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Regional left atrial interstitial remodeling in patients with chronic atrial fibrillation undergoing mitral-valve surgery
- Source :
- Virchows Archiv. 445:498-505
- Publication Year :
- 2004
- Publisher :
- Springer Science and Business Media LLC, 2004.
-
Abstract
- Ablation of the left atrial free wall around the pulmonary vein ostia (LAFW) may be effective in the treatment of chronic atrial fibrillation associated with mitral disease (CAF-MVD). Using light and conventional electron microscopy analyses, we wanted to evaluate, in CAF-MVD, the interstitial remodeling in the LAFW as well as in a more remote region, such as the left atrial appendage (LAA). LAFW and LAA samples were obtained from 33 CAF-MVD patients during combined mitral surgery and radiofrequency ablation and from 16 autoptic controls. Interstitial fibrosis (IF) and perivascular fibrosis (PF), capillary densities and the maximal oxygen diffusion distance were morphometrically determined. In CAF-MVD patients, the LAFW, compared with the LAA, showed a higher percentage of IF (7.16+/-3.23% versus 2.51+/-1.40%, respectively), a lower myocardial capillary density per mm(2) (830+/-106 versus 989+/-173) and an increased oxygen maximal diffusion distance (19.70+/-1.27 microm versus 18.13+/-1.58 microm). All these values were also significantly different than controls. No differences were found in evaluating PF. At variance with the LAA, in CAF-MVD patients, the LAFW around the pulmonary vein ostia is a region characterized by a marked interstitial remodeling such that it may be morphologically indicated as an appropriate target for ablation treatment aimed at sinus rhythm restoration.
- Subjects :
- Adult
Male
medicine.medical_specialty
Heart disease
Radiofrequency ablation
medicine.medical_treatment
Heart Valve Diseases
Pathology and Forensic Medicine
Pulmonary vein
law.invention
Fibrosis
law
Internal medicine
Mitral valve
Atrial Fibrillation
medicine
Humans
Atrial Appendage
Sinus rhythm
Molecular Biology
Aged
Aged, 80 and over
business.industry
Myocardium
Atrial fibrillation
Cell Biology
General Medicine
Middle Aged
Ablation
medicine.disease
medicine.anatomical_structure
Chronic Disease
cardiovascular system
Cardiology
Mitral Valve
Female
business
Subjects
Details
- ISSN :
- 14322307 and 09456317
- Volume :
- 445
- Database :
- OpenAIRE
- Journal :
- Virchows Archiv
- Accession number :
- edsair.doi.dedup.....93395d7f0bb668880922a109ed721cf3