{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T16:35:47Z","timestamp":1786725347019,"version":"build-2736575974"},"reference-count":40,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Metabolites"],"abstract":"<jats:p>Background: Extensive prior work has established severe aortic stenosis as a whole-heart remodeling process involving chronic pressure overload, concentric hypertrophy, myocardial stiffness, and progressive ventricular fibrosis. However, direct paired histological characterization of both atria remains limited. Methods: This single-center observational comparative study included 28 patients with severe aortic stenosis referred for surgical aortic valve replacement and 14 coronary artery bypass grafting (CABG) controls without significant valvular disease, consecutively enrolled between 9 May 2024 and 28 April 2025. Left- and right-atrial tissue samples were collected intraoperatively. The relative expression of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and transforming growth factor-beta (TGF-beta) was quantified by RT-qPCR using pooled tissue samples and interpreted descriptively as a group-level molecular output. Atrial fibrosis was measured histologically at the patient level using Masson\u2019s trichrome staining and digital image analysis. Results: Compared with CABG controls, patients with severe aortic stenosis demonstrated greater left-atrial fibrosis (median: 19.12% [IQR: 16.12\u201323.12] vs. 11.54% [9.53\u201314.29]; p &lt; 0.0001) and right-atrial fibrosis (16.33% [15.07\u201319.13] vs. 8.40% [5.75\u201311.27]; p = 0.0001). Pooled RT-qPCR outputs descriptively suggested higher IL-6, TNF-alpha, and TGF-beta expression in both atria, although biological replication was insufficient for inferential testing. Echocardiographically, the aortic stenosis group showed higher aortic jet velocity and transvalvular gradients, thicker ventricular walls, a larger right-ventricular diameter, higher pulmonary artery systolic pressure, and a larger estimated left-atrial volume. A sensitivity analysis of 13 within-group correlations found that no correlation retained statistical significance at q &lt; 0.05. Exploratory regressions restricted to patient-level histological outcomes suggested that severe aortic stenosis status remained associated with left- and right-atrial fibrosis after limited adjustment for age and sex. Conclusions: These findings complement the extensive ventricular fibrosis literature by providing paired human biatrial tissue evidence of greater atrial fibrosis in severe aortic stenosis compared with CABG controls. The pooled molecular findings remain descriptive and require validation using patient-level biological measurements.<\/jats:p>","DOI":"10.3390\/metabo16080574","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T15:48:36Z","timestamp":1786722516000},"page":"574","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Biatrial Inflammatory and Fibrotic Remodeling in Severe Aortic Stenosis Compared with CABG Controls"],"prefix":"10.3390","volume":"16","author":[{"given":"Adrian-Grigore","family":"Merce","sequence":"first","affiliation":[{"name":"Doctoral School Medicine\u2013Pharmacy, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy Timi\u0219oara, Efimie Murgu Sq. No. 2, 300041 Timi\u0219oara, Romania"},{"name":"Department of Cardiology, Institute of Cardiovascular Diseases Timi\u0219oara, 300310 Timi\u0219oara, Romania"},{"name":"Advanced Research Center, Institute for Cardiovascular Diseases Timi\u0219oara, 300310 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1298-9090","authenticated-orcid":false,"given":"Daniel Dumitru","family":"Ni\u0219ulescu","sequence":"additional","affiliation":[{"name":"Doctoral School Medicine\u2013Pharmacy, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy Timi\u0219oara, Efimie Murgu Sq. No. 2, 300041 Timi\u0219oara, Romania"},{"name":"Department of Cardiology, Institute of Cardiovascular Diseases Timi\u0219oara, 300310 Timi\u0219oara, Romania"},{"name":"Advanced Research Center, Institute for Cardiovascular Diseases Timi\u0219oara, 300310 Timi\u0219oara, Romania"},{"name":"Multidisciplinary Doctoral School, \u201cVasile Goldi\u0219\u201d Western University of Arad, 310025 Arad, Romania"},{"name":"Department of Histology, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University of