Kwak Jae Gun, Seo Jeong-Wook, Oh Sam Se, Lee Sang Yun, Ham Eui Keun, Kim Woong-Han, Kim Soo-Jin, Bae Eun Jung, Lim Cheoung, Lee Chang-Ha, Lee Cheul
Department of Thoracic and Cardiovascular Surgery, Sejong General Hostpial, Bucheon, Republic of Korea.
Department of Pathology, Seoul National University Hospital, Seoul, Republic of Korea.
Cardiovasc Pathol. 2014 Jul-Aug;23(4):185-92. doi: 10.1016/j.carpath.2014.01.008. Epub 2014 Jan 28.
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.
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.
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.
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.
成年房间隔缺损（ASD）患者的心房颤动（AF）伴有右心房（RA）扩大，左心房（LA）扩大程度较小，这与AF合并二尖瓣疾病的患者情况相反。本研究旨在比较两种不同病因（ASD和二尖瓣疾病）的AF患者心房的组织病理学变化。
纳入24例患者。第1组包括ASD患者（8例），第2组包括合并AF的ASD患者（6例），第3组包括合并AF的二尖瓣疾病患者（10例）。测量术前心房容积。在手术过程中获取心房组织，并用过碘酸希夫染色、平滑肌肌动蛋白染色、天狼星红染色和马松三色染色，以检测与AF相符的组织病理学变化。在分析染色的数字化图像后，用“阳性”和“强阳性”表示组织病理学变化的严重程度。我们根据分组和组织研究心房扩张程度与组织病理学变化严重程度之间的关系。
与彼此相比，第2组和第3组患者分别显示出RA容积扩大和LA容积扩大的趋势。然而，在组织病理学分析中，特殊染色中“阳性”和“强阳性”与心房容积程度无显著正相关。
AF患者（第2组和第3组）的两个心房均观察到相似程度的组织病理学变化，无论心房容积扩张程度和疾病实体如何。
