Arrhythmogenic Right Ventricular Cardiomyopathy: Progress Toward Personalized Management.

Abstract:

:Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited heart disease characterized by fibrofatty replacement of the ventricular myocardium, a high risk of ventricular arrhythmias, and progressive ventricular dysfunction. The clinical course is highly variable, and optimal approaches to management remain undefined. ARVC is associated with pathogenic variants in genes encoding the cardiac desmosome. Genetic testing facilitates identification of at-risk family members, but penetrance of ARVC in pathogenic variant carriers is difficult to predict. Participation in endurance exercise is a known key risk factor. However, there remains significant uncertainty about which family member will develop disease and how best to approach longitudinal screening. Our clinically focused review describes how new insights gained from natural history studies, improved understanding of pathogenic mechanisms, and appreciation of genetic and environmental modifiers have set the stage for developing personalized approaches to managing both ARVC patients and their at-risk family members.

journal_name

Annu Rev Med

authors

James CA,Calkins H

doi

10.1146/annurev-med-041217-010932

subject

Has Abstract

pub_date

2019-01-27 00:00:00

pages

1-18

eissn

0066-4219

issn

1545-326X

journal_volume

70

pub_type

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