This study aimed to evaluate atrium extracellular matrix remodeling in atrial fibrillation (AF) patients with severe aortic stenosis, through histological fibrosis quantification and extracellular matrix gene expression analysis, as well as serum quantification of selected protein targets.
A posthoc analysis of a prospective study was performed in a cohort of aortic stenosis patients. Between 2014 and 2019, 56 patients with severe aortic stenosis submitted to aortic valve replacement surgery in a tertiary hospital were selected.
Fibrosis was significantly increased in the AF group when compared to sinus rhythm (SR) patients ( p = 0.024). Moreover, cardiomyocyte area was significantly higher in AF patients versus SR patients ( p = 0.008). Conversely, collagen III gene expression was increased in AF patients ( p = 0.038). TIMP1 was less expressed in the atria of AF patients. MMP16/TIMP4 ratio was significantly decreased in AF patients ( p = 0.006). TIMP1 ( p = 0.004) and TIMP2 ( p = 0.012) were significantly increased in the serum of AF patients. Aortic valve maximum ( p = 0.0159) and mean ( p = 0.031) gradients demonstrated a negative association with serum TIMP1.