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Morphology of atrial myocardium in human pulmonary veins

A postmortem analysis in patients with and without atrial fibrillation

Rutger J. Hassink, MD^*,*, H. Thomas Aretz, MD, Jeremy Ruskin, MD and David Keane, MD, PhD

^* University Medical Center, Heart Lung Center, Department of Cardio-Thoracic Surgery, Utrecht, Netherlands
Massachusetts General Hospital, Cardiac Unit, Harvard University, Boston, Massachusetts, USA
Massachusetts General Hospital, Pathology Department, Harvard University, Boston, Massachusetts, USA

View larger version (103K): [in a new window]   Figure 1 Extension of atrial myocardium (red/brown; arrows), stained with Masson's trichrome, in the wall of a human left superior pulmonary vein from a patient with atrial fibrillation. (Bottom side of figure represents luminal side of the vein.)

View larger version (74K): [in a new window]   Figure 2 Longitudinal section of a human left superior pulmonary vein from a patient with atrial fibrillation, showing discontinuous atrial myocardium (arrows) stained with cardiac troponin-T. (Bottom side of figure represents luminal side of the vein.)

View larger version (96K): [in a new window]   Figure 3 Longitudinal section of a human left superior pulmonary vein from a patient with atrial fibrillation, stained with Masson's trichrome, showing loosely coupled atrial cardiomyocytes (red/brown) with high degree (>50% of atrial myocardium) of intercellular fibrosis (blue; arrows). (Bottom side of figure represents luminal side of the vein.)

View larger version (90K): [in a new window]   Figure 4 Longitudinal section of a human left superior pulmonary vein from a patient with atrial fibrillation, with atrial myocardium stained with monoclonal mouse anti-cardiac troponin-T (brown; arrows). (Bottom side of figure represents luminal side of the vein.)

View larger version (77K): [in a new window]   Figure 5 Same section as in Figure 4, now stained with monoclonal mouse anti-smooth muscle actin (white arrow; black arrow points to smooth muscle of vasa vasorum). The smooth muscle layer is always internal from the extended atrial myocardium. (Bottom side of figure represents luminal side of the vein.)