Right atrial pathology in arrhythmogenic right ventricular dysplasia.
arrhythmogenic right ventricular dysplasia
atrial arrhythmias
atrium
pathological substrate
Journal
Cardiology journal
ISSN: 1898-018X
Titre abrégé: Cardiol J
Pays: Poland
ID NLM: 101392712
Informations de publication
Date de publication:
2019
2019
Historique:
received:
30
08
2018
accepted:
11
10
2018
pubmed:
6
11
2018
medline:
4
8
2020
entrez:
6
11
2018
Statut:
ppublish
Résumé
Atrial fibrillation (AF) is the most common atrial arrhythmia in arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVD). Considering the histologic changes known in the right ventricular (RV) in ARVD, the aim of the present study was to examine right atrial (RA) pathology in patients with ARVD. Histology of RA and RV was assessed from autopsy material in 3 patients with ARVD without persistent atrial arrhythmia. RA histology in 3 patients with permanent AF without ARVD and 5 patients without cardiovascular disease was also studied. Staining with hematoxylin phloxine saffron was performed for the ARVD patients to identify fibrosis, and hematoxylin-eosin for identification of lymphocytes. Masson's trichrome staining was performed for control groups taken from a collection of standard glass slides. In all 3 ARVD cases, RA anomalies were observed that revealed a reduction of cardiomyocytes, the presence of adipocytes, some of them inside the mediomural atrial layer and interstitial fibrosis. In 2 ARVD cases, interstitial fibrosis was also associated with a focus of replacement fibrosis, which was also observed in patients with permanent AF without ARVD. The histologic specimen of the RA and RV from the control group without cardiovascular disease did not display any evidence of fat or fibrosis with a preserved cardiomyocyte architecture. A similar histopathological substrate, as can be observed in the RV of patients with ARVD can also be seen in the RA of these patients. This may explain the high prevalence of atrial arrhythmias, particularly AF, in patients with ARVD.
Sections du résumé
BACKGROUND
Atrial fibrillation (AF) is the most common atrial arrhythmia in arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVD). Considering the histologic changes known in the right ventricular (RV) in ARVD, the aim of the present study was to examine right atrial (RA) pathology in patients with ARVD.
METHODS
Histology of RA and RV was assessed from autopsy material in 3 patients with ARVD without persistent atrial arrhythmia. RA histology in 3 patients with permanent AF without ARVD and 5 patients without cardiovascular disease was also studied. Staining with hematoxylin phloxine saffron was performed for the ARVD patients to identify fibrosis, and hematoxylin-eosin for identification of lymphocytes. Masson's trichrome staining was performed for control groups taken from a collection of standard glass slides.
RESULTS
In all 3 ARVD cases, RA anomalies were observed that revealed a reduction of cardiomyocytes, the presence of adipocytes, some of them inside the mediomural atrial layer and interstitial fibrosis. In 2 ARVD cases, interstitial fibrosis was also associated with a focus of replacement fibrosis, which was also observed in patients with permanent AF without ARVD. The histologic specimen of the RA and RV from the control group without cardiovascular disease did not display any evidence of fat or fibrosis with a preserved cardiomyocyte architecture.
CONCLUSIONS
A similar histopathological substrate, as can be observed in the RV of patients with ARVD can also be seen in the RA of these patients. This may explain the high prevalence of atrial arrhythmias, particularly AF, in patients with ARVD.
Identifiants
pubmed: 30394508
pii: VM/OJS/J/59812
doi: 10.5603/CJ.a2018.0123
pmc: PMC8083043
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
736-743Références
J Vet Cardiol. 2017 Feb;19(1):57-67
pubmed: 27769725
Heart. 2014 May;100(10):806-13
pubmed: 23904360
Eur J Nucl Med Mol Imaging. 2012 Mar;39(3):416-20
pubmed: 22113617
Circulation. 2017 Nov 21;136(21):2068-2082
pubmed: 29158215
Am J Cardiol. 2016 Sep 1;118(5):750-3
pubmed: 27378141
Circulation. 1982 Feb;65(2):384-98
pubmed: 7053899
Heart Rhythm. 2015 Apr;12(4):766-73
pubmed: 25616123
J Electrocardiol. 2011 Mar-Apr;44(2):237-41
pubmed: 21093870
J Am Coll Cardiol. 2002 Mar 6;39(5):892-5
pubmed: 11869858
Eur Heart J. 2017 Jan 1;38(1):53-61
pubmed: 26612579
Circ J. 2014;78(12):2854-61
pubmed: 25327952
Cardiol Res Pract. 2010 Aug 24;2010:
pubmed: 20885777
Am J Cardiol. 1991 May 15;67(13):1153
pubmed: 2024612
Circ J. 2015;79(2):447
pubmed: 25482384