Guoliang Li1, Guy H Fontaine2, Shuanliang Fan3, Yang Yan3, Peter K Bode4, Firat Duru5, Robert Frank2, Ardan M Saguner5. 1. Cardiology Institute, Rhythmology Unit, Hôpital Universitaire La Pitié-Salpêtrière, Paris, France. liguoliang_med@163.com. 2. Cardiology Institute, Rhythmology Unit, Hôpital Universitaire La Pitié-Salpêtrière, Paris, France. 3. Xi'an Jiaotong University. 4. Institute of Pathology, University Hospital Zurich, Zurich, Switzerland. 5. Department of Cardiology, University Heart Center, Zurich, Switzerland.
Abstract
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.
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 ARVDpatients 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.
Entities:
Keywords:
arrhythmogenic right ventricular dysplasia; atrial arrhythmias; atrium; pathological substrate
Authors: Pyotr G Platonov; Alex H Christensen; Fredrik Holmqvist; Jonas Carlson; Stig Haunsø; Jesper H Svendsen Journal: J Electrocardiol Date: 2010-11-20 Impact factor: 1.438
Authors: Matthias Paul; Kambiz Rahbar; Joachim Gerss; Peter Kies; Otmar Schober; Klaus Schäfers; Günter Breithardt; Eric Schulze-Bahr; Thomas Wichter; Michael Schäfers Journal: Eur J Nucl Med Mol Imaging Date: 2011-11-24 Impact factor: 9.236
Authors: Jose Maria Lopez-Ayala; Francisco Pastor-Quirante; Josefa Gonzalez-Carrillo; David Lopez-Cuenca; Juan Jose Sanchez-Munoz; Maria Jose Oliva-Sandoval; Juan Ramon Gimeno Journal: Heart Rhythm Date: 2015-01-20 Impact factor: 6.343
Authors: F I Marcus; G H Fontaine; G Guiraudon; R Frank; J L Laurenceau; C Malergue; Y Grosgogeat Journal: Circulation Date: 1982-02 Impact factor: 29.690