Histopathological Study of Left and Right Atria in Isolated Rheumatic Mitral Stenosis With and Without Atrial Fibrillation

Autor:	S.R. Kalpana, Mukund Aravind Prabhu, Ravikumar Kalyani Nagashetty, Jayaprakash Shenthar, Maneesh K. Rai, Giridhar Kamlapurkar
Rok vydání:	2016
Předmět:	medicine.medical_specialty business.industry medicine.medical_treatment Mitral valve replacement Atrial fibrillation Odds ratio 030204 cardiovascular system & hematology medicine.disease 03 medical and health sciences Stenosis 0302 clinical medicine Physiology (medical) Internal medicine cardiovascular system medicine Cardiology Sinus rhythm Histopathology 030212 general & internal medicine Cardiology and Cardiovascular Medicine Prospective cohort study business Myocytolysis
Zdroj:	Journal of Cardiovascular Electrophysiology. 27:1047-1054
ISSN:	1045-3873
Popis:	Histopathological Study of Atria in Rheumatic Mitral Stenosis With Respect to RhythmBackground Mitral stenosis (MS) has the highest incidence of atrial fibrillation (AF) in chronic rheumatic valvular disease. There are very few studies in isolated MS comparing histopathological changes in patients with sinus rhythm (SR) and AF. Objectives To analyze the histological changes associated with isolated MS and compare between changes in AF and SR. Methods This was a prospective study in patients undergoing valve replacement surgery for symptomatic isolated MS who were divided into 2 groups, Group I AF (n = 13) and Group II SR (n = 10). Intra-operative biopsies performed from 5 different sites from both atria were analyzed for 10 histopathologic changes commonly associated with AF. Results On multivariate analysis, myocytolysis (odds ratio [OR]: 1.48, P = 0.05) was found to be associated with AF, whereas myocyte hypertrophy (OR: 0.21, P = 0.003), and glycogen deposition (OR: 0.43, P = 0.002) was associated with SR. Interstitial fibrosis the commonest change was uniformly distributed across both atria irrespective of the rhythm. Conclusion In rheumatic MS, SR is associated with myocyte hypertrophy whereas AF is associated with myocytolysis. Endocardial inflammation is more common in left atrial appendage irrespective of rhythm. Interstitial fibrosis is seen in >90% of patients distributed in both the atria and is independent of the rhythm. Amyloid and Aschoff bodies are uncommon and the rest of the changes are uniformly distributed across both the atria.
Databáze:	OpenAIRE
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