Histopathological Study of Left and Right Atria in Isolated Rheumatic Mitral Stenosis With and Without Atrial Fibrillation

Jayaprakash Shenthar, Saligrama Ramegowda Kalpana, Mukund A. Prabhu, Maneesh K. Rai, Ravikumar Kalyani Nagashetty, Giridhar Kamlapurkar

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Mitral stenosis (MS) has the highest incidence of atrial fibrillation (AF) in chronic rheumatic valvular disease. There are very few studies in isolated MS comparing histopathological changes in patients with sinus rhythm (SR) and AF. Objectives: To analyze the histological changes associated with isolated MS and compare between changes in AF and SR. Methods: This was a prospective study in patients undergoing valve replacement surgery for symptomatic isolated MS who were divided into 2 groups, Group I AF (n = 13) and Group II SR (n = 10). Intra-operative biopsies performed from 5 different sites from both atria were analyzed for 10 histopathologic changes commonly associated with AF. Results: On multivariate analysis, myocytolysis (odds ratio [OR]: 1.48, P = 0.05) was found to be associated with AF, whereas myocyte hypertrophy (OR: 0.21, P = 0.003), and glycogen deposition (OR: 0.43, P = 0.002) was associated with SR. Interstitial fibrosis the commonest change was uniformly distributed across both atria irrespective of the rhythm. Conclusion: In rheumatic MS, SR is associated with myocyte hypertrophy whereas AF is associated with myocytolysis. Endocardial inflammation is more common in left atrial appendage irrespective of rhythm. Interstitial fibrosis is seen in >90% of patients distributed in both the atria and is independent of the rhythm. Amyloid and Aschoff bodies are uncommon and the rest of the changes are uniformly distributed across both the atria.

Original languageEnglish
Pages (from-to)1047-1054
Number of pages8
JournalJournal of Cardiovascular Electrophysiology
Volume27
Issue number9
DOIs
Publication statusPublished - 01-09-2016

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Mitral Valve Stenosis
Heart Atria
Atrial Fibrillation
Odds Ratio
Muscle Cells
Hypertrophy
Rheumatic Nodule
Fibrosis
Atrial Appendage
Rheumatic Diseases
Glycogen
Amyloid
Multivariate Analysis
Prospective Studies
Inflammation
Biopsy
Incidence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Shenthar, Jayaprakash ; Kalpana, Saligrama Ramegowda ; Prabhu, Mukund A. ; Rai, Maneesh K. ; Nagashetty, Ravikumar Kalyani ; Kamlapurkar, Giridhar. / Histopathological Study of Left and Right Atria in Isolated Rheumatic Mitral Stenosis With and Without Atrial Fibrillation. In: Journal of Cardiovascular Electrophysiology. 2016 ; Vol. 27, No. 9. pp. 1047-1054.
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abstract = "Background: Mitral stenosis (MS) has the highest incidence of atrial fibrillation (AF) in chronic rheumatic valvular disease. There are very few studies in isolated MS comparing histopathological changes in patients with sinus rhythm (SR) and AF. Objectives: To analyze the histological changes associated with isolated MS and compare between changes in AF and SR. Methods: This was a prospective study in patients undergoing valve replacement surgery for symptomatic isolated MS who were divided into 2 groups, Group I AF (n = 13) and Group II SR (n = 10). Intra-operative biopsies performed from 5 different sites from both atria were analyzed for 10 histopathologic changes commonly associated with AF. Results: On multivariate analysis, myocytolysis (odds ratio [OR]: 1.48, P = 0.05) was found to be associated with AF, whereas myocyte hypertrophy (OR: 0.21, P = 0.003), and glycogen deposition (OR: 0.43, P = 0.002) was associated with SR. Interstitial fibrosis the commonest change was uniformly distributed across both atria irrespective of the rhythm. Conclusion: In rheumatic MS, SR is associated with myocyte hypertrophy whereas AF is associated with myocytolysis. Endocardial inflammation is more common in left atrial appendage irrespective of rhythm. Interstitial fibrosis is seen in >90{\%} of patients distributed in both the atria and is independent of the rhythm. Amyloid and Aschoff bodies are uncommon and the rest of the changes are uniformly distributed across both the atria.",
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Histopathological Study of Left and Right Atria in Isolated Rheumatic Mitral Stenosis With and Without Atrial Fibrillation. / Shenthar, Jayaprakash; Kalpana, Saligrama Ramegowda; Prabhu, Mukund A.; Rai, Maneesh K.; Nagashetty, Ravikumar Kalyani; Kamlapurkar, Giridhar.

