Human pathology

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arrhythmogenic right ventricular dysplasia

ARVD
Definition: Arrhythmogenic right ventricular dysplasia (ARVD), a familial cardiomyopathy occurring with a prevalence of 1 in 5000, is characterized by replacement of myocytes with fatty and fibrous tissue. Clinical manifestations include structural and functional abnormalities of the right ventricle and arrhythmias, leading to a sudden death rate of 2.5% per year. Six loci have been mapped. One gene has been identified. (Name: 1978 - Ent: 1978)

Epidemiology

- Possible recurrence in siblings (1)
- Can occur in childhood (1,2)
- May represent 38% or perioperative sudden death (1)

Microscopical synopsis

- adipocytes (fatty infiltration of the myocardium)
- chronic inflammation

Etiology

Loci

ARVD114q23-q24
ARVD21q42.1-q43
ARVD314q12-q22MIM.602086
ARVD42q32.1-q32.3MIM.602287
ARVD5
ARVD610p12-p14MIM.604401
ARVD7
ARVD8
ARVD9

- ARVD2 (MIM.600996) (1q42.1-q43)

  • Mutations in the cardiac ryanodine receptor gene (MIM.180902). The ryanodine receptor on the sarcoplasmic reticulum is the major source of calcium required for cardiac muscle excitation-contraction coupling. The channel is a tetramer comprised of 4 RYR2 polypeptides and 4 FK506-binding proteins (FKBP1A; MIM.186945) (8589694)

- ARVD3 (MIM.602086) (14q12-q22) (8824801)
- ARVD4 (MIM.602287) 2q32.1-q32.3 (9344647)
- 3p23 (9860777)
- 10p12-p14 ARVD6 (MIM.604401) (early onset) (10631146)
- mutations in desmoplakin (12373648)
- mutations in plakoglobin

Associations

- Naxos disease (Keratosis palmoplantaris with arrhythmogenic cardiomyopathy) (MIM.601214) 10q mutation in the plakoglobin gene (MIM.173325)
- ARVD and anterior polar cataracts (MIM.115650) - locus CTAA1 - 14q24 (9409860)
- myelomeningocele (11465566)
- fluorescent antinuclear antibody (FANA) positiveness (1835322)
- tuberculosis (1780299)

Complications

- Right ventricular thrombus (1)
- heart failure (10636531)

References

- Chimenti C, Pieroni M, Maseri A, Frustaci A. Histologic findings in patients with clinical and instrumental diagnosis of sporadic arrhythmogenic right ventricular dysplasia. J Am Coll Cardiol. 2004 Jun 16;43(12):2305-13. PMID: 15193698

- Schionning JD, Frederiksen P, Kristensen IB. Arrhythmogenic right ventricular dysplasia as a cause of sudden death. Am J Forensic Med Pathol. 1997 Dec;18(4):345-8. PMID: 9430285

P.S.

MIM.107970 http://www.arvd.com http://www.arvd.org