Amiodarone distribution in human tissues after long-term therapy: a case