Rheumatic Heart Disease in Modern Urban America: A Cohort Study of Immigrant and Indigenous Patients in Chicago

Bayissa, Yohannes Aberra; Abusin, Salaheldin; Ansari, Asimul H.; Kelly, Russell F.; Doukky, Rami; Stroger, John H.

doi:10.1016/s0735-1097(14)61954-9

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“…Rheumatic heart disease (RHD) is endemic in many parts of the world, with age-standardized disability-adjusted life years of >200/100 000 people. 1,2 It is responsible for 15 million cases worldwide, 282 000 new cases, and 233 000 deaths annually.…”

Section: Introductionmentioning

confidence: 99%

A histological study of the atria in patients with isolated rheumatic mitral regurgitation with and without atrial fibrillation

Kalpana

Shenthar

Padmanabhan

et al. 2021

Cardiovasc electrophysiol

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Background: There is a high incidence of atrial fibrillation (AF) in patients with isolated rheumatic mitral regurgitation (MR). The histopathologic changes in the atria of patients with isolated rheumatic MR with and without AF are unknown.Objectives: We aimed to determine the histological findings in patients with isolated severe rheumatic MR with and without AF.Methods: Patients with severe isolated rheumatic MR undergoing valve replacement surgeries underwent endocardial biopsies from right atrial appendage, left atrial appendage, right free wall, left free wall, left posterior wall, and mitral valve. Group I consisted of patients in sinus rhythm (SR), and Group II included patients with AF.We analyzed and compared these 10 histological features in the biopsies of patients in Groups I and II.Results: Of the 25 patients, 12 were in Group I and 13 in Group II. In Group I, patients had severe myocyte hypertrophy (60% vs. 18%, p = .04) that was significantly more in the right atrium (22.7% vs. 11.4%, p = .059). Interstitial adipose tissue deposition was more common in Group I (30% vs. 25%, p = .06). Interstitial fibrosis was evenly distributed at all sites without significant difference between the two groups. Group II patients had a higher prevalence and severity of vacuolar degeneration (91% vs. 60%, p = .09). Conclusions: Patients with isolated severe rheumatic MR and AF have more vacuolar degeneration in the atrial tissue. Patients with SR have myocyte hypertrophy and interstitial adipose tissue deposition. Interstitial fibrosis is uniformly distributed in patients in SR and AF.

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Section: Introductionmentioning

confidence: 99%