Visceroatrial heterotaxy syndrome in the NOD mouse with special reference to atrial situs

Following the onset of diabetes mellitus (DM) in the NOD mouse, diabetic dams have many offspring with severe anomalies, especially with visceroatrial heterotaxy syndrome. The purpose of the present study is to analyze this syndrome with special reference to atrial situs. The fetuses from a colony of NOD mice in our laboratory were divided into two study groups: Group A included fetuses from dams before the onset of DM and group B included fetuses from dams with overt DM before day 8 of pregnancy. The fetuses which had cardiac anomalies with viscero-atrial heterotaxy were classified into four subtypes according to the atrial morphology, i.e., "incomplete situs solitus" (or solitus-like), "incomplete situs inversus" (inversus-like), right isomerism, and left isomerism. Group A (671 fetuses) included only one case with right isomerism (0.15%) and four cases with left isomerism (0.6%). Group B (158 fetuses) had 57 fetuses with heterotaxy syndrome (36.1%), including 20 cases with solitus-like, 6 with inversus-like, 30 with right isomerism, and one with left isomerism. A tendency for right isomerism to occur was found in fetuses with solitus-like and inversus-like anomalies. These results show that the maternal DM in this mouse had an influence upon the morphological mechanism determining right isomerism of visceroatrial heterotaxy syndrome. Thus this syndrome in the NOD mouse is equivalent to asplenia in humans, and it may be useful in elucidating the mechanism of the human syndrome.