TY - JOUR
T1 - Regional left atrial interstitial remodeling in patients with chronic atrial fibrillation undergoing mitral-valve surgery
AU - Corradi, Domenico
AU - Callegari, Sergio
AU - Benussi, Stefano
AU - Nascimbene, Simona
AU - Pastori, Paolo
AU - Calvi, Simone
AU - Maestri, Roberta
AU - Astorri, Ettore
AU - Pappone, Carlo
AU - Alfieri, Ottavio
PY - 2004/11
Y1 - 2004/11
N2 - 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 mm2 (830±106 versus 989±173) and an increased oxygen maximal diffusion distance (19.70± 1.27 μm versus 18.13±1.58 μm). 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.
AB - 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 mm2 (830±106 versus 989±173) and an increased oxygen maximal diffusion distance (19.70± 1.27 μm versus 18.13±1.58 μm). 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.
KW - Ablation
KW - Atrial fibrillation
KW - Capillaries
KW - Fibrosis
KW - Remodeling
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U2 - 10.1007/s00428-004-1040-2
DO - 10.1007/s00428-004-1040-2
M3 - Article
C2 - 15221371
AN - SCOPUS:9944254279
VL - 445
SP - 498
EP - 505
JO - Virchows Archiv - A Pathological Anatomy and Histopathology
JF - Virchows Archiv - A Pathological Anatomy and Histopathology
SN - 0945-6317
IS - 5
ER -