Structural Abnormalities in Atrial Walls Are Associated With Presence and Persistency of Atrial Fibrillation But Not With Age
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Objectives The purpose of this study was to assess the association between structural changes in human atria, age, and history of atrial fibrillation (AF).Background Development of fibrosis in atrial walls is associated with deterioration of atrial conduction and predisposes to AF in experiment. Human data, however, are scarce, and whether fibrosis is a cause or consequence of AF is not known.Methods Medical records for consecutive autopsies were checked for AF history and duration. Atrial specimens from 30 patients (ages 64 ± 12 years) were collected in 3 equal age-matched groups as patients without AF history, with paroxysmal AF, or with permanent AF. Tissue samples were obtained at the level of superior pulmonary veins, inferior pulmonary veins, center of posterior left atrial wall, terminal crest, and Bachmann's bundle. Histology sections were assessed for extent of fibrosis, fatty tissues, and inflammatory infiltration at each location.Results No correlation was observed between age and fibrosis at any location. Fibrosis extent and fatty infiltration were twofold to threefold higher at all locations in patients with history of AF and correlated with lymphomononuclear infiltration. Patients with permanent AF had greater fibrosis extent than did patients with paroxysmal AF.Conclusions In post-mortem material, structural changes in the atria were not associated with age, but were significantly correlated with presence of AF and its severity. Our findings suggest that age-related changes per se are unlikely to be the sole cause of advanced fibrosis underlying AF.
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A number of observational studies have demonstrated the association between female sex and risk of AF-related stroke and thromboembolism.
“A number of observational studies have demonstrated the association between female sex and risk of AF-related stroke and thromboembolism (Supplementary Table S6).”
From Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis (2016) · cites this paper as [68]
Most studies report an increased risk of stroke in women with atrial fibrillation.
“most studies report an increased risk of stroke in women.68–71”
From Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis (2016) · cites this paper as [68]
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- Authors
- Platonov, P. G., Mitrofanova, L. B., Orshanskaya, V., & Ho, S. Y.
- Affiliations
- Lund University (SE)
- Royal Brompton Hospital (GB)
- Corresponding author
- Platonov, Pyotr G.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2011-11
- Volume
- 58
- Issue
- 21
- Pages
- 2225-2232
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2062105156
- Cited by
- 496
- References
- 31
- Citations by year
- 2026: 21 · 2025: 26 · 2024: 38 · 2023: 42 · 2022: 44 · 2021: 44 · 2020: 39 · 2019: 39 · 2018: 36 · 2017: 43 · 2016: 36 · 2015: 30 · 2014: 20 · 2013: 22 · 2012: 14
- FWCI
- 12.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion, other-oa)
- Funders
- Lund University Hospital
- Swedish Heart-Lung Foundation
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- atrial fibrillation, atrial fibrosis, age, paroxysmal atrial fibrillation, permanent atrial fibrillation, fatty infiltration, pulmonary veins, left atrial wall, Bachmann's bundle, atrial conduction
- MeSH terms
- Adult, Aged, Aged, 80 and over, Atrial Fibrillation, Biopsy, Needle, Female, Fibrosis, Follow-Up Studies, Heart Atria, Heart Diseases, Humans, Male, Middle Aged, Prognosis, Retrospective Studies, Disease Progression
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