ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY/DYSPLASIA, APPROACHESTO DIAGNOSIS. PROCEEDING II
An analysis of 33 cases of sudden cardiac death in young people (mean age 31±8 years) with morphologic diagnosis of arrhythmogenic right Ventricular dysplasia / Cardiomyopathy (arVd/C) was conducted. histological examination was performed using he, van gieson, and immunohistochemical staining. morphometric analysis for determination of lipomatosis, fibrosis, as well as the measurement of cardiomyocytes was conducted using image analyze leicascope. The mrI of the heart was conducted in 22 cases. all cased of arVd/C were diagnosed in accordance with arVd/C “large morphometric criteria” - task Force Criteria 2010. The most common observations were: extension of right ventricle (rV) in all cases; aneurysm of rV - 30%; myocardium replacement by fibrous or fatty tissues spreading from endocardial to subepicardial layers in 76%; multiple chaotic diffuse «impregnation» of adipose tissue and fibrosis - in 24%; combination of right ventricle hypertrabeculation/noncompaction and arVd/C - in 12%; disorganization of rVmuscle fibers - in 33%. aforementioned lesions spread beyond rV in more than 50%. every third case of arVd/C associated with myocardial changes characteristic of myocarditis. In 14 (64%) cases, agreement between mrI and morphological evaluation in location of fatty infiltration was achieved. In the remaining 8 (36%) cases, fatty infiltration was not visualized on mrI because of small size (up to 1 mm) and mosaic location of the lesions.