A Sphincter-like Function of Pulmonary Vein Ostia in Normal and Atrial Fibrillation Subjects

Background: Early anatomical study suggested that the pulmonary vein (PVs) junction may have putative sphincter-like activity. The aim of this study was to evaluate this activity in normal and paroxysmal/persistent atrial fibrillation subjects. Methods: The Cardiac Computed Tomography (CCT) scans of...

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Main Authors: Stefano Bonapace, Matteo Falanga, Carmelo Cicciò, Cristiana Corsi, Giulio Molon
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Journal of Cardiovascular Development and Disease
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Online Access:https://www.mdpi.com/2308-3425/12/6/203
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Summary:Background: Early anatomical study suggested that the pulmonary vein (PVs) junction may have putative sphincter-like activity. The aim of this study was to evaluate this activity in normal and paroxysmal/persistent atrial fibrillation subjects. Methods: The Cardiac Computed Tomography (CCT) scans of 45 subjects [15 normal controls, 15 patients with paroxysmal atrial fibrillation (PAR-AF), and 15 with persistent AF (PER-AF)] were retrospectively analyzed. All subjects were in sinus rhythm during the CCT scan. A 3D anatomical model was developed, enabling us to identify the PV ostia and to measure their area dynamic changes during the cardiac cycle. Results: The area changes in the superior PVs within the three groups were significantly higher compared to the inferior (control <i>p</i> = 0.007, PAR-AF <i>p</i> = 0.0003, PER-AF <i>p</i> = 0.04). Moreover, these variations were significantly reduced in PAR-AF and PER-AF compared to the control in all PVs (LSPV (<i>p</i> < 0.001), RSPV (<i>p</i> < 0.001), RIPV (<i>p</i> = 0.037), and LIPV (<i>p</i> < 0.001)). Conclusions: This sphincter-like activity, most prominent in superior PVs, is progressively impaired in patients with paroxysmal and persistent AF.
ISSN:2308-3425