Arrhythmogenic Right Ventricular Cardiomyopathy With an Initial Manifestation of Severe Left Ventricular Impairment and Normal Contraction of the Right Ventricle
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概要
- 論文の詳細を見る
A case of arrhythmogenic right ventricular cardiomyopathy(ARVC) with an initial manifestation of severe impairment of the left ventricle(LV) and normal contraction of the right ventricle(RV) is presented. A 43-year-old man was admitted to hospital because of congestive heart failure following a common cold. The LV function was diffusely and severely hypokinetic. Coronary arteriogram revealed normal vessels. An endomyocardial biopsy specimen obtained from the RV septum revealed mild infiltration of lymphocytes with focal myocytes necrosis and so healing myocarditis was suspected. The specimen did not include any fatty replacement of myocytes. Since then, the patient suffered from recurrent congestive heart failure as well as nonsustained ventricular tachycardia and required frequent hospitalization. Progressive impairment, dilation, and thinning of both ventricles were observed on serial echocardiographic examinations. Although the RV gradually enlarged and became impaired, severe dilatation and impairment of the LV has always been predominant in the patient's clinical course. After medical follow-up for 10 years, he died suddenly of ventricular fibrillation and pump failure. The autopsy revealed extensive fibrofatty replacement of myocytes in both the ventricles, extending from the outer layer to the inner layer of myocardium in the RV and to the middle layer in the LV. These features were compatible with arrhythmogenic right ventricular cardiomyopathy or perimyocarditis, although only the rightsided bundle of the interventricular septum was completely replaced by fatty tissue, which can not be explained as a sequel of perimyocarditis. Moreover, apoptosis was present in the myocyte nuclei of the myocardial layers bordering the area of fatty replacement. Therefore, myocarditis may have triggered or accelerated the process of apoptosis leading to ARVC.
- 社団法人日本循環器学会の論文
- 2000-02-20
著者
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SUMIYOSHI Masataka
Department of Cardiology, Juntendo University Nerima Hospital
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NAKAZATO Yuji
Department of Cardiology, Juntendo University Urayasu Hospital
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DAIDA Hiroyuki
Department of Cardiology, Juntendo University School of Medicine
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Yamaguchi Hiroshi
Department Of Cardiology Juntendo University
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Kawai Sachio
Department Of Cardiovascular Surgery Sakakibara Heart Institute
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TAKAGI Atsutoshi
Department of Cardiology, Juntendo University, School of Medicine
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Suzuki Hiromasa
Department of Cardiology, Juntendo University, School of Medicine, Tokyo, and Juntendo Urayasu Hospi
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Sakurai Hidehiko
Department of Cardiology, Juntendo University, School of Medicine, Tokyo, and Juntendo Urayasu Hospi
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Wada Akiko
Department of Cardiology, Juntendo University School of Medicine
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SAKURAI Hidehiko
the Departments of Cardiology
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YAMAGUCHI Hiroshi
順天堂大学医学部 循環器内科
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Wada Akiko
Department Of Cardiology Juntendo University School Of Medicine
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Sumiyoshi Masataka
Department Of Cardiology Juntendo University Nerima Hospital
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Nakata Yasuro
Department Of Cardiology Juntendo University Urayasu Hospital
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Nakazato Yuji
Cardiovascular Medicine Juntendo University Urayasu Hospital
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Sakurai Hidehiko
Department Of Cardiology Juntendo University Shizuoka Hospital
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Suzuki Hiromasa
Department Of Cardiology Juntendo University
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Nakata Yasuro
Cardiology Dept. Of Internal Medicine Juntendo University
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Takagi Atsutoshi
Department Of Cardiology Juntendo University School Of Medicine
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Daida Hiroyuki
Department Of Cardiology
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Kawai Sachio
Department Of Cardiology Juntendo University
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Nakazato Yuji
Department Of Cardiology Heart Center Juntendo University Urayasu Hospital
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Nakata Yasuro
Division Of Cardiology Department Of Internal Medicine School Of Medicine Juntendo University
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Kawai Sachio
Research Laboratory For Cardiovascular Pathology Juntendo University
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Suzuki Hiromasa
Department Of Cadiology Juntendo University School Of Medicine
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Kamata Satoshi
Department Of Cardiovascular Surgery Sakakibara Heart Institute
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Kawai Sachio
Research Laboratory For Cardiovascular Pathology Department Of Internal Medicine Juntendo University
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Kawai Sachio
Res. Lab. for Cardiovasc. Pathol. Juntendo Univ.
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Yamaguchi Hiroshi
Department Of Anatomic Pathology Graduate School Of Medical Sciences Kyushu University
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Sakurai Hidehiko
Department Of Cardiology Juntendo University School Of Medicine
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Sakurai Hidehiko
Department Of Cardiology Juntendo University School Of Medicine Tokyo And Juntendo Urayasu Hospital
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Yamaguchi Hiroshi
Departments Of Physiology Juntendo University
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Sakurai Hidehiko
Cardiology Dept. Intern. Med. Juntendo University School Of Medicine Tokyo.
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Sakurai Hidehiko
Department Of Cardiology Jnutendo University School Of Medicine
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