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The clinical significance of the atrial subendocardial smooth muscle layer and cardiac myofibroblasts in human atrial tissue with valvular atrial fibrillation

 Jae Hyung Park  ;  Hui-Nam Pak  ;  Sak Lee  ;  Han Ki Park  ;  Jeong-Wook Seo  ;  Byung-Chul Chang 
 CARDIOVASCULAR PATHOLOGY, Vol.22(1) : 58-64, 2013 
Journal Title
Issue Date
Actins/analysis ; Adult ; Aged ; Atrial Appendage/chemistry ; Atrial Appendage/pathology* ; Atrial Appendage/physiopathology ; Atrial Appendage/surgery ; Atrial Fibrillation/metabolism ; Atrial Fibrillation/pathology* ; Atrial Fibrillation/physiopathology ; Atrial Fibrillation/surgery ; Biomarkers/analysis ; Cardiac Surgical Procedures ; Collagen/analysis ; Connexin 43/analysis ; Female ; Fibrosis ; Glycogen/analysis ; Heart Valve Diseases/metabolism ; Heart Valve Diseases/pathology* ; Heart Valve Diseases/physiopathology ; Heart Valve Diseases/surgery ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Muscle, Smooth/chemistry ; Muscle, Smooth/pathology* ; Myofibroblasts/chemistry ; Myofibroblasts/pathology* ; Prospective Studies ; Staining and Labeling ; Young Adult
Atrial fibrillation ; Myofibroblast ; Subendocardial smooth muscle layer
BACKGROUND: The existence of myofibroblasts (MFBs) and the role of subendocardial smooth muscle (SSM) layer of human atrial tissue in atrial fibrillation (AF) have not yet been elucidated. We hypothesized that the SSM layer and MFB play some roles in atrial structural remodeling and maintenance of valvular AF in patients who undergo cardiac surgery. METHODS: We analyzed immunohistochemical staining of left atrial (LA) appendage tissues taken from 17 patients with AF and 15 patients remaining in sinus rhythm (SR) who underwent cardiac surgery (male 50.0%, 54.1 ± 14.2 years old, valve surgery 87.5%). SSM was quantified by α-smooth muscle actin (α-SMA) stain excluding vascular structure. MFB was defined as α-SMA+ cells with disorganized Connexin 43-positive gap junctions in Sirius red-positive fibrotic area. RESULTS: The SSM layer of atrium was significantly thicker in patients with AF than in those with SR (P=.0091). Patients with SSM layer ≥ 14 μm had a larger LA size (P=.0006) and greater fibrotic area (P=.0094) than those patients whose SSM layer <14 μm. MFBs were found in 7 of 17 (41.2%) patients with AF and 2 of 15 (13.3%) in SR group (P=.0456) in SSM area, colocalized with Periodic Acid-Schiff (PAS) stain-positive glycogen storage cells (95.5%). CONCLUSION: SSM layer was closely related to the existence of AF, degrees of atrial remodeling, and fibrosis in patients who underwent open heart surgery. We found that MFB does exist in SSM layer of human atrial tissue co-localized with PAS-positive cells.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Park, Jae Hyung(박재형)
Park, Han Ki(박한기) ORCID logo https://orcid.org/0000-0002-7472-7822
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Lee, Sak(이삭) ORCID logo https://orcid.org/0000-0001-6130-2342
Chang, Byung Chul(장병철)
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