Histopathological substrate for chronic atrial fibrillation in humans.
Histopathological substrate for chronic atrial fibrillation in humans.
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DOI：
10.1016/j.hrthm.2009.01.010
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发表时间：
2009-04
期刊：
影响因子：
5.5
通讯作者：
Masroor, Saqib
中科院分区：
文献类型：
--
作者：
Nguyen, Bich Lien;Fishbein, Michael C.;Chen, Lan S.;Chen, Peng-Sheng;Masroor, Saqib
对于房颤（AF）患者的微折返回路和肺静脉（PV）肌袖和心房的触发活动的基质缺乏了解。为了检查慢性AF患者的组织学基质，我们使用过碘酸-希夫（PAS）和超极化激活的环核苷酸门控钾通道4（HCN 4）、CD 117/c-kit、肌红蛋白、酪氨酸羟化酶（TH）、生长相关蛋白43、胆碱乙酰转移酶和突触素以及三色。与SR患者的内皮层下聚集在一起相反，AF患者的PAS阳性细胞被炎性浸润和胶原纤维彼此分离。这些细胞对HCN 4和肌红蛋白染色阳性，表明它们是可能具有潜在起搏功能的心肌细胞，但不同于CD 117/c-kit阳性间质Cajal样细胞（ICLC）。在AF患者中，细胞间隙被淋巴瘤浸润占据（100% vs. SR患者33%，p=0.002），间质纤维化量更大（37±5.6% vs. 7.4± 2.8%，p=0.009）。AF和SR患者之间的神经密度没有差异。然而，AF患者的交感神经分支的密度显著大于其他神经（p=0.03）。HCN 4/PAS阳性的心肌细胞和CD 117/c-kit阳性的ICLC分散在心房和PV-LA交界处的大量炎性浸润、纤维组织和交感神经结构中，可能是维持慢性AF的基质。
There is a lack of understanding of the substrate for microreentrant circuits and triggered activity of the pulmonary vein (PV) muscle sleeves and atria, in patients with atrial fibrillation (AF). To examine the histological substrate of patients with chronic AF. We stained 23 biopsies taken from the PV-LA junction and RAA from 5 chronic AF patients and 3 sinus rhythm (SR) patients undergoing mitral valve surgery using periodic acid-Schiff (PAS), and antibodies to hyperpolarization-activated cyclic nucleotide-gated potassium channel 4 (HCN4), CD117/c-kit, myoglobin, tyrosine hydroxylase (TH), growth-associated protein 43, cholineacetyltransferase, and synaptophysin, as well as trichrome. As opposed to being clustered together in the subendocardial layer in SR patients, PAS-positive cells were separated from each other by inflammatory infiltrate and collagen fibers in AF patients. These cells stained positively for HCN4 and myoglobin, indicating they were cardiomyocytes that might have a potential pacemaking function, but different from CD117/c-kit-positive interstitial Cajal-like cells (ICLC). In AF patients, the intercellular space was occupied by a lymphomononuclear infiltrate (100% vs. 33% in SR patients, p=0.002), and a greater amount of interstitial fibrosis (37±5.6% vs. 7.4±2.8%, p=0.009). Nerve densities did not differ between AF and SR patients. However, the density of sympathetic nerve twigs in AF patients was significantly greater as compared to the others nerves (p=0.03). HCN4-/PAS-positive cardiomyocytes, and CD117/c-kit-positive ICLC scattered among abundant inflammatory infiltrate, fibrous tissue, and sympathetic nerve structures in the atria and at the PV-LA junctions might be a substrate for the maintenance of chronic AF.
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影响因子：
24
作者：
Ogawa, Masahiro;Zhou, Shengmei;Chen, Peng-Sheng
通讯作者：
Chen, Peng-Sheng
影响因子：
37.8
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Haïssaguerre, M;Shah, DC;Clémenty, J
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Clémenty, J
影响因子：
37.8
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Hamabe, A;Okuyama, Y;Chen, PS
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Chen, PS
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Ho, SY;Cabrera, JA;Sánchez-Quintana, D
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Sánchez-Quintana, D
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37.8
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Chou, CC;Nihei, M;Chen, PS
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