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Evolution of left ventricular involvement in arrhythmogenic right ventricular cardiomyopathy
M Horimoto1, M Akino, T Takenaka
1Division of Cardiology, Sapporo National Hospital, Sapporo, Japan. horimoto@sap-cc.go.jp
Insights
Arrhythmogenic right ventricular cardiomyopathy (ARVC) can progress to affect the left ventricle over time. This case study shows diffuse myocardial disease impacting both ventricles in ARVC.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Myocardial Diseases
Background:
- Arrhythmogenic right ventricular cardiomyopathy (ARVC) is primarily known for right ventricular disease.
- Left ventricular (LV) involvement in ARVC is recognized but its long-term evolution remains poorly documented.
Observation:
- A case of ARVC was followed for 9 years to observe the progression of LV involvement.
- Myocardial scintigraphy revealed progressive perfusion defects in the LV wall.
- Left ventriculography demonstrated developing LV asynergy and ventricular aneurysm formation.
Findings:
- The patient exhibited progressive LV wall abnormalities over the 9-year follow-up period.
- Simultaneously, the right ventricle showed progressive enlargement.
- These findings indicate that ARVC is a diffuse myocardial disease affecting both ventricles.
Implications:
- ARVC should be considered a progressive disease affecting the entire heart, not just the right ventricle.
- Long-term cardiovascular imaging is crucial for understanding the full spectrum of ARVC.
- This case highlights the importance of monitoring for biventricular dysfunction in ARVC patients.
Abstract:
Left ventricular (LV) involvement in arrhythmogenic right ventricular cardiomyopathy (ARVC) is fairly well known, but the evolution of LV involvement during long-term follow-up has not been well documented. We describe such evolution in a patient followed for 9 years. Evolution was confirmed by a progressive perfusion defect of the LV wall in myocardial scintigrams and by the development of LV asynergy with ventricular aneurysm formation in left ventriculograms. As the right ventricle progressively enlarged, we concluded that ARVC is a diffuse and progressive myocardial disease that affects both ventricles.