Arad, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8510-6653","authenticated-orcid":false,"given":"Anca","family":"Hermenean","sequence":"additional","affiliation":[{"name":"\u201cAurel Ardelean\u201d Institute of Life Sciences, \u201cVasile Goldi\u0219\u201d Western University of Arad, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian-Petru","family":"Merce","sequence":"additional","affiliation":[{"name":"Advanced Research Center, Institute for Cardiovascular Diseases Timi\u0219oara, 300310 Timi\u0219oara, Romania"},{"name":"Department of Cardiovascular Surgery, Institute of Cardiovascular Diseases Timi\u0219oara, 300310 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9501-5530","authenticated-orcid":false,"given":"Raluca","family":"Muntean","sequence":"additional","affiliation":[{"name":"Doctoral School Medicine\u2013Pharmacy, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy Timi\u0219oara, Efimie Murgu Sq. No. 2, 300041 Timi\u0219oara, Romania"},{"name":"Advanced Research Center, Institute for Cardiovascular Diseases Timi\u0219oara, 300310 Timi\u0219oara, Romania"},{"name":"Department of Cardiovascular Surgery, Institute of Cardiovascular Diseases Timi\u0219oara, 300310 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel-Miron","family":"Brie","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Institute of Cardiovascular Diseases Timi\u0219oara, 300310 Timi\u0219oara, Romania"},{"name":"Advanced Research Center, Institute for Cardiovascular Diseases Timi\u0219oara, 300310 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oana-Maria","family":"Burciu","sequence":"additional","affiliation":[{"name":"Doctoral School Medicine\u2013Pharmacy, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy Timi\u0219oara, Efimie Murgu Sq. No. 2, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0320-6779","authenticated-orcid":false,"given":"Dan","family":"G\u0103i\u021b\u0103","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Institute of Cardiovascular Diseases Timi\u0219oara, 300310 Timi\u0219oara, Romania"},{"name":"Advanced Research Center, Institute for Cardiovascular Diseases Timi\u0219oara, 300310 Timi\u0219oara, Romania"},{"name":"Cardiology Department, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy Timi\u0219oara, Eftimie Murgu Sq. No. 2, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adina","family":"Ionac","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Institute of Cardiovascular Diseases Timi\u0219oara, 300310 Timi\u0219oara, Romania"},{"name":"Advanced Research Center, Institute for Cardiovascular Diseases Timi\u0219oara, 300310 Timi\u0219oara, Romania"},{"name":"Cardiology Department, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy Timi\u0219oara, Eftimie Murgu Sq. 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Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1056\/NEJMra1313875","article-title":"Aortic-valve stenosis\u2014From patients at risk to severe valve obstruction","volume":"371","author":"Otto","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1854","DOI":"10.1016\/j.jacc.2012.02.093","article-title":"Calcific aortic stenosis: A disease of the valve and the myocardium","volume":"60","author":"Dweck","year":"2012","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"16006","DOI":"10.1038\/nrdp.2016.6","article-title":"Calcific aortic stenosis","volume":"2","author":"Lindman","year":"2016","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/j.jacc.2015.05.066","article-title":"Calcification in aortic stenosis: The skeleton key","volume":"66","author":"Pawade","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1161\/01.ATV.0000227513.13697.ac","article-title":"Pathogenesis of calcific aortic valve disease: A disease process comes of age (and a good deal more)","volume":"26","year":"2006","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.1161\/CIRCULATIONAHA.110.006767","article-title":"Calcific aortic valve disease: Not simply a degenerative process: A review and agenda for research from the National Heart, Lung, and Blood Institute Aortic Stenosis Working Group","volume":"124","author":"Rajamannan","year":"2011","journal-title":"Circulation"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2387","DOI":"10.1161\/ATVBAHA.114.302523","article-title":"Calcific aortic valve disease: A consensus summary from the Alliance of Investigators on Calcific Aortic Valve Disease","volume":"34","author":"Yutzey","year":"2014","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e007451","DOI":"10.1161\/CIRCIMAGING.117.007451","article-title":"Progression