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Left ventricular involvement in right ventricular dysplasia/cardiomyopathy
F V Lobo1, M D Silver, J Butany
1Hamilton General Hospital, Hamilton, Canada. lobof@hamcivhos.on.ca
The Canadian Journal of Cardiology
|December 1, 1999
Summary
Left ventricular (LV) involvement is common in arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C), often affecting the LV free wall and septum. Pathologists must carefully examine hearts for these subtle LV changes.
Area of Science:
- Cardiovascular Pathology
- Cardiac Morphology
- Histopathology
Background:
- Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is a primary myocardial disease.
- Left ventricular (LV) involvement is increasingly recognized but less understood than right ventricular pathology.
Purpose of the Study:
- To define the pathological characteristics of LV involvement in ARVD/C.
- To assess the prevalence and patterns of LV myocardial changes in a cohort of ARVD/C patients.
Main Methods:
- Retrospective morphological analysis of 17 hearts from individuals with ARVD/C.
- Inclusion of cases with sudden cardiac death and explanted hearts due to arrhythmias or heart failure.
- Detailed gross and microscopic examination of both right and left ventricles.
Main Results:
- All 17 hearts exhibited typical right ventricular features of ARVD/C and evidence of LV wall involvement.
- LV free wall was affected in all cases, and the ventricular septum (VS) in 15.
- Histological findings included myocyte atrophy and inflammation, with more severe LV changes in older patients.
Conclusions:
- LV free wall and frequent VS involvement are likely in ARVD/C patients with longer survival.
- LV involvement may be missed on gross examination and requires diligent histological assessment.
- Examination of appropriate histological sections from both LV free wall and septum is crucial for accurate diagnosis.