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Updated: Feb 15, 2026

High-Resolution Endocardial and Epicardial Optical Mapping in a Sheep Model of Stretch-Induced Atrial Fibrillation
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Endocardial Changes in Nonvalvular Atrial Fibrillation Without Atrial Thrombus-Thrombomodulin and Tissue Factor

Kang An1, Ju Mei2, Jiaquan Zhu2

  • 11 Department of Surgery, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|January 25, 2018
PubMed

Insights

Atrial fibrillation (AF) is linked to reduced thrombomodulin (TM) expression in the heart

Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Biochemistry

Background:

  • Atrial fibrillation (AF) is a primary cause of thromboembolism.
  • Mechanisms include blood stasis and hypercoagulability, but endocardial changes are less understood.
  • Endocardial alterations may influence local coagulation and thrombus formation in AF.

Purpose of the Study:

  • To investigate endocardial changes in nonvalvular AF.
  • To assess the expression of thrombomodulin (TM) and tissue factor pathway inhibitor (TFPI) in AF patients.
  • To explore the relationship between these markers and left atrial diameter (LAD).

Main Methods:

  • Left atrial appendage samples were collected from nonvalvular AF and non-AF patients.
  • Immunohistochemistry was used to semiquantitatively grade TM and TFPI expression.
  • Statistical analysis compared marker expression and LAD between groups.

Main Results:

  • Decreased TM expression was observed in nonvalvular AF patients compared to controls (P < .001).
  • No significant difference in TFPI expression was found between AF and non-AF groups (P = .213).
  • Lower TM scores correlated with larger left atrial diameter (LAD) (P = .009).

Conclusions:

  • Nonvalvular AF is associated with reduced atrial endocardial TM expression.
  • TFPI expression remains unchanged in AF patients without thrombus.
  • Downregulated TM may be linked to enlarged LAD in AF.

Keywords:
atrial fibrillationendocardiumthrombomodulintissue factor pathway inhibitor

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