A histological study of the atria in patients with isolated rheumatic mitral regurgitation with and without atrial fibrillation

A histological study of the atria in patients with isolated rheumatic mitral regurgitation with and without atrial fibrillation

Background There is a high incidence of atrial fibrillation (AF) in patients with isolated rheumatic mitral regurgitation (MR). The histopathologic changes in the atria of patients with isolated rheumatic MR with and without AF are unknown. Objectives We aimed to determine the histological findings...

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Bibliographic Details
Published in:Journal of cardiovascular electrophysiology Vol. 33; no. 1; pp. 32 - 39
Main Authors: Kalpana, Saligrama R., Shenthar, Jayaprakash, Padmanabhan, Deepak, Rai, Maneesh K., Singh, Ankit, Banavalikar, Bharatraj, Kalyani, Ravikumar N., Kamalapurkar, Giridhar
Format: Journal Article
Language:English
Published: United States Wiley Subscription Services, Inc 01-01-2022
Subjects:
Adipose tissue
Atrial Fibrillation - diagnosis
Atrial Fibrillation - epidemiology
Atrial Fibrillation - etiology
Biopsy
Body fat
Cardiac arrhythmia
Degeneration
Fibrillation
Fibrosis
Heart Atria
Humans
Hypertrophy
mitral regurgitation
Mitral Valve
Mitral Valve Insufficiency - diagnostic imaging
Mitral Valve Insufficiency - surgery
Myocytes
Patients
Regurgitation
rheumatic atrial fibrillation
rheumatic heart disease
Rheumatic Heart Disease - complications
Rheumatic Heart Disease - diagnostic imaging
Rheumatic Heart Disease - surgery
vacuolar degeneration
valvular heart disease
valvular heart disease
vacuolar degeneration
rheumatic atrial fibrillation
mitral regurgitation
rheumatic heart disease
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Summary:Background There is a high incidence of atrial fibrillation (AF) in patients with isolated rheumatic mitral regurgitation (MR). The histopathologic changes in the atria of patients with isolated rheumatic MR with and without AF are unknown. Objectives We aimed to determine the histological findings in patients with isolated severe rheumatic MR with and without AF. Methods Patients with severe isolated rheumatic MR undergoing valve replacement surgeries underwent endocardial biopsies from right atrial appendage, left atrial appendage, right free wall, left free wall, left posterior wall, and mitral valve. Group I consisted of patients in sinus rhythm (SR), and Group II included patients with AF. We analyzed and compared these 10 histological features in the biopsies of patients in Groups I and II. Results Of the 25 patients, 12 were in Group I and 13 in Group II. In Group I, patients had severe myocyte hypertrophy (60% vs. 18%, p = .04) that was significantly more in the right atrium (22.7% vs. 11.4%, p = .059). Interstitial adipose tissue deposition was more common in Group I (30% vs. 25%, p = .06). Interstitial fibrosis was evenly distributed at all sites without significant difference between the two groups. Group II patients had a higher prevalence and severity of vacuolar degeneration (91% vs. 60%, p = .09). Conclusions Patients with isolated severe rheumatic MR and AF have more vacuolar degeneration in the atrial tissue. Patients with SR have myocyte hypertrophy and interstitial adipose tissue deposition. Interstitial fibrosis is uniformly distributed in patients in SR and AF.
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ISSN:1045-3873
1540-8167
DOI:10.1111/jce.15286