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Inflammatory-mediated atrial cardiomyopathy diagnosed using multimodality imaging and successfully treated with

Birgitte Carbuhn Larsen1,2, Kadhem Helo Abbas Al-Badri1, Søren Mellemkjær1

  • 1Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.

European Heart Journal. Case Reports
|June 18, 2024
PubMed

Insights

Isolated atrial cardiomyopathy, a rare condition causing atrial fibrillation and heart failure, was successfully treated with prednisolone in a patient with type 1 diabetes mellitus. This highlights the potential of anti-inflammatory therapy for managing this cardiac condition.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Inflammatory Diseases

Background:

  • Atrial fibrillation (AF) is a common arrhythmia often secondary to structural heart changes.
  • Atrial cardiomyopathy and heart failure (HF) can arise from AF or structural changes.
  • Isolated atrial cardiomyopathy from focal atrial thickening is rare, typically linked to inflammation.

Observation:

  • A patient presented with inflammatory-mediated atrial cardiomyopathy, causing AF and acute decompensated HF.
  • Left atrial wall thickening was noted on transesophageal echocardiography.
  • Diagnosis was confirmed via multimodality imaging and endomyocardial biopsy, with possible association to type 1 diabetes mellitus.

Findings:

  • Multimodality imaging confirmed isolated atrial cardiomyopathy.
  • The patient showed successful treatment response to prednisolone.
  • Histology revealed no specific etiology, but type 1 diabetes mellitus was considered a potential factor.

Implications:

  • Prednisolone's anti-inflammatory effects may regress atrial thickening and reduce AF occurrence.
  • Early diagnosis and treatment are crucial for managing rare inflammatory atrial cardiomyopathies.
  • Comprehensive imaging approaches are essential for diagnosis and monitoring treatment efficacy.
Abstract

Keywords:
Atrial fibrillationAtrial remodellingAtrial wall thickeningCase reportDiabetes mellitusIsolated atrial myopathyLeft atrial enlargement

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