Arrhythmogenic left ventricular cardiomyopathy


Authors: Štěpán Havránek 1;  Tomáš Paleček 1;  Petr Kuchynka 1;  Ivana Vítková 2
Authors‘ workplace: II. interní klinika kardiologie a angiologie 1. LF UK a VFN v Praze 1;  Ústav patologie 1. LF UK a VFN v Praze 2
Published in: Vnitř Lék 2016; 62(9): 728-735
Category: Reviews

Overview

Arrhythmogenic left ventricular cardiomyopathy (ALVC) is a rare condition characterised by progressive fibrofatty replacement of the myocardium of the left ventricle in combination with arrhythmias of left ventricular origin. ALVC has been linked to autosomal dominant mutations of genes encoding desmosomal proteins, similarly to the classic arrhythmogenic right ventricular cardiomyopathy with which it also shares pathological and prognostic features. It seems that isolated left or right ventricular abnormalities represent two extremes of the spectrum of clinical manifestations of a single disease: arrhythmogenic cardiomyopathy. In addition to arrhythmias originating from the left ventricle, the diagnosis of ALVC is based on identification of morphological changes of the left ventricle including late gadolinium enhancement with subepicardial to midwall distribution, corresponding to fibrous or fibrofatty replacement on histopathology. The diagnosis is confirmed by detection of a causal mutation. ALVC should be kept in mind in the differential diagnosis of ventricular tachycardia of non-ischemic origin.

Key words:
arrhythmogenic cardiomyopathy – cardiac magnetic resonance – late gadolinium enhancement – ventricular tachycardia


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