Expression of the von Willebrand Factor in Atrial Endocardium is Increased in Atrial Fibrillation Depending on the Extent of Structural Remodeling

Koji Kumagai, Mitsumasa Fukuchi, Jun Ohta, Shigeo Baba, Katsuhiko Oda, Hiroji Akimoto, Yutaka Kagaya, Jun Watanabe, Koichi Tabayashi, Kunio Shirato

Research output: Contribution to journalArticlepeer-review

39 Citations (Scopus)

Abstract

Background: The incidence of stroke in patients suffering atrial fibrillation (AF) is increased when left atrial enlargement occurs. Recently, the platelet adhesive molecule, von Willebrand factor (vWF), located in the atrial endocardium, has been shown to be increased in patients with a variety of heart diseases compared with patients who have no cardiac problems. Methods and Results: We investigated the expression of vWF mRNA and protein in the endocardium as a possible prothrombotic alteration of AF in association with atrial structural remodeling. Atrial appendage specimens were obtained during either heart surgery or at an autopsy from AF patients with and without underlying heart disease. The immunohistochemical and in situ hybridization signals for vWF in the endocardium were well correlated and varied widely among the individual atrial appendages examined. The increased expression of vWF in the endocardium was associated with enlarged left atrial dimensions in mitral valvular disease or increased myocyte diameters in the underlying myocardium. Platelet adhesion/aggregation on the endocardium was always found under the fresh thrombi and was colocalized with strong vWF staining, but not necessarily with fibrinogen and/or fibrin staining. Conclusions: Endocardial overexpression of vWF may occur during the process of atrial structural remodeling contributing to the thrombotic predilection of AF in association with underlying heart disease.

Original languageEnglish
Pages (from-to)321-327
Number of pages7
JournalCirculation Journal
Volume68
Issue number4
DOIs
Publication statusPublished - 2004 Apr

Keywords

  • Atrial fibrillation
  • Platelets
  • Structural remodeling
  • Thrombosis
  • Von Willebrand factor

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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