{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:47:23Z","timestamp":1790146043543,"version":"4.0.1"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2011,9,28]],"date-time":"2011-09-28T00:00:00Z","timestamp":1317168000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2012,3]]},"abstract":"<jats:p><jats:bold>Structural Remodeling in Atrial Fibrillation<\/jats:bold>. <jats:italic>Introduction:<\/jats:italic> Atrial fibrillation (AF) in mitral regurgitation (MR) is a complex disease where multiple factors may induce left\u2010atrial structural remodeling (SR). We explored the differential SR of the left\u2010atrial posterior wall (LAPW) of patients affected by MR with or without persistent AF, and the expression of key proteins involved in its pathogenesis.<\/jats:p><jats:p><jats:italic>Methods and Results:<\/jats:italic> Light microscopy of LAPW samples from 27 patients with MR and persistent AF (group 1), 33 with MR in sinus rhythm (group 2), and 15 autopsy controls (group 3) was used to measure myocyte diameter, percentage of myocytolytic myocytes, interstitial fibrosis, and capillary density; RT\u2010PCR and Western blotting were used to assess the mRNA and protein levels of SOD\u20101, SOD\u20102, HO\u20101, calpain, MMP\u20102, MMP\u20109, TIMP\u20101, TIMP\u20102, and VEGF; immunofluorescence was used to locate these proteins. Myocyte diameter was similar in groups 1 and 2, but larger than controls. Compared to group 2, group 1 had more myocytolytic myocytes (20.8\u2003\u00b1\u20035.6% vs 14.7\u2003\u00b1\u20034.5%; P &lt; 0.0001), increased interstitial fibrosis (10.4\u2003\u00b1\u20035.1% vs 7.5\u2003\u00b1\u20034.2%; P &lt; 0.05), and decreased capillary density (923\u2003\u00b1\u2003107 No\/mm<jats:sup>2<\/jats:sup> vs 1,040\u2003\u00b1\u2003100 No\/mm<jats:sup>2<\/jats:sup>; P &lt; 0.0001). All of the proteins were more expressed in groups 1 and 2 than in controls. The protein and mRNA levels of SOD\u20101, SOD\u20102, MMP\u20102, and MMP\u20109 were higher in group 1 than in group 2.<\/jats:p><jats:p><jats:italic>Conclusions:<\/jats:italic> The LAPW of MR patients with or without AF shows considerable SR. The former has more severe histopathological changes and higher levels of proteins involved in SR, thereby reaching a threshold beyond which the sinus impulse cannot normally activate atrial myocardium. <jats:italic>(J Cardiovasc Electrophysiol, Vol. 23 p. 271\u2010279, March 2012.)<\/jats:italic><\/jats:p>","DOI":"10.1111\/j.1540-8167.2011.02187.x","type":"journal-article","created":{"date-parts":[[2011,9,28]],"date-time":"2011-09-28T16:47:46Z","timestamp":1317228466000},"page":"271-279","source":"Crossref","is-referenced-by-count":69,"title":["Differential Structural Remodeling of the Left\u2010Atrial Posterior Wall in Patients Affected by Mitral Regurgitation with or Without Persistent Atrial Fibrillation: A Morphological and Molecular 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