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Clinical and familial study of arrhythmogenic right ventricular cardiomyopathy
作者姓名:单其俊  曹克将  黄元铸  廖铭扬  陈明龙  李闻奇  邹建刚  朱必顺  马文珠
作者单位:南京医科大学第一附属医院心脏科 南京 210029
摘    要:Objective To explore the characteristics of arrhythmogenic right ventricular cardiomyopathy (ARVC). Methods Seven patients with arrhythmogenic right ventricular cardiomyopathy and 34 members of three families were studied. All patients and family members underwent history collection, clinical examination, electrocardiogram (ECG), two-dimensional echocardiography (2-DE) and a signal averaging electrocardiogram. Programmed ventricular stimulation was performed in five patients. Results All patients and family members had normal morphologic characteristics and normal function of the left ventricular by 2-DE. Fourteen persons had abnormal findings indicating ARVC. Five had enlargement of the right ventricular with diffused hypocontractility, eight had thin and systolic bulging in the focal anterior wall with hypokinesia and one had bulging of the inferior wall. Twenty-five persons (seven patients and 18 family members) had abnormal findings in ECG. Positive ventricular late potential was recorded in 13 persons (six patients). Two to three monomorphic ventricular tachycardia (VT) with left bundle branch block (LBBB) configurations were induced in five patients. Ventricular fibrillation was induced in two patients during the electrophysiologic study (EPS). Five patients had very high pacing threshold and/or ineffective pacing in one or many regions of the right ventricle. Two members of one family died suddenly. One member was a dwarf with ARVC. Spontaneous VT with a left bundle branch block (LBBB) configuration was recorded in five patients, polymorphic VT with extremely short coupling interval in one, and premature ventricular complexes with LBBB configuration in 12 (six patients). Conclusion Our familial study strongly suggests that ARVC may be a hereditary disease and it is helpful in the diagnosis and detection of ARVC. The most common manifestations were abnormal structure and function of the right ventricle and abnormal ECG of repolarization and ventricular arrhythmia which originates from the right ventricle.

关 键 词:致心律失常性右室心肌病  室性心律失常  家系调查

Clinical and familial study of arrhythmogenic right ventricular cardiomyopathy
Shan QJ,Cao KJ,Huang YZ,Liao MY,Chen ML,Li WQ,Zou JG,Zhu BS,Ma WZ.Clinical and familial study of arrhythmogenic right ventricular cardiomyopathy[J].Chinese Medical Journal,2001,114(4):369-373.
Authors:Shan QJ  Cao KJ  Huang YZ  Liao MY  Chen ML  Li WQ  Zou JG  Zhu BS  Ma WZ
Institution:Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China;Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China;Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China;Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China;Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China;Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China;Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China;Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China;Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Abstract:Objective To explore the characteristics of arrhythmogenic right ventricular cardiomyopathy (ARVC) Methods Seven patients with arrhythmogenic right ventricular cardiomyopathy and 34 members of three families were studied All patients and family members underwent history collection, clinical examination, electrocardiogram (ECG), two dimensional echocardiography (2 DE) and a signal averaging electrocardiogram Programmed ventricular stimulation was performed in five patients Results All patients and family members had normal morphologic characteristics and normal function of the left ventricular by 2 DE Fourteen persons had abnormal findings indicating ARVC Five had enlargement of the right ventricular with diffused hypocontractility, eight had thin and systolic bulging in the focal anterior wall with hypokinesia and one had bulging of the inferior wall Twenty five persons (seven patients and 18 family members) had abnormal findings in ECG Positive ventricular late potential was recorded in 13 persons (six patients) Two to three monomorphic ventricular tachycardia (VT) with left bundle branch block (LBBB) configurations were induced in five patients Ventricular fibrillation was induced in two patients during the electrophysiologic study (EPS) Five patients had very high pacing threshold and/or ineffective pacing in one or many regions of the right ventricle Two members of one family died suddenly One member was a dwarf with ARVC Spontaneous VT with a left bundle branch block (LBBB) configuration was recorded in five patients, polymorphic VT with extremely short coupling interval in one, and premature ventricular complexes with LBBB configuration in 12 (six patients) Conclusion Our familial study strongly suggests that ARVC may be a hereditary disease and it is helpful in the diagnosis and detection of ARVC The most common manifestations were abnormal structure and function of the right ventricle and abnormal ECG of repolarization and ventricular arrhythmia which originates from the right ventricle
Keywords:arrhythmogenic right ventricular cardiomyopathy  ventricular arrhythmia  familial study
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