Abstract
Background: Atrial cardiomyopathy (ACM) is characterized by multiple histopathological features but the entity lacks systematic validation. Objectives: We sought to correlate atrial histopathology with clinical characteristics of patients with ACM and AF and outcomes following cardiac surgery. Methods: The pathological findings of the atrial myocardial biopsies from 178 patients who underwent any cardiac surgery between 2016-2018. Atrial cell nuclear structure and morphology, myocyte hypertrophy and interstitial fibrosis were graded and analyzed quantitatively. Study population was divided in three groups based on preoperative ECG: 1) patients in sinus rhythm with no signs of ACM (P wave duration <120ms)(SRn); 2) patients in sinus rhythm and ACM (P>=120 or biphasic waves in inferior leads)(SRa); and 3) atrial fibrillation (AF). Results: SRa patients had decreased number of nuclei/area and smaller total cardiomyocyte area compared to SRn patients (p=0.04 forboth). Patients with AF had bigger, less solid and circular nuclei compared to SRn patients (p<0.01 for all). AF patients had increased area of interstitial fibrosis (p<0.01) compared to SRn patients. Conclusions: Histopathological characteristics of ACM include changes in nuclear chromatin structure.
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