title: Structural abnormalities in atrial walls are associated with presence and persistency of atrial fibrillation but not with age.
abstract: OBJECTIVE
  The purpose of this study was to assess the association between structural changes in human atria, age, and history of atrial fibrillation (AF).
  
  
  BACKGROUND
  Development of fibrosis in atrial walls is associated with deterioration of atrial conduction and predisposes to AF in experiment. Human data, however, are scarce, and whether fibrosis is a cause or consequence of AF is not known.
  
  
  METHODS
  Medical records for consecutive autopsies were checked for AF history and duration. Atrial specimens from 30 patients (ages 64 ± 12 years) were collected in 3 equal age-matched groups as patients without AF history, with paroxysmal AF, or with permanent AF. Tissue samples were obtained at the level of superior pulmonary veins, inferior pulmonary veins, center of posterior left atrial wall, terminal crest, and Bachmann's bundle. Histology sections were assessed for extent of fibrosis, fatty tissues, and inflammatory infiltration at each location.
  
  
  RESULTS
  No correlation was observed between age and fibrosis at any location. Fibrosis extent and fatty infiltration were twofold to threefold higher at all locations in patients with history of AF and correlated with lymphomononuclear infiltration. Patients with permanent AF had greater fibrosis extent than did patients with paroxysmal AF.
  
  
  CONCLUSIONS
  In post-mortem material, structural changes in the atria were not associated with age, but were significantly correlated with presence of AF and its severity. Our findings suggest that age-related changes per se are unlikely to be the sole cause of advanced fibrosis underlying AF.
authors.affiliation: Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden.
authors.forename: Pyotr G
authors.initials: PG
authors.lastname: Platonov
authors.forename: Lubov B
authors.initials: LB
authors.lastname: Mitrofanova
authors.forename: Victoria
authors.initials: V
authors.lastname: Orshanskaya
authors.forename: Siew Yen
authors.initials: SY
authors.lastname: Ho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000175:diagnosis; D001707:Biopsy, Needle; D018450:Disease Progression; D005260:Female; D005355:Fibrosis / Q000150:complications / Q000473:pathology; D005500:Follow-Up Studies; D006325:Heart Atria / Q000473:pathology*; D006331:Heart Diseases / Q000150:complications / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies