{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T03:24:57Z","timestamp":1761017097190},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,3,17]],"date-time":"2015-03-17T00:00:00Z","timestamp":1426550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:p>In the normal individual, the parietal components of the body are mirror\u2010imaged and appropriately described as isomeric. The thoraco\u2010abdominal organs, in contrast, are lateralized. However, in \u201cvisceral heterotaxy,\u201d the thoraco\u2010abdominal organs also show some degree of isomerism, best seen in the arrangement of the bronchial tree. Whether isomerism can be found within the heart remains controversial. One of two recent publications in this journal emphasized the crucial features of bronchial isomerism; the other, in contrast, confused the situation of isomerism within the heart. In this review, we show how the topic of cardiac isomerism is clarified by concentrating on the anatomical features of the cardiac components and determining how best they can be described. Appropriate manipulation of developing mice produces unequivocal evidence of isomerism of the atrial appendages, but with no evidence of ventricular isomerism. In hearts from patients with so\u2010called \u201cheterotaxy,\u201d only the atrial appendages, distinguished on the basis of the pectinate muscles lining their walls, are uniformly isomeric, permitting the syndrome to be differentiated into the subsets of left as opposed to right atrial appendage isomerism. Thus, controversies are defused by simply describing the isomerism of the atrial appendages rather than \u201catrial isomerism,\u201d recognizing the frequency of abnormal venoatrial connections in these settings. Any suggestion of ambiguity is removed by the equally simple expedient of describing all the variable cardiac features, describing the arrangements of the thoracic and abdominal organs separately should there be discordances. Clin. Anat. 28:477\u2013486, 2015. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ca.22517","type":"journal-article","created":{"date-parts":[[2015,3,17]],"date-time":"2015-03-17T19:33:45Z","timestamp":1426620825000},"page":"477-486","source":"Crossref","is-referenced-by-count":10,"title":["The importance of being isomeric"],"prefix":"10.1002","volume":"28","author":[{"given":"Robert H.","family":"Anderson","sequence":"first","affiliation":[{"name":"Institute of Genetic Medicine, Newcastle University Newcastle upon Tyne United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nigel A.","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of Biomedical Sciences St George's University London United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chikara","family":"Meno","sequence":"additional","affiliation":[{"name":"Graduate School of Medical Sciences, Kyushu University Fukuoka Kyushu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane E.","family":"Spicer","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology University of Florida Gainesville Florida"},{"name":"Congenital Heart Institute of Florida St. Petersburg Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,3,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng1446"},{"key":"e_1_2_7_3_1","first-page":"1539","volume-title":"The Science and Practice of Pediatric Cardiology","author":"Gutgesell HP","year":"1998"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951107001138"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.59.2.403"},{"key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"2039","DOI":"10.1242\/dev.128.11.2039","article-title":"Regulation of left\u2010right asymmetry by thresholds of Pitx2c activity","volume":"128","author":"Liu C","year":"2001","journal-title":"Development"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.44.6.657"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0092-8674(00)81472-5"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.36.5.789"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00006.2003"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2007.2113"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.60.3.227"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951106000382"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.22445"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12265-012-9432-1"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(95)00538-V"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(99)80243-4"},{"key":"e_1_2_7_18_1","first-page":"1303","article-title":"Isomerism of the atria in the asplenia syndrome","volume":"11","author":"Van Mierop LHS","year":"1962","journal-title":"Lab Invest"},{"key":"e_1_2_7_19_1","first-page":"36","article-title":"Asplenia and polysplenia syndromes","volume":"8","author":"Van Mierop LHS","year":"1972","journal-title":"Birth Defects: Original Article Series"},{"key":"e_1_2_7_20_1","first-page":"4","volume-title":"Birth Defects Original Article Series, Vol. VIII, No. 5. 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