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Endomyocardial biopsy findings in patients with atrioventricular block in the absence of apparent heart disease

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Summary

The purpose of this study was to examine the histopathological findings of right ventricular endomyocardial biopsies from ten patients less than 60 years of age (47 ± 9.8 (mean ± SD) years) with documented atrioventricular block but without apparent heart disease. They underwent electrophysiological testing, echocardiography, coronary angiography, and right ventricular endomyocardial biopsy. Biopsy specimens were assessed for morphologic changes in myocyte diameter, fibrosis, disarray, and degeneration. Electrophysiological testing demonstrated atrioventricular nodal block in 2, intra-His bundle block in 2, and infra-His bundle block in 6 patients. Histology revealed evidence of myocardial fibrosis with either myocyte hypertrophy or disarray in 7 of the 10 patients. The results of electrophysiological testing did not correlate with the histopathological findings or severity. In one patient, heart failure appeared during the follow-up period. We conclude that patients with atrioventricular block of unknown etiology have histological abnormalities of the ventricular endomyocardium in addition to the conduction system disturbances. We consider such cases as constituting one of the disease groups of cardiomyopathy, and suggest that it is necessary to follow up the clinical course in these patients.

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Authors and Affiliations

  1. First Department of Internal Medicine, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, 545-8585, Osaka, Japan

    Masakazu Teragaki, Iku Toda, Kenei Shimada, Hiroyuki Yamagishi, Minoru Yoshiyama, Kaname Akioka, Kazuhide Takeuchi & Junichi Yoshikawa

  2. Department of Internal Medicine, Tane General Hospital, 550-0024, Osaka, Japan

    Kazuo Sakamoto

  3. Department of Internal Medicine, Izumi City Hospital, 594-0071, Izumi, Japan

    Yoshio Kawase & Masaki Nishimoto

Authors
  1. Masakazu Teragaki
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  2. Iku Toda
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  3. Kazuo Sakamoto
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  4. Kenei Shimada
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  5. Hiroyuki Yamagishi
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  6. Minoru Yoshiyama
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  7. Kaname Akioka
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  8. Yoshio Kawase
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  9. Masaki Nishimoto
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  10. Kazuhide Takeuchi
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  11. Junichi Yoshikawa
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Teragaki, M., Toda, I., Sakamoto, K. et al. Endomyocardial biopsy findings in patients with atrioventricular block in the absence of apparent heart disease. Heart Vessels 14, 170–176 (1999). https://doi.org/10.1007/BF02482303

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  • DOI: https://doi.org/10.1007/BF02482303

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