of Hypertrophy and Myocardial Fibrosis in Aortic Stenosis: A Multicenter Cardiac Magnetic Resonance Study","volume":"11","author":"Everett","year":"2018","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1016\/j.jcmg.2016.10.007","article-title":"Myocardial Fibrosis and Cardiac Decompensation in Aortic Stenosis","volume":"10","author":"Chin","year":"2017","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1161\/CIRCULATIONAHA.108.847772","article-title":"Impact of myocardial fibrosis in patients with symptomatic severe aortic stenosis","volume":"120","author":"Weidemann","year":"2009","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.jacc.2009.12.074","article-title":"Prognostic significance of myocardial fibrosis quantification by histopathology and magnetic resonance imaging in patients with severe aortic valve disease","volume":"56","author":"Azevedo","year":"2010","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1016\/j.jacc.2011.03.064","article-title":"Midwall fibrosis is an independent predictor of mortality in patients with aortic stenosis","volume":"58","author":"Dweck","year":"2011","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1016\/j.jtcvs.2011.11.024","article-title":"Prognostic value of myocardial fibrosis in patients with severe aortic valve stenosis","volume":"144","author":"Milano","year":"2012","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1093\/eurheartj\/ehx353","article-title":"Reappraising myocardial fibrosis in severe aortic stenosis: An invasive and non-invasive study in 133 patients","volume":"39","author":"Treibel","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/j.jacc.2019.11.032","article-title":"Extracellular Myocardial Volume in Patients With Aortic Stenosis","volume":"75","author":"Everett","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.jcmg.2018.11.026","article-title":"Imaging and Impact of Myocardial Fibrosis in Aortic Stenosis","volume":"12","author":"Bing","year":"2019","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1007\/s11936-015-0391-0","article-title":"Patterns of left ventricular remodeling in aortic stenosis: Therapeutic implications","volume":"17","author":"Elmariah","year":"2015","journal-title":"Curr. Treat. Options Cardiovasc. Med."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Lisi, M., Pastore, M.C., Fiorio, A., Cameli, M., Mandoli, G.E., Righini, F.M., Cavigli, L., D\u2019Ascenzi, F., Focardi, M., and Rubboli, A. (2022). Left Atrial Remodeling in Response to Aortic Valve Replacement: Pathophysiology and Myocardial Strain Analysis. Life, 12.","DOI":"10.3390\/life12122074"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/1476-7120-10-38","article-title":"Atrial fibrillation in aortic stenosis--echocardiographic assessment and prognostic importance","volume":"10","author":"Kristensen","year":"2012","journal-title":"Cardiovasc. Ultrasound"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Frag\u00e3o-Marques, M., Miranda, I., Martins, D., Barroso, I., Mendes, C., Pereira-Neves, A., Falc\u00e3o-Pires, I., and Leite-Moreira, A. (2020). Atrial matrix remodeling in atrial fibrillation patients with aortic stenosis. BMC Cardiovasc. Disord., 20.","DOI":"10.1186\/s12872-020-01754-0"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1111\/echo.15225","article-title":"Left atrial volume index predicts adverse events in asymptomatic moderate or severe aortic stenosis","volume":"38","author":"Saeed","year":"2021","journal-title":"Echocardiography"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1016\/j.jacc.2007.09.064","article-title":"Atrial fibrosis: Mechanisms and clinical relevance in atrial fibrillation","volume":"51","author":"Burstein","year":"2008","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1161\/CIRCEP.107.754564","article-title":"Atrial remodeling and atrial fibrillation: Mechanisms and implications","volume":"1","author":"Nattel","year":"2008","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1016\/j.jacc.2015.06.1313","article-title":"Cardiac Fibrosis in Patients With Atrial Fibrillation: Mechanisms and Clinical Implications","volume":"66","author":"Dzeshka","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1038\/nrcardio.2015.2","article-title":"Inflammation and the pathogenesis of atrial fibrillation","volume":"12","author":"Hu","year":"2015","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/joa3.12473","article-title":"Role of inflammation in atrial fibrillation: A comprehensive review of current knowledge","volume":"37","author":"Nso","year":"2021","journal-title":"J. Arrhythm."