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Regional left atrial interstitial remodeling in patients with chronic atrial fibrillation undergoing mitral-valve surgery.

Authors :
Domenico Corradi
Sergio Callegari
Stefano Benussi
Simona Nascimbene
Paolo Pastori
Simone Calvi
Roberta Maestri
Ettore Astorri
Carlo Pappone
Ottavio Alfieri
Source :
Virchows Archiv: European Journal of Pathology; Number 5, Vol. 445 Issue 5, p498-505, 91p
Publication Year :
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 <superscript>2</superscript> (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. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
09456317
Volume :
445
Issue :
5
Database :
Complementary Index
Journal :
Virchows Archiv: European Journal of Pathology
Publication Type :
Academic Journal
Accession number :
20038148