In: Journal of Cardiovascular Electrophysiology, Vol. 27, No. 9, 01.09.2016, p. 1047-1054.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Histopathological Study of Left and Right Atria in Isolated Rheumatic Mitral Stenosis With and Without Atrial Fibrillation

AU - Shenthar, Jayaprakash

AU - Kalpana, Saligrama Ramegowda

AU - Prabhu, Mukund A.

AU - Rai, Maneesh K.

AU - Nagashetty, Ravikumar Kalyani

AU - Kamlapurkar, Giridhar

PY - 2016/9/1

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N2 - Background: Mitral stenosis (MS) has the highest incidence of atrial fibrillation (AF) in chronic rheumatic valvular disease. There are very few studies in isolated MS comparing histopathological changes in patients with sinus rhythm (SR) and AF. Objectives: To analyze the histological changes associated with isolated MS and compare between changes in AF and SR. Methods: This was a prospective study in patients undergoing valve replacement surgery for symptomatic isolated MS who were divided into 2 groups, Group I AF (n = 13) and Group II SR (n = 10). Intra-operative biopsies performed from 5 different sites from both atria were analyzed for 10 histopathologic changes commonly associated with AF. Results: On multivariate analysis, myocytolysis (odds ratio [OR]: 1.48, P = 0.05) was found to be associated with AF, whereas myocyte hypertrophy (OR: 0.21, P = 0.003), and glycogen deposition (OR: 0.43, P = 0.002) was associated with SR. Interstitial fibrosis the commonest change was uniformly distributed across both atria irrespective of the rhythm. Conclusion: In rheumatic MS, SR is associated with myocyte hypertrophy whereas AF is associated with myocytolysis. Endocardial inflammation is more common in left atrial appendage irrespective of rhythm. Interstitial fibrosis is seen in >90% of patients distributed in both the atria and is independent of the rhythm. Amyloid and Aschoff bodies are uncommon and the rest of the changes are uniformly distributed across both the atria.

AB - Background: Mitral stenosis (MS) has the highest incidence of atrial fibrillation (AF) in chronic rheumatic valvular disease. There are very few studies in isolated MS comparing histopathological changes in patients with sinus rhythm (SR) and AF. Objectives: To analyze the histological changes associated with isolated MS and compare between changes in AF and SR. Methods: This was a prospective study in patients undergoing valve replacement surgery for symptomatic isolated MS who were divided into 2 groups, Group I AF (n = 13) and Group II SR (n = 10). Intra-operative biopsies performed from 5 different sites from both atria were analyzed for 10 histopathologic changes commonly associated with AF. Results: On multivariate analysis, myocytolysis (odds ratio [OR]: 1.48, P = 0.05) was found to be associated with AF, whereas myocyte hypertrophy (OR: 0.21, P = 0.003), and glycogen deposition (OR: 0.43, P = 0.002) was associated with SR. Interstitial fibrosis the commonest change was uniformly distributed across both atria irrespective of the rhythm. Conclusion: In rheumatic MS, SR is associated with myocyte hypertrophy whereas AF is associated with myocytolysis. Endocardial inflammation is more common in left atrial appendage irrespective of rhythm. Interstitial fibrosis is seen in >90% of patients distributed in both the atria and is independent of the rhythm. Amyloid and Aschoff bodies are uncommon and the rest of the changes are uniformly distributed across both the atria.

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