title: Histopathologic analysis of atrial tissue in patients with atrial fibrillation: comparison between patients with atrial septal defect and patients with mitral valvular heart disease.
abstract: BACKGROUND
  Atrial fibrillation (AF) in adult patients with atrial septal defect (ASD) accompanies an enlarged right atrium (RA) with a less enlarged left atrium (LA), which is the opposite situation in patients with AF and mitral valvular disease. This study was to compare the histopathological change in the atrium of patients with AF of two different etiologies: ASD and mitral disease.
  
  
  METHODS
  Twenty-four patients were enrolled. Group 1 included patients with ASD (8), Group 2 included patients with ASD with AF (6), and Group 3 included patients with mitral disease with AF (10). Preoperative atrial volumes were measured. Atrial tissues were obtained during surgical procedures and stained with periodic acid-Schiff, smooth muscle actin, Sirius red, and Masson's trichrome to detect histopathologic changes compatible with AF. The severity of histopathological changes was represented with "positivity" and "strong positivity" after analyzing digitalized images of the staining. We investigated the relationship between the degree of atrial dilatation and severity of histopathological changes according to the groups and tissues.
  
  
  RESULTS
  Group 2 and Group 3 patients showed a tendency toward an enlarged RA volume and enlarged LA volume, respectively, compared with each others. However, in the histopathologic analysis, "positivity" and "strong positivity" showed no significant positive correlations with the degree of atrial volume in special staining.
  
  
  CONCLUSIONS
  A similar degree of histopathologic changes was observed in both atria in patients with AF (Group 2 and 3) regardless of the degree of dilatation of atrial volume and disease entities.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Sejong General Hostpial, Bucheon, Republic of Korea.
authors.forename: Jae Gun
authors.initials: JG
authors.lastname: Kwak
authors.affiliation: Department of Pathology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Jeong-Wook
authors.initials: JW
authors.lastname: Seo
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Sejong General Hostpial, Bucheon, Republic of Korea.
authors.forename: Sam Se
authors.initials: SS
authors.lastname: Oh
authors.affiliation: Department of Pediatrics, Sejong General Hospital, Bucheon, Republic of Korea.
authors.forename: Sang Yun
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Pathology, Sejong General Hospital, Bucheon, Republic of Korea.
authors.forename: Eui Keun
authors.initials: EK
authors.lastname: Ham
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital, Seoul, Republic of Korea. Electronic address: woonghan@snu.ac.kr.
authors.forename: Woong-Han
authors.initials: WH
authors.lastname: Kim
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, School of Medicine, Konkuk University, Seoul, Republic of Korea.
authors.forename: Soo-Jin
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea.
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Bae
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Cheoung
authors.initials: C
authors.lastname: Lim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Sejong General Hostpial, Bucheon, Republic of Korea.
authors.forename: Chang-Ha
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Sejong General Hostpial, Bucheon, Republic of Korea.
authors.forename: Cheul
authors.initials: C
authors.lastname: Lee
mesh_terms: D000199:Actins / Q000378:metabolism; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology* / Q000378:metabolism / Q000473:pathology*; D006325:Heart Atria / Q000378:metabolism / Q000473:pathology*; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D006349:Heart Valve Diseases / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve; D011446:Prospective Studies; D013194:Staining and Labeling
chemical_list: C541116:ACTA2 protein, human; D000199:Actins
keywords: Atrial fibrillation; Atrium; Congenital heart disease; Mitral regurgitation; Pathology (atrium); Septal defects