Carvedilol Therapy Improved Left Ventricular Function in a Patient With Arrhythmogenic Right Ventricular Cardiomyopathy
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概要
- 論文の詳細を見る
An asymptomatic 35 year-old man was referred to our hospital because of abnormal ECG findings. The ECG showed complete right bundle branch block and left anterior hemiblock. Echocardiography revealed a moderately enlarged right ventricle (RV) and an apical aneurysm. RV wall motion showed diffusely moderate impairment, while the systolic function of the left ventricle (LV) was slightly decreased. The ejection fractions (EF) of the RV and LV were calculated as 28.1% and 41.9% by Simpsons method using multiple cardiac computed tomography (CT) scans. A 24 hour ambulatory ECG showed only 372 single premature ventricular contractions (PVC). Cardiac catheterizaion revealed that the RV was enlarged with prominent trabeculation and decreased motion. In an electrophysiologic study, neither electrical stimulation of the RV nor electrical stimulation plus isoproterenol infusion could induce ventricular tachycardia. Pathological examination of a biopsy from the interventricular septum of the RV revealed fibrofatty change in the myocardium. Based on these results, we made a diagnosis of arrhythmogenic right ventriclular cardiomyopathy (ARVC) and administered 5 mg of carvedilol. Sixty days after the initiation of carvedilol therapy, we performed repeat cardiac CT. The EF of the LV was markedly improved from 41.9% to 62.0%, although the EF of the RV was not changed. The number of PVCs showed no change. This case suggests that carvedilol is not only useful for controlling arrhythmia but also for improving left ventriclular function in some patients with ARVC. Sympathetic overactivity is reported to cause sudden death, so carvedilol may be a first-line drug for some patients with ARVC.
- Japanese Heart Journal Associationの論文
著者
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NAGAI Ryozo
Department of Cardiovascular Medicine, University of Tokyo
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OHNO Minoru
Department of Cardiovascular Center, Toranomon Hospital
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Ajiki Kohsuke
Department of Cardiovascular Medicine, University of Tokyo
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Fujiu Katsuhito
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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Imai Yasushi
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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Hirata Yasunobu
Department of Cardiovascular Medicine, The University of Tokyo
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Sonoda Makoto
Department of Cardiovascular Medicine, Graduate School of Medicine
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Imai Yasushi
Department Of Cardiovascular Medicine Graduate School Of Medicine The University Of Tokyo
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Nakamura Fumitaka
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
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Ohtomo Kuni
Departments of Radiology, Faculty of Medicine and Graduate School of Medicine, University of Tokyo
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Murakawa Yuji
Departments of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
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HAYAMI Noriyuki
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japa
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Oishi Yumiko
東京大学 医学系研究科循環器内科
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Hiroi Yukio
Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine
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Komatsu Shuhei
Department of Radiology, University of Tokyo Graduate School of Medicine
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Sakomura Yasunari
Department of Cardiology, Heart Institute of Japan, Tokyo Womens University
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Oishi Yumi
Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine
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Ohno Minoru
Department Of Cardiology Toranomon Hospital
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Murakawa Yuji
Department Of Cardiology Dokkyo Medical University
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Hiroi Yukio
Department Of Cardiovascular Medicine University Of Tokyo Graduate School Of Medicine
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Hayami Noriyuki
Department Of Cardiovascular Medicine Graduate School Of Medicine University Of Tokyo
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Hirata Yasunobu
Department Of Advanced Clinical Science And Therapeutics Cardiovascular Medicine Graduate School Of
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Ohtomo Kuni
Department Of Radiology Faculty Of Medicin University Of Tokyo
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Fujiu Katsuhito
Department Of Cardiology The University Of Tokyo
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Sakomura Yasunari
Department Of Cardiology The Heart Institute Of Japan Tokyo Women's Medical College
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Ajiki Kohsuke
Department Of Cardiovascular Medicine Tokyo University
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Sonoda Makoto
Department Cardiovascular Medicine The University Of Tokyo Hospital
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Nakamura Fumitaka
Department Of Astronomy Faculty Of Science Kyoto University
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Nagai Ryozo
Department Cardiovascular Medicine The University Of Tokyo Hospital
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Sakomura Yasunari
Department of Cardiology, Heart Institute of Japan, Tokyo Women's University
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Sonoda Makoto
Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine
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Hayami Noriyuki
Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine
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Ajiki Kohsuke
Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine
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Nakamura Fumitaka
Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine
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Ohno Minoru
Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine
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Komatsu Shuhei
Department of Radiology, Graduate School of Medicine, The University of Tokyo
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