Margaret Loewy Kirby, PhD
273 pages. Oxford, UK: Oxford University Press; 2007. $150.00. ISBN 0–19517–819-X
The developing heart has been an area of scientific interest since the time of Aristotle. The field of classical embryology has provided detailed descriptions of cardiac development, but the genetic mechanisms underlying cardiac morphogenesis have only begun to be elucidated with the use of molecular biology techniques. Novel approaches to investigating cardiac development have produced different paradigms of development that have not been reconciled with the classical descriptive embryology. As Dr Kirby herself remarked in a 2000 editorial, “For anyone who has ever been on the sidelines during a discussion of congenital heart defects…the complexity of cardiovascular development that underlies this pathology is painfully obvious. Our understanding of heart development in particular has lagged behind that of other more tidily developing organs that have the leisure of putting themselves together before they have to do anything. Perhaps it is for these reasons that the molecular age has come to heart development a bit slower and more painstakingly than to other systems.”1
In her new textbook Cardiac Development, Dr Kirby attempts to rectify the gap between the classical descriptive embryology of the heart and recent insights into the genetic mechanisms underlying heart development. This book takes the uncommon approach of a single author format, which lends unity to the book as a whole and provides a more even-handed overview of cardiac development than other recent texts have offered. Disciplines not traditionally discussed in cardiac embryology books have been added, including a chapter on “Functional Developmental Biology of the Myocardium” written by Tony Creazzo, and a chapter on “Evolutionary Developmental Biology of the Heart” coauthored with Fred Schaat. The structure of the book follows the traditional organization by chronology of development, including chapters on cardiogenic fields and heart tube formation, induction and differentiation of the myocardium, molecular control of looping, chamber specification and ventricular septation, valve development, and outflow tract septation. The book also includes chapters on topics that are less commonly presented in detail in embryology texts but that are critical for development of the cardiovascular system as a whole. These include chapters on vascular development, cardiac conduction system, coronary vessel development, and cardiac innervation. The closing chapters of the book highlight both translational research linking animal studies to clinical human syndromes and also recent work in myocardial stem cell biology.
The text is written with an eye to providing an introductory overview to cardiac developmental biology. As such, the author provides concise reviews of relevant background basic science concepts and makes every attempt to link the basic science presented in each chapter with a clinical correlation, such as a specific cardiac malformation or syndrome. This systematic attempt to illuminate the translational nature of the field is very useful in demonstrating the interconnectedness of heart development and malformations. In some sections, the attempt at conciseness leaves certain concepts seemingly oversimplified, but in all, Dr Kirby should be commended for this book, which provides a unified framework to view the very exciting recent work in transcriptional regulation and genetic mechanisms driving heart development. This holistic approach is unique among recently published texts. The extensive glossary is a useful feature of this book, as the different systems of nomenclature that have historically been applied to cardiac embryology and anatomy have made complex topics even more opaque. The glossary also provides information on the basic science aspects that are less familiar to clinically trained readers. As noted in the author’s preface, some of the points made in this book are outside of the mainstream consensus; however, this is not a weakness of the book, but merely a chance to “think outside the box” and actively re-evaluate our current understanding of heart development.
In summary, the complexity of cardiac development and the rapid advances currently being made in the field have made cardiac embryology a daunting topic of study, especially to newcomers. This textbook synthesizes a vast amount of basic science into a concise and clinically relevant summary of heart development and will be very useful to cardiologists, cardiac surgeons, pathologists, and researchers involved in the study of heart malformations and the care of patients with congenital heart disease.