Key result
Morphological and histological investigation of 83 equine hearts revealed a mean of 4.5 pulmonary vein ostia and confirmed the presence of conductive tissue in the entire myocardial sleeve.
Why the study?
Information on anatomical, histological, and immunohistochemical assessment of equine pulmonary vein ostia and the conduction system of the myocardial sleeve remains limited, despite pulmonary vein triggers being identified in equine AF.
Cross-Sectional (n=83)
Conductive tissue is present throughout the myocardial sleeve in all equine pulmonary vein ostia, providing an anatomical basis for pulmonary vein triggers in equine atrial fibrillation and informing future ablation techniques.
BACKGROUND: Atrial fibrillation is the most common arrhythmia in horses causing poor performance. The role of pulmonary vein triggers in the pathogenesis has been identified in horses. Ablation methods have been investigated, but the available information on anatomical, histological and immunohistochemical assessment of the pulmonary vein ostia and the conduction system of the myocardial sleeve is still limited. OBJECTIVES: The aim of the study was to describe the morphological properties of the myocardial sleeve in healthy horses. STUDY DESIGN: Cross-sectional. METHODS: Eighty-three equine hearts were dissected. The number and diameters of pulmonary vein ostia were determined, and anatomical localisation was described. Fifty-eight tissue samples were collected for routine histology and 12 of these were used for immunohistochemistry (connexin 43, 45, S100, and tyrosine hydroxylase antibodies). RESULTS: The mean number of pulmonary vein ostia was 4.5 (4 veins: 46 horse, 5 veins: 31 horses, 6 veins: 6 horses). Diameters (mean ± SD) of the main ostia were as follows: vein I: 20.2 ± 7.0 mm, vein II: 32.7 ± 7.1 mm, vein III: 33.4 ± 5.9 mm, vein IV: 18.1 ± 4.5 mm. Diameters of supernumerary vein ostia varied between 3.0 and 28.0 mm (11.5 ± 5.5 mm). Early branching was found in 26 horses (31.3%) and 30 veins (vein I: 14, vein II: 9, vein III: 5, vein IV: 2). Histology confirmed the presence of a muscle sleeve composed of myocardial tissue in each pulmonary vein. S100 and TH positivity was detected in each vein, and it confirmed the presence of adrenergic and non-adrenergic nerve fibres within the myocardial sleeve. Cx43 and 45 positivity were also found in each vein indicating the presence of gap junctions. MAIN LIMITATIONS: The effect of bodyweight on pulmonary vein dimensions is unknown. CONCLUSIONS: Future ablation techniques should consider that conductive tissue is present in the entire myocardial sleeve in all pulmonary vein ostia.
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Kovács et al. (2023) conducted a cross-sectional in Healthy horses (n=83). Morphological and histological investigation was evaluated on Number and diameters of pulmonary vein ostia, and histological/immunohistochemical properties. Morphological and histological investigation of 83 equine hearts revealed a mean of 4.5 pulmonary vein ostia and confirmed the presence of conductive tissue in the entire myocardial sleeve.
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