Atrial endocardial changes in mitral valve disease: A scanning electron microscopy study

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

“…22 Goldsmith et al have shown that the plasma levels of vWF in such patients are correlated with the extent of endothelial cell damage in the endocardium. 7 Although it is unclear whether high plasma levels of vWF reflect endothelial activation or endothelial dysfunction, 23 our results suggest there is increased synthesis of vWF in the left atrial endocardium of AF patients with mitral valvular disease.…”

Prognostic Value of Plasma von Willebrand Factor and Soluble P-Selectin as Indices of Endothelial Damage and Platelet Activation in 994 Patients With Nonvalvular Atrial Fibrillation

“…10,25 Certainly, Heppel et al 10 found raised plasma levels of vWf to be predictive of the presence of LAA thrombus visible by TEE, whereas Fukuchi et al 25 found a significant correlation between the degree of endocardial expression of vWf and the degree of platelet adhesion/thrombus formation in the atrial appendage. Furthermore, Goldsmith et al 26 found raised plasma vWf associated with damaged atrial appendage endocardium in patients with mitral valve disease and (in most cases) AF. Further studies are therefore needed to establish the true mechanism of stroke associated with raised plasma vWf in AF, to evaluate the endothelium/endocardium (or vWf itself) as a target for novel antithrombotic therapies in AF, to investigate other indices of endothelial dysfunction in AF, and to examine the potential for plasma vWf as an aid to clinical risk stratification in AF.…”

Mitral Regurgitation as the Cause of Atrial Tachycardia – 3-Dimensional Mapping and 3-Dimensional Transesophageal Echocardiography –

“…First, although it has been reported that endothelial damage can be observed in patients with MR or mitral stenosis, 9 we have no direct evidence that the turning flow of MR caused the scar area in this case, which might have occurred coincidentally. Second, future studies are required to confirm that MR flow is able to directly cause localized dense scar in left atrium.…”