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[致心律失常性右室发育不良。一种新的临床实体]

[Arrhythmogenic right ventricular dysplasia. A new clinical entity].

作者信息

Fontaine G, Fontaliran F, Frank R, Lascault G, Tonet J, Tchoubrieva J, Rosas F, Grosgogeat Y

机构信息

Centre de Rythmologie et de Stimulation Cardiaque, Hôpital Jean Rostand, Ivry.

出版信息

Bull Acad Natl Med. 1993 Mar;177(3):501-12; discussion 512-4.

PMID:8364754
Abstract

Arrhythmogenic right ventricular dysplasia has been identified in 1977. It affects the right ventricle and its etiology is unknown. It has been recently included in the group of cardiomyopathies since it affects mainly the right ventricular muscle. It is found in young adults, frequently sportsmen who have a nearly normal cardiac physical examination. Ventricular arrhythmias could lead to palpitations, syncopes or even sudden death. This accident could be the first presenting sign of the disease. Two physiopathogenic mechanisms have been considered: heredo-familial origin or the result of a burned out myocarditis which could be the result of an abnormal immunological response. Its treatment mainly involves antiarrhythmic drugs. In the resistant cases ablative techniques, implantable defibrillator or surgery and even cardiac transplantation could be considered. Correctly treated, ARVD has a good prognosis. More extensive studies are necessary both on the clinical as well as the basic science standpoints.

摘要

致心律失常性右室心肌病于1977年被发现。它累及右心室,病因不明。由于它主要影响右心室肌肉,最近被归入心肌病组。多见于年轻人,常为心脏体格检查基本正常的运动员。室性心律失常可导致心悸、晕厥甚至猝死。这种意外情况可能是该病的首发症状。已考虑两种病理生理机制:遗传家族性起源或既往心肌炎痊愈后的结果,而既往心肌炎可能是异常免疫反应的结果。其治疗主要涉及抗心律失常药物。对于耐药病例,可考虑采用消融技术、植入式除颤器或手术,甚至心脏移植。经过正确治疗,致心律失常性右室心肌病预后良好。从临床和基础科学的角度来看,都需要进行更广泛的研究。

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