The autonomic nerves around the vein of Marshall: a postmortem study with clinical implications

• Published in: APMIS : acta pathologica, microbiologica et immunologica Scandinavica Vol. 132; no. 6; pp. 430 - 443
• Main Authors: Depes, Denis, Mennander, Ari, Immonen, Paavo, Mäkinen, Artturi, Huhtala, Heini, Paavonen, Timo, Kholová, Ivana
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01.06.2024
• Subjects: Acetyltransferase; Adult; Aged; Aged, 80 and over; Atrial Fibrillation - pathology; Atrial Fibrillation - physiopathology; Autonomic nervous system; Autonomic Nervous System - pathology; Autonomic Pathways - pathology; Autopsies; Autopsy; Choline; Choline O-acetyltransferase; Coronary artery disease; Female; Fibrosis; Heart - innervation; Heart diseases; Humans; Immunohistochemistry; Innervation; Male; Middle Aged; Morphometry; Myocardial infarction; Nerves; Parasympathetic nervous system; Substrates; Sympathetic nerves; Tyrosine; Tyrosine 3-monooxygenase; Veins; Cardiac autonomic nervous system; cardiovascular cause of death; atrial fibrillation; interstitial fibrosis; vein of Marshall
• ISSN: 0903-4641; 1600-0463
• DOI: 10.1111/apm.13400

This study aims to analyze the vein of Marshall (VOM) in human autopsy hearts and its correlation with clinical data to elucidate the morphological substrates of atrial fibrillation (AF) and other cardiac diseases. Twenty-three adult autopsy hearts were studied, assessing autonomic nerves by immunohistochemistry with tyrosine hydroxylase (sympathetic nerves), choline acetyltransferase (parasympathetic nerves), growth-associated protein 43 (neural growth), and S100 (general neural marker) antibodies. Interstitial fibrosis was assessed by Masson trichrome staining. Measurements were conducted via morphometric software. The results were correlated with clinical data. Sympathetic innervation was abundant in all VOM-adjacent regions. Subjects with a history of AF, cardiovascular cause of death, and histologically verified myocardial infarction had increased sympathetic innervation and neural growth around the VOM at the mitral isthmus. Interstitial fibrosis increased with age and heart weight was associated with AF and cardiovascular cause of death. This study increases our understanding of the cardiac autonomic innervation in the VOM area in various diseases, offering implications for the development of new therapeutic approaches targeting the autonomic nervous system.