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Dynamics of human cardiogenesis and its disruption in trisomy 21

James Cranley iD, Kazumasa Kanemaru, Semih Bayraktar iD, Vincent Knight-Schrijver iD, Rebecca Hulbert iD, Eva Lana-Elola, Rifdat Aoidi, Jan Patrick Pett iD, Anna Wilbrey-Clark, Krzysztof Polanski iD, Monika Dabrowska, Ilaria Mulas iD, Harriet Johnson iD, Noemie Combemorel, Yizhou Yu iD, Jack A. Palmer, Woochan Lee, Jore Van Wauwe iD, John-Poul Ng-Blichfeldt, Laura Richardson iD, Claudia I. Semprich iD, Rakeshlal Kapuge, Shani Perera, Xiaoling He iD, Siew Yen Ho iD, Nadav Yayon iD, Liz Tuck iD, Kenny Roberts iD, Hongorzul Davaapil, Laure Gambardella iD, Anna Philpott iD, Minal Patel, Richard C. V. Tyser iD, Andreia Sofia Bernardo, Victor L. J. Tybulewicz iD, Sanjay Sinha iD, Sarah A. Teichmann iD

DOI10.1038/s41586-026-11125-y
PublisherSpringer Science and Business Media LLC
Journal / SourceNature
Published2026-10-07
Metadata Deposited2026-10-07 (updated: 2026-10-07)
Subject—
Languageen
ISSN0028-0836, 1476-4687
Typejournal-article
Volume / Issue / Pages— / — / —
Citations0
References deposited71
Access / license metadataOpen license identified License 1 ↗A reuse license does not by itself establish whether the full text is freely readable.

Abstract

Abstract Developmental dynamics involve the specification of diverse cell types and their spatial organization into multicellular niches 1 . Here we combine single-cell and spatial multiomics to define 21 distinct tissue niches in the developing heart, which we use to develop a context-aware, resolution-agnostic niche classification tool (TissueTypist). Applying high-resolution spatial profiling to the developing sinoatrial node, we resolve three pacemaker cell subtypes arrayed along a linear axis. First trimester subpopulations, such as pacemaker cells in the sinus horn and sinoatrial node head region, display neuroattractant programs and interact with parasympathetic neurons via interactions that include Eph–ephrin and semaphorin–plexin signalling. Temporal trajectories map the maturation of atrial and ventricular cardiomyocytes and uncover a lipid–metabolic switch and potential key regulators of cell-type identity. In the ventricle, we identify cellular and transcriptional gradients along both pseudotime and transmural axes, which provide molecular insights into myocardial compaction and maturation. Comparative profiling revealed that hearts with trisomy 21 are depleted in compact cardiomyocytes and exhibit increased apoptosis relative to euploid hearts. This finding was validated in isogenic-matched trisomy 21 and euploid cardiomyocytes derived from induced pluripotent stem cells. These early developmental perturbations may contribute to the increased risk of congenital heart disease associated with Down’s syndrome. In summary, we present a spatially resolved framework of human cardiac development to enable systematic explorations of developmental niches in health and disease.