Arrangement of the Autonomic Nerves Around the Pulmonary Vein-Left Atrial Junctions —Histologic and Immunohistochemical Analyses—

DOI 4 Citations 30 References
  • Matsuyama Taka-aki
    Second Department of Pathology, Showa University School of Medicine
  • Inoue Shin
    Department of Internal Medicine, Showa University Dental Hospital
  • Kobayashi Youichi
    Third Department of Internal Medicine, Showa University School of Medicine
  • Makino Mutsuki
    Second Department of Pathology, Showa University School of Medicine
  • Sakai Tetsuo
    Third Department of Internal Medicine, Showa University School of Medicine
  • Saito Tsukasa
    Third Department of Internal Medicine, Showa University School of Medicine
  • Asano Taku
    Third Department of Internal Medicine, Showa University School of Medicine
  • Tanno Kaoru
    Third Department of Internal Medicine, Showa University School of Medicine
  • Katagiri Takashi
    Third Department of Internal Medicine, Showa University School of Medicine
  • Ota Hidekazu
    Second Department of Pathology, Showa University School of Medicine

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Abstract

Introduction: Imbalanced autonomic activity in the area of the pulmonary veins (PVs) can result in spontaneous atrial fibrillation (AF). Histologic characteristics of the PV sleeve musculature and associated autonomic nerve are not fully understood. We investigated the arrangement of autonomic nerve fibers around PV-left atrium (LA) junctional musculature.<BR>Methods: Thirteen autopsied adult hearts (9 men and 4 women; mean age at death, 66.2 years) were studied. The atria were removed from each heart, along with all PV stalks, and cut longitudinally to each PV myocardial sleeve. After treatment with azan-Mallory stain and immunohistochemical staining for S-100 and tyrosine hydroxylase (TH), autonomic nerve distribution was assessed by counting the numbers of TH-positive (adrenergic) and -negative (non-adrenergic) fibers within S-100-positive fibers (>50 μm in diameter) in the anterior, posterior, and septal junctions.<BR>Results: TH-positive adrenergic fibers, consisting of sympathetic nerves, were most predominant in the anterior and septal junctions. In the anterior junction, these fibers were packed tightly among myocardial sleeve fascicles. In the posterior junction, the numbers of adrenergic and non-adrenergic fibers were fewer. In the septal junction, the number of TH-negative non-adrenergic fibers (predominantly parasympathetic nerves) was greater, concomitant diffuse ganglionic nodule distribution in the interatrial fat pad.<BR>Conclusions: In each PV-LA junction, autonomic nerves were localized on the anterior and septal walls. Heterogeneous distribution of TH-positive and TH-negative fibers and ganglion nodules around each PV opening appears to represent the major histologic characteristic in these areas.

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