Histologic assessment of right atrial appendage myocardium in patients with atrial fibrillation after coronary artery bypass graft surgery
Histologic assessment of right atrial appendage myocardium in patients with atrial fibrillation after coronary artery bypass graft surgery
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DOI：
10.1159/000095936
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发表时间：
2007-01-01
期刊：
影响因子：
1.9
通讯作者：
Leung, Jacqueline M.
中科院分区：
文献类型：
--
作者：
Nakai, Toshiko;Chandy, Joby;Leung, Jacqueline M.
心房颤动（AF）是冠状动脉旁路移植术（CABG）后常见的并发症。尽管心脏手术后房颤的发病率很高，但其病理生理机制尚不完全清楚。我们以前的研究表明，年龄和左心房扩大是术后AF的独立预测因素。因此，本研究的目的是确定是否发生在随后发展为术后AF的患者的心房中的细胞变化，如纤维化和/或肥大。右心耳组织在接受择期CABG手术的患者的心房切开术中获得。天狼星红染色定量评估心房纤维化，HE染色测量心房细胞直径。采用直线回归、t检验、卡方检验或Fisher精确检验进行统计学分析。研究了61例患者（平均年龄71 ± 8岁）。年龄增加与纤维化显著相关（β 0.3，95% CI：0.06 - 0.55，p = 0.017）。右心房纤维化程度与术后AF发生率相关（p = 0.08）。术后AF患者与无术后AF患者之间的细胞直径无显著差异（p = 0.85）。提示年龄相关性心房纤维化而非细胞肥大可能是CABG术后AF的重要发病机制，值得进一步研究。版权所有（c）2007 S. Karger AG，巴塞尔。
Atrial fibrillation ( AF) is a common complication after coronary artery bypass graft ( CABG) surgery. Despite the prevalence of AF occurring after cardiac surgery, its pathophysiology is incompletely understood. Our previous study demonstrated that age and left atrial enlargement were independent predictors of postoperative AF. Accordingly, the purpose of this study was to determine whether cellular changes such as fibrosis and/ or hypertrophy occurred in the atrium in patients who subsequently developed postoperative AF. Right atrial appendage tissue was obtained during atriotomy in patients undergoing elective CABG surgery. Quantitative assessment of atrial fibrosis was performed with Sirius red stain, and atrial cell diameter was measured with the HE stain. Linear regression, t test, chi(2) 2 test or Fisher exact test were used for statistical analysis. Sixty-one patients ( mean age 71 +/- 8 years) were studied. Increasing age was significantly associated with fibrosis ( beta 0.3, 95% Cl: 0.06 - 0.55, p = 0.017). The amount of right atrial fibrosis tended to correlate with the incidence of postoperative AF ( p = 0.08). Cell diameter was not significantly different between patients with versus without postoperative AF ( p = 0.85). These results suggest that the age-related atrial fibrosis rather than cellular hypertrophy may be important in the pathogenesis of AF after CABG surgery and should be further investigated. Copyright (c) 2007 S. Karger AG, Basel.