Strong desmin immunoreactivity in the myocardial sleeves around pulmonary veins, superior caval vein and coronary sinus supports the presumed arrhythmogenicity of these regions

• Published in: Journal of anatomy Vol. 244; no. 1; pp. 120 - 132
• Main Authors: Kugler, Szilvia, Tőkés, Anna‐Mária, Nagy, Nándor, Fintha, Attila, Danics, Krisztina, Sághi, Márton, Törő, Klára, Rácz, Gergely, Nemeskéri, Ágnes
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.01.2024; John Wiley and Sons Inc
• Subjects: Adult; arrhythmia; Cardiomyocytes; caval vein; Conduction; conduction system; Coronary Sinus; Desmin; Fetuses; Heart; Humans; Immunoreactivity; Monoclonal antibodies; Myocardium; Myocardium - pathology; Myocytes, Cardiac; Original; pulmonary vein; Pulmonary Veins - pathology; Purkinje fibers; Veins & arteries; Vena Cava, Superior; Ventricle; caval vein; desmin; pulmonary vein; conduction system; arrhythmia; coronary sinus
• ISSN: 0021-8782; 1469-7580; 1469-7580
• DOI: 10.1111/joa.13947

Myocardial sleeve around human pulmonary veins plays a critical role in the pathomechanism of atrial fibrillation. Besides the well‐known arrhythmogenicity of these veins, there is evidence that myocardial extensions into caval veins and coronary sinus may exhibit similar features. However, studies investigating histologic properties of these structures are limited. We aimed to investigate the immunoreactivity of myocardial sleeves for intermediate filament desmin, which was reported to be more abundant in Purkinje fibers than in ventricular working cardiomyocytes. Sections of 16 human (15 adult and 1 fetal) hearts were investigated. Specimens of atrial and ventricular myocardium, sinoatrial and atrioventricular nodes, pulmonary veins, superior caval vein and coronary sinus were stained with anti‐desmin monoclonal antibody. Intensity of desmin immunoreactivity in different areas was quantified by the ImageJ program. Strong desmin labeling was detected at the pacemaker and conduction system as well as in the myocardial sleeves around pulmonary veins, superior caval vein, and coronary sinus of adult hearts irrespective of sex, age, and medical history. In the fetal heart, prominent desmin labeling was observed at the sinoatrial nodal region and in the myocardial extensions around the superior caval vein. Contrarily, atrial and ventricular working myocardium exhibited low desmin immunoreactivity in both adults and fetuses. These differences were confirmed by immunohistochemical quantitative analysis. In conclusion, this study indicates that desmin is abundant in the conduction system and venous myocardial sleeves of human hearts. Double labeling immunofluorescence analysis for muscle‐specific intermediate filament desmin (red) and conduction system marker connexin 45 (green). Strong sarcomeric and junctional pattern for desmin labeling is present in the myocardial sleeve of pulmonary vein. Connexin 45 immunoreactivity is restricted to the intercalated discs where it overlaps extensively with desmin. The co‐localisation of connexin 45 and desmin supports the presumed arrhythmogenicity of the venous myocardial sleeves.