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Los microaneurismas inflamatorios del ventrículo izquierdo como causa de las taquiarritmias ventriculares
C Chimenti1, F Calabrese, G Thiene
1Department of Cardiology, Catholic University, Rome, Italy.
Circulation
|July 12, 2001
Resumen
Los microaneurismas inflamatorios del ventrículo izquierdo (LV) son una causa clave de las arritmias ventriculares idiopáticas. Estas condiciones relacionadas con el virus tienen un pronóstico benigno y se manejan eficazmente con medicamentos antiarrítmicos.
Área de la Ciencia:
- Cardiología Cardiología.
- Enfermedades infecciosas Enfermedades infecciosas.
- Patología Patología Patología.
Sus antecedentes:
- Las arritmias ventriculares idiopáticas pueden estar relacionadas con microaneurismas inflamatorios del ventrículo izquierdo (LV).
- Este estudio investiga el papel, la incidencia, el tratamiento y el pronóstico de estos microaneurismas.
Objetivo del estudio:
- Para determinar el papel aritmogénico de los microaneurismas LV inflamatorios.
- Evaluar la incidencia, el tratamiento y el pronóstico de estas afecciones en pacientes con taquiarritmias ventriculares.
Principales métodos:
- Se estudiaron 156 pacientes con arritmias ventriculares severas y eco 2D normal.
- Utilizó angiografía coronaria / ventricular, biopsia endomiocárdica y estudio electrofisiológico.
- Se empleó la reacción en cadena de la polimerasa (PCR) para detectar genomas virales en muestras de miocardio.
Principales resultados:
- 15 pacientes (9,6%) exhibieron microaneurismas de LV.
- Las arritmias se originaron cerca de microaneurismas en pacientes mapeados.
- La miocarditis linfocítica se encontró en todas las biopsias de LV; los genomas virales se detectaron en el 42% de las muestras analizadas por PCR (HCV, enterovirus, influenza A).
Conclusiones:
- Los microaneurismas inflamatorios de LV, a menudo inducidos por virus, son una causa significativa de las arritmias ventriculares idiopáticas.
- El pronóstico para estos microaneurismas es generalmente benigno.
- Las estrategias de tratamiento agresivas suelen ser innecesarias; los antiarrítmicos son efectivos.
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