythm 7:942–950

    Article  PubMed  Google Scholar 

  • Saccomanno G (1943) The components of the upper thoracic sympathetic nerves. J Comp Neurol 79:355–378

    Article  Google Scholar 

  • Sakaguchi T (2010) Tips and pitfall in heart transplantation (in Japanese). Sinzo 42:15–19

    Google Scholar 

  • Schwaiger M, Hutchins GD, Kalff V, Rosenspire K, Haka MS, Mallette S, Deeb GM, Abrams GD, Wieland D (1991) Evidence for regional catecholamine uptake and storage sites in the transplanted human heart by position emission tomography. J Clin Invest 87:1681–1690

    Article  CAS  PubMed  Google Scholar 

  • Sharner RF (1930) On the development of the nerves to the mammalian heart. Anat Rec 46:23–39

    Article  Google Scholar 

  • Sheehan D, Pick J (1943) The rami communicantes in the rhesus monkey. J Anat 77:125–139

    CAS  PubMed  Google Scholar 

  • Shimada K, Shibata M, Tanaka J, Setoyama S, Suzuki M, Ito J (1997) A rare variation of the right subclavian artery combined with a variation of the right vertebral artery. Showa Med 57:349–353 (in Japanese with English abstract)

    Google Scholar 

  • Shoba T, Tay SS (2000) Nitrergic and peptidergic innervation in the developing rat heart. Anat Embryol 201:491–500

    Article  CAS  PubMed  Google Scholar 

  • Sonntag CF (1922) On the anatomy of the drill (Mandrillus leucophceus). Proc Zool Soc 29:429–453

    Google Scholar 

  • Sonntag CF (1924) On the anatomy, physiology, and pathology of the orang-outan. Proc Zool Soc 24:349–450

    Google Scholar 

  • Suzuki T, Chiba S, Takahashi D, Kasai T (1990) Morphological considerations of the bronchial arteries and cardiac nerves, in the so-called Adachi’s type-G aortic arch (in Japanese with English abstract). Hirosaki Med 42:176–182

    Google Scholar 

  • Tanaka S (2000) Vagal cardiac branches. In: Sato T, Akita K (eds) Anatomic variations in Japanese (in Japanese). University of Tokyo Press, Tokyo, pp 513–516

  • Tanaka S, Nakatani T, Mizukami S, Yasui K, Uemura M, Lee HY, Chung IH (1998) Branches of the vagus nerve destined for the heart and the adjoining great vessels in the house shrew, Suncus murinus, with special reference to the terminology of the vagal cardiac branches. Acta Anat Nippon 73:141–156

    CAS  PubMed  Google Scholar 

  • Tanaka A, Tanaka S, Miyamoto K, Yi SQ, Nakatani T (2007) Gross anatomical study of the sympathetic cardiac nerves in the house musk shrew (Suncus murinus). Anat Rec 290:468–476

    Article  Google Scholar 

  • Überfuhr P, Ziegler S, Schwaiblmair M, Reichart B, Schwaiger M (2000) Incomplete sympathic reinnervation of the orthotopically transplanted human heart: observation up to 13 years after heart transplantation. Eur J Cardiothorac Surg 17:161–168

    Article  PubMed  Google Scholar 

  • van den Broek AJP (1908) Untersuchungen über den Bau des sympathischen Nervensystems der Säugetiere. Morphol Jahrb 37:202–288

    Google Scholar 

  • Verberne ME, Gittenberger-de Groot AC, Poelmann RE (1998) Lineage and development of the parasympathetic nervous system of the embryonic chick heart. Anat Embryol 198:171–184

    Article  CAS  PubMed  Google Scholar 

  • White JC, Smithwick RH (1952) The autonomic nervous system, 2nd edn. Macmillan, New York

    Google Scholar 

  • Wilson RF, Christensen BV, Olivari MT, Simon A, White CW, Laxson DD (1991) Evidence for structural sympathetic reinnervation after orthotopic cardiac transplantation in humans. Circulation 83:1210–1220

    CAS  PubMed  Google Scholar 

  • Wrete M (1959) The anatomy of the sympathetic trunk in man. J Anat 93:448–459

    CAS  PubMed  Google Scholar 

  • Zuckerman S (1938) Observations on the autonomic nervous system and on vertebral and neural segmentation in monkeys. Trans Zool Soc Lond 23:315–378

    Article  Google Scholar 

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Acknowledgments

I would like to devote this paper to my two directors, Prof. Dr. Hiroshi Sasaki of Tokyo Women’s Medical University and Prof. Dr. Kenji Sato of Tokyo Medical and Dental University, as a memorial to their retirement. I also thank Prof. Emeritus Dr. Tatsuo Sato and Prof. Dr. Keiichi Akita of Tokyo Medical and Dental University for their continuous instructions as well as encouragement, and Prof. Dr. Nobuhisa Hagiwara and Dr. Takatomo Nakajima of Tokyo Women’s Medical University for supplying computed tomography data from clinical cases. This research was supported by grants from the Scientific Research (KAKENHI) of the Ministry of Education, Culture, Sports Science and Technology (MEXT) (No. 16790804, 2004–2006; No. 19790985, 2007–2009), the Japan Society for the Promotion of Science (JSPS) core-to-core program HOPE (2005–2007), and the Global COE program TWMU-MERCREM (2010–2011).

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  1. Department of Anatomy, School of Medicine, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Tomokazu Kawashima

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Kawashima, T. Anatomy of the cardiac nervous system with clinical and comparative morphological implications. Anat Sci Int 86, 30–49 (2011). https://doi.org/10.1007/s12565-010-0096-0

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