Confusing aspects of arrhythmogenic right ventricular dysplasia: Current clinical view

Abstract

Arrhythmogenic right ventricular dysplasia is an inherited fatal cardiomyopathy causing fat and connective tissue infiltration of right ventricle. In advanced disease, it may also involve left ventricle. Heart failure, arrhythmias and sudden death are main clinical components. Many different genetic mutations can cause this cardiomyopathy. All mutations lead to the formation of the disease are not yet defined. Basis of pathogenetic event is corruption of physical connection as well as the electrical conduction between cardiomyocytes due to these genetic reasons. Genetical inheritance is frequently autosomal dominant but incomplete. Because of the many different phenotypes, there may be great heterogenity of clinical manifestations in same family. Diagnostic criteria are renovated lately. Current cardiac imaging techniques for the diagnosis is gradually progressing. A combination of several tests should be used for diagnosis. Early and accurate diagnosis will save lives and improve the patient’s quality of life. In this paper, after mentioning the features and diagnosis of ARVD, differential diagnosis of ARVD from other diseases which may cause fatty infiltration of heart, arrhythmias and sudden death will be focused.

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Ulucam, M. (2013) Confusing aspects of arrhythmogenic right ventricular dysplasia: Current clinical view. World Journal of Cardiovascular Diseases, 3, 154-158. doi: 10.4236/wjcd.2013.31A022.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Dalal, D., Nasir, K., Bomma, C., Prakasa, K., Tandri, H., Piccini, J., et al. (2005) Arrhythmogenic right ventricular dysplasia: A United States experience. Circulation, 112, 3823-3832. doi:10.1161/CIRCULATIONAHA.105.542266
[2] Basso, C., Corrado, D., Marcus, F.I., Nava, A. and Thiene, G. (2009) Arrhythmogenic right ventricular cardiomyopathy. Lancet, 373, 1289-1300. doi:10.1016/S0140-6736(09)60256-7
[3] Calkins,H ( 2008) Classification of the cardiomyopathies: A position statement from the European Society of Carology Working Group on myocardial and pericardial disses. European Heart Journal, 29, 270-276. doi:10.1093/eurheartj/ehm342
[4] Elliott, P., Andersson, B., Arbustini, E., Bilinska, Z., Cecchi, F., Charron, P, et al. (2008) Classification of the cardiomyopathies: A position statement from the European Society of Cardiology Working Group on myocardial and pericardial diseases. European Heart Journal, 29, 270-276. doi:10.1093/eurheartj/ehm342
[5] McKenna, W.J., Thiene, G., Nava, A., Fontaliran, F., Blomstrom-Lundqvist, C., Fontaine, G., et al. (1994) Diagnosis of arrhythmogenic right ventricular dysplasia/cardiomyopathy. Task Force of the Working Group Myocardial and Pericardial Disease of the European Society of Cardiology and of the Scientific Council on Cardiomyopathies of the International Society and Federation of Cardiology. British Heart Journal, 71, 215-218. doi:10.1136/hrt.71.3.215
[6] Fontaine, G. and Frank, R. (2006) Arrhythmogenic right ventricular dysplasia: 2006 update. Training for Audiovisual Preservation in Europe, 4, 99-107
[7] Marcus, F.I., McKenna, W.J., Sherrill, D., Basso, C., Bauce, B., Bluemke, D.A., et al. (2010) Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: Proposed mofification of the Task Force Criteria. European Heart Journal, 31, 806-814. doi:10.1093/eurheartj/ehq025
[8] Yoerger, D.M., Marcus, F., Sherrill, D., Calkins, H., Towbin, J.A., Zareba, W., et al. (2005) Multidisciplinary study of right ventricular dysplasia investigators. Echocardiographic findings in patients meeting task force criteria for arrhytmogenic right ventricular dysplasia: New insights from the multidisciplinary study of right ventricular dysplasia. Journal of the American College of Cardiology, 45, 860-865. doi:10.1016/j.jacc.2004.10.070
