Document Detail


Histologic findings in patients with clinical and instrumental diagnosis of sporadic arrhythmogenic right ventricular dysplasia.
MedLine Citation:
PMID:  15193698     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Cristina Chimenti; Maurizio Pieroni; Attilio Maseri; Andrea Frustaci
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
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:
Created Date:  2004-06-14     Completed Date:  2004-07-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2305-13     Citation Subset:  AIM; IM    
Affiliation:
Cardio-Thoracic and Vascular Department, San Raffaele Hospital, Milan, Italy.
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MeSH Terms
Descriptor/Qualifier:
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:
0/Anti-Arrhythmia Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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