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Ihara, K., and Sasano, T. (2022). Role of Inflammation in the Pathogenesis of Atrial Fibrillation. Front. Physiol., 13.","DOI":"10.3389\/fphys.2022.862164"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e006615","DOI":"10.1161\/JAHA.117.006615","article-title":"Left Atrial Volume and Mortality in Patients With Aortic Stenosis","volume":"6","author":"Rusinaru","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1159\/000514665","article-title":"The Prognostic Value of Left Atrial Global Longitudinal Strain and Left Atrial Phasic Volumes in Patients Undergoing Transcatheter Valve Implantation for Severe Aortic Stenosis","volume":"146","author":"Weber","year":"2021","journal-title":"Cardiology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.echo.2022.10.011","article-title":"Prognostic Value of Left Atrial Strain in Aortic Stenosis: A Competing Risk Analysis","volume":"36","author":"Tan","year":"2023","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1093\/ehjci\/jew335","article-title":"Recommendations on the echocardiographic assessment of aortic valve stenosis: A focused update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography","volume":"18","author":"Baumgartner","year":"2017","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2008.11.029","article-title":"Echocardiographic assessment of valve stenosis: EAE\/ASE recommendations for clinical practice","volume":"22","author":"Baumgartner","year":"2009","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Rosca, C.I., Lighezan, D.F., Georgescu, D., Branea, H.S., Kundnani, N.R., Nicoras, A.V., Bita, R.G., and Nisulescu, D.D. (2026). Triglyceride-to-HDL Cholesterol Ratio Is Associated with Ischemic Stroke Risk in Patients-With Paroxysmal Atrial Fibrillation. Metabolites, 16.","DOI":"10.3390\/metabo16020110"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1002\/ejhf.3145","article-title":"Myocardial sodium-glucose cotransporter 2 expression and cardiac remodelling in patients with severe aortic stenosis: The BIO-AS study","volume":"26","author":"Scisciola","year":"2024","journal-title":"Eur. J. Heart Fail."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Sastre-Oliva, T., Corbacho-Alonso, N., Rodriguez-Sanchez, E., Mercado-Garc\u00eda, E., Perales-Sanchez, I., Hernandez-Fernandez, G., Juarez-Alia, C., Tejerina, T., L\u00f3pez-Almod\u00f3var, L.F., and Padial, L.R. (2024). Albumin Redox Modifications Promote Cell Calcification Reflecting the Impact of Oxidative Status on Aortic Valve Disease and Atherosclerosis. Antioxidants, 13.","DOI":"10.3390\/antiox13010108"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Koschutnik, M., Brunner, C., Nitsche, C., Don\u00e0, C., Dannenberg, V., Halavina, K., Koschatko, S., Jantsch, C., Mascherbauer, K., and Kronberger, C. (2025). Biomarkers of Inflammation and Association with Cardiovascular Magnetic Resonance Imaging for Risk Stratification and Outcome in Patients with Severe Aortic Stenosis. J. Clin. Med., 14.","DOI":"10.3390\/jcm14072512"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/j.jacbts.2025.01.018","article-title":"Transcriptomic Signatures of Calcific Aortic Valve Stenosis Severity in Human Tricuspid and Bicuspid Aortic Valves","volume":"10","author":"Houessou","year":"2025","journal-title":"JACC Basic Transl. Sci."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1038\/s41588-025-02417-6","article-title":"Genomic and transcriptomic analyses of aortic stenosis enhance therapeutic target discovery and disease prediction","volume":"58","author":"Small","year":"2026","journal-title":"Nat. Genet."}],"container-title":["Metabolites"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2218-1989\/16\/8\/574\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T16:01:36Z","timestamp":1786723296000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2218-1989\/16\/8\/574"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,14]]},"references-count":40,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["metabo16080574"],"URL":"https:\/\/doi.org\/10.3390\/metabo16080574","relation":{},"ISSN":["2218-1989"],"issn-type":[{"value":"2218-1989","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,14]]}}}