[9] Teske, A.J., Cox, M.G., De Boeck, B.W., Doevendans, P.A., Hauer, R.N. and Cramer, M.J. (2009) Echocardiographic tissue deformation imaging quantifies abnormal regional right ventricular function in arrhythmogenic right ventricular dysplasia/cardiomyopathy. Journal of the American Society of Echocardiography, 22, 920-927. doi:10.1016/j.echo.2009.05.014
[10] Prakasa, K.R., Wang, J., Tandri, H., Dalal, D., Bomma, C., Chojnowski, R., et al. (2007) Utility of tissue Doppler and strain echocardiography in arrhythmogenic right ventricular dysplasia/cardiomyopathy. American Journal of Cardiology, 100, 507-512. doi:10.1016/j.amjcard.2007.03.053
[11] Kjaergaard, J., Hastrup Svendsen, J., Sogaard, P., Chen, X., Bay Nielsen, H., Kober, L., et al. (2007) Advanced quantitative echocardiography in arrhythmogenic right ventricular cardiomyopathy. Journal of the American Society of Echocardiography, 20, 27-35. doi:10.1016/j.echo.2006.07.006
[12] Jain, A., Tandri, H., Calkins, H. and Bluemke, D.A. (2008) Role of cardiovascular magnetic resonance imaging in arrhytmogenic right ventricular dysplasia. Journal of Cardiovascular Magnetic Resonance, 10, 32. doi:10.1186/1532-429X-10-32
[13] Tandri, H., Castillo, E., Ferrari, V.A., Nasir, K., Dalal, D., Bomma, C., et al. (2006) Magnetic resonance imaging of arrhythmogenic right ventricular dysplasia: sensitivity, specificity, and observer variability of fat detection versus functional analysis of the right ventricle. Journal of the American College of Cardiology, 48, 2277-2284. doi:10.1016/j.jacc.2006.07.051
[14] Soh, E.K., Villines, T.C. and Feuerstein, I.M. (2008) Sixty-four-multislice computed tomography in a patient with arrhythmogenic right ventricular dysplasia. Journal of Cardiovascular Computed Tomography, 2, 191-192. doi:10.1016/j.jcct.2008.02.006
[15] Marchlinski, F.E., Zado, E., Dixit, S., Gerstenfeld, E., Callans, D.J., Hsia, H., et al. (2004) Elecroanatomic substrate and outcome of catheter ablative therapy for ventricular tachhycardia in setting of right ventricular cardiomyopathy. Circulation, 110, 2293-2298. doi:10.1161/01.CIR.0000145154.02436.90
[16] Kimura, F., Matsuo, Y., Nakajima, T., Nishikawa, T., Kawamura, S., Sannohe, S., et al. (2010) Myocardial fat at cardiac imaging: How can we differentiate pathologic from physiologic fatty infiltration? RadioGraphics, 30, 1587-1602. doi:10.1148/rg.306105519
[17] Sen-Chowdhry, S., Syrris, P., Prasad, S.K., Hughes, S.E., Merrifield, R., Ward, D., et al. (2008) Left-dominant arrhythmogenic cardiomyopathy: An under-recognized clinical entity. Journal of the American College of Cardiology, 52, 2175-2187. doi:10.1016/j.jacc.2008.09.019
[18] John, B.T., Tamarappoo, B.K., Titus, J.L., Edwards, W.D., Shen, W.K. and Chugh, S.S. (2004) Global remodeling of the ventricular interstitium in idiopathic myocardial fibrosis and sudden cardiac death. Heart Rhythm, 1, 141-149. doi:10.1016/j.hrthm.2004.02.021
[19] Pamuru, P.R., Dokuparthi, M.V., Remersu, S., Calambur, N. and Nallari, P. (2010) Comparison of Uhl’s anomaly, right ventricular outflow tract ventricular tachycardia (RVOT VT) & arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) with an insight into genetics of ARVD/C. Indian Journal of Medical Research, 131, 35-45.
[20] Tekin, M., Canbay, A. and Diker, E. (2009) Arrhythmogenic right ventricular cardiomyopathy mimicking right ventricular outflow tract tachycardia. Archives of the Turkish Society of Cardiology, 37, 566-568.
[21] Naccarella, F., Naccarelli, G., Fattori, R., Nava, A., Martini, B., Corrado, D., et al. (2001) Arrhythmogenic right ventricular dysplasia: Cardiomyopathy current opinions on diagnostic and therapeutic aspects. Current Opinion in Cardiology, 16, 8-16. doi:10.1097/00001573-200101000-00002

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