| Histologic findings in patients with clinical and instrumental diagnosis of sporadic arrhythmogenic right ventricular dysplasia. | |
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MedLine Citation:
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PMID: 15193698 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We sought to analyze the histologic findings of 30 patients with a diagnosis of arrhythmogenic right ventricular dysplasia (ARVD) based on established clinical and instrumental criteria, who did not have a family history of ARVD. BACKGROUND: The diagnostic role of endomyocardial biopsy (EMB) in patients with a clinical profile of ARVD is still debated. METHODS: Thirty patients (19 male, 11 female, mean age 27 +/- 10 years) with left bundle branch block morphology ventricular tachyarrhythmias and echocardiographic, angiographic, and magnetic resonance imaging (MRI) findings diagnostic of ARVD were studied. All patients, besides diagnostic, noninvasive, and invasive cardiac studies, underwent EMB in the apex, anterior free wall, inferior wall of the right ventricle (RV) and in the septal-apical region of the left ventricle. RESULTS: Diagnostic histologic features of ARVD were found only in 9 (30%) patients and a myocarditis, according to the Dallas criteria, in the remaining 21 (70%) patients. Morphometric evaluation of RV samples showed significant differences in fatty tissue and myocyte percent area between ARVD and myocarditis (p < 0.001). Conversely, no difference was found between the two groups in arrhythmic patterns and structural and functional echocardiographic, angiographic, and MRI RV alterations. Magnetic resonance imaging showed hyperintense signals in 67% of ARVD and in 62% of myocarditis group (p = NS). During follow-up (mean, 23 +/- 14 months), all patients with myocarditis remained stable on antiarrhythmic therapy while five patients with ARVD required implantation of an implantable cardioverter defibrillator. CONCLUSIONS: A myocarditis involving the RV can mimic ARVD. An EMB appears the most reliable diagnostic technique, with significant prognostic and therapeutic implications. |
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Authors:
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Cristina Chimenti; Maurizio Pieroni; Attilio Maseri; Andrea Frustaci |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 43 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2004 Jun |
Date Detail:
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Created Date: 2004-06-14 Completed Date: 2004-07-23 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 2305-13 Citation Subset: AIM; IM |
Affiliation:
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Cardio-Thoracic and Vascular Department, San Raffaele Hospital, Milan, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Anti-Arrhythmia Agents / therapeutic use Arrhythmogenic Right Ventricular Dysplasia / diagnosis*, physiopathology, therapy Biopsy Bundle-Branch Block / diagnosis, physiopathology, therapy Defibrillators, Implantable Diagnosis, Differential Echocardiography, Doppler Electrocardiography Female Follow-Up Studies Heart Conduction System / pathology, radiography, ultrasonography Heart Ventricles / pathology, radiography, ultrasonography Humans Italy Magnetic Resonance Imaging Male Middle Aged Myocardium / pathology, ultrastructure Stroke Volume / physiology Treatment Outcome Ventricular Dysfunction, Right / diagnosis, physiopathology, therapy |
| Chemical | |
Reg. No./Substance:
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0/Anti-Arrhythmia Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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