Summary
The pathogenesis of disturbances of the initiation and conduction of the cardiac impulse in cardiac amyloidosis has been a matter of controversy. In this study, we have analyzed the histopathology of the sinoatrial node and the atrial myocardium in nine cases of familial amyloidosis with polyneuropathy. Our results indicate that in this disease, amyloid infiltration of the sinoatrial node and the atrial musculature per se may account for the electrophysiological disturbances of these regions.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Andersson R (1970) Hereditary amyloidosis with polyneuropathy. Acta Med Scand 188:85–94
Bharati S, Lev M, Dhingra R, Wu D, Aruguete J, Mir J, Rosen KM (1976) Pathologic correlations in three cases of bilateral bundle branch disease with unusual electrophysiologic manifestations in two cases. Am J Cardiol 38:508–518
Bharati S, Lev M, Denes P, Modlinger J, Wyndham C, Bauernfeind R, Greenblatt M, Rosen KM (1980) Infiltrative cardiomyopathy with conduction disease and ventricular arrhythmia: electrophysiologic and pathologic correlations. Am J Cardiol 45:163–173
Bharati S, Nordenberg A, Bauernfeind R, Varghese JP, Carvalho AG, Rosen K, Lev M (1980) The anatomic substrate for the sick sinus syndrome in adolescence. Am J Cardiol 46:163–172
Buja LM, Khoi NB, Roberts WC (1970) Clinically significant cardiac amyloidosis. Clinicopathologic findings in 15 patients. Am J Cardiol 26:394–405
Davies MJ (1971) Pathology of conducting tissue of the heart. Butterworths, London
Davies MJ, Pomerance A (1972) Quantitative study of ageing changes in the human sinoatrial node and internodal tracts. Br Heart J 34:150–152
De Freitas AF, Barbedo A (1978) Conduction disturbances in 190 patients with familial amyloidotic polyneuropathy (Andrade's type). Adv Cardiol 21:206–209
Eriksson A, Eriksson P, Olofsson BO, Thornell LE (1983) The cardiac atrioventricular conduction system in familial amyloidosis with polyneuropathy. A clinico-pathologic study of six cases from northern Sweden. Acta Pathol Microbiol Immunol Scand Sect A 91:343–349
Evans R, Shaw DB (1977) Pathological studies in sinoatrial disorder (sick sinus syndrome). Br Heart J 39:778–786
Gray LW, Duca PR, Chung EK (1978) Sick sinus syndrome due to cardiac amyloidosis. Cardiology 63:212–219
Hofer PÅ, Andersson R (1975) Postmortem findings in primary familial amyloidosis with polyneuropathy. A study based on six cases from Northern Sweden. Acta Pathol Microbiol Scand Sect A 83:309–322
Hudson REB (1963) The human conducting-system and its examination. J Clin Pathol 16:492–498
Ih S, Saitoh S (1982) The histopathological substratum for atrial fibrillation in man. Acta Pathol Jpn 32:183–191
Isokane N, Fukushima N, Miyazaki T, Dohi I (1978) A case of sick sinus syndrome in primary systemic amyloidosis. J Electrocardiol 11:191–196
James TN (1961) Anatomy of the human sinus node. Anat Rec 141:109–139
James TN (1966) Pathology of cardiac conduction system in amyloidosis. Ann Intern Med 65:28–36
James TN, Sherf L (1971) Specialized tissues and preferential conduction in the atria of the heart. Am J Cardiol 28:414–427
Janse MJ, Anderson RH (1974) Specialized internodal atrial pathways - fact or fiction? Eur J Cardiol 2:117–136
Kyle RA, Bayrd ED (1975) Amyloidosis: Review of 236 cases. Medicine 54:271–299
Lev M (1954) Aging changes in the human sinoatrial node. J Gerontol 9:1–9
Olofsson BO, Andersson R, Furberg B (1980) Atrioventricular and intraventricular conduction in familial amyloidosis with polyneuropathy. Acta Med Scand 208:77–80
Olofsson BO, Eriksson P, Eriksson A (1983) The sick sinus syndrome in familial amyloidosis with polyneuropathy. Int J Cardiol 4:71–73
Ridolfi RL, Bulkley BH, Hutchins GM (1977) The conduction system in cardiac amyloidosis, Clinical and pathologic features of 23 patients. Am J Med 62:677–686
Schroeder JS, Billingham ME, Rider AK (1975) Cardiac amyloidosis. Diagnosis by transvenous endomyocardial biopsy. Am J Med 59:269–273
Wan SH, Lee GS, Toh CCS (1972) The sick sinus syndrome. A study of 15 cases. Br Heart J 34:942–952
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Eriksson, A., Eriksson, P., Olofsson, BO. et al. The sinoatrial node in familial amyloidosis with polyneuropathy. Vichows Archiv A Pathol Anat 402, 239–246 (1984). https://doi.org/10.1007/BF00695078
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00695078