open access

Vol 26, No 6 (2019)
Original articles — Clinical cardiology
Published online: 2018-10-19
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Right atrial pathology in arrhythmogenic right ventricular dysplasia

Guoliang Li, Guy H. Fontaine, Shuanliang Fan, Yang Yan, Peter K. Bode, Firat Duru, Robert Frank, Ardan M. Saguner
DOI: 10.5603/CJ.a2018.0123
·
Pubmed: 30394508
·
Cardiol J 2019;26(6):736-743.

open access

Vol 26, No 6 (2019)
Original articles — Clinical cardiology
Published online: 2018-10-19

Abstract

Background: Atrial fibrillation (AF) is the most common atrial arrhythmia in arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVD). Considering the histologic changes known in the right ventricular (RV) in ARVD, the aim of the present study was to examine right atrial (RA) pathology in patients with ARVD. Methods: Histology of RA and RV was assessed from autopsy material in 3 patients with ARVD without persistent atrial arrhythmia. RA histology in 3 patients with permanent AF without ARVD and 5 patients without cardiovascular disease was also studied. Staining with hematoxylin phloxine saffron was performed for the ARVD patients to identify fibrosis, and hematoxylin-eosin for identification of lymphocytes. Masson’s trichrome staining was performed for control groups taken from a collection of standard glass slides. Results: In all 3 ARVD cases, RA anomalies were observed that revealed a reduction of cardiomyocytes, the presence of adipocytes, some of them inside the mediomural atrial layer and interstitial fibrosis. In 2 ARVD cases, interstitial fibrosis was also associated with a focus of replacement fibrosis, which was also observed in patients with permanent AF without ARVD. The histologic specimen of the RA and RV from the control group without cardiovascular disease did not display any evidence of fat or fibrosis with a preserved cardiomyocyte architecture. Conclusions: A similar histopathological substrate, as can be observed in the RV of patients with ARVD can also be seen in the RA of these patients. This may explain the high prevalence of atrial arrhythmias, particularly AF, in patients with ARVD.

Abstract

Background: Atrial fibrillation (AF) is the most common atrial arrhythmia in arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVD). Considering the histologic changes known in the right ventricular (RV) in ARVD, the aim of the present study was to examine right atrial (RA) pathology in patients with ARVD. Methods: Histology of RA and RV was assessed from autopsy material in 3 patients with ARVD without persistent atrial arrhythmia. RA histology in 3 patients with permanent AF without ARVD and 5 patients without cardiovascular disease was also studied. Staining with hematoxylin phloxine saffron was performed for the ARVD patients to identify fibrosis, and hematoxylin-eosin for identification of lymphocytes. Masson’s trichrome staining was performed for control groups taken from a collection of standard glass slides. Results: In all 3 ARVD cases, RA anomalies were observed that revealed a reduction of cardiomyocytes, the presence of adipocytes, some of them inside the mediomural atrial layer and interstitial fibrosis. In 2 ARVD cases, interstitial fibrosis was also associated with a focus of replacement fibrosis, which was also observed in patients with permanent AF without ARVD. The histologic specimen of the RA and RV from the control group without cardiovascular disease did not display any evidence of fat or fibrosis with a preserved cardiomyocyte architecture. Conclusions: A similar histopathological substrate, as can be observed in the RV of patients with ARVD can also be seen in the RA of these patients. This may explain the high prevalence of atrial arrhythmias, particularly AF, in patients with ARVD.

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Keywords

arrhythmogenic right ventricular dysplasia, atrial arrhythmias, pathological substrate, atrium

About this article
Title

Right atrial pathology in arrhythmogenic right ventricular dysplasia

Journal

Cardiology Journal

Issue

Vol 26, No 6 (2019)

Pages

736-743

Published online

2018-10-19

DOI

10.5603/CJ.a2018.0123

Pubmed

30394508

Bibliographic record

Cardiol J 2019;26(6):736-743.

Keywords

arrhythmogenic right ventricular dysplasia
atrial arrhythmias
pathological substrate
atrium

Authors

Guoliang Li
Guy H. Fontaine
Shuanliang Fan
Yang Yan
Peter K. Bode
Firat Duru
Robert Frank
Ardan M. Saguner

References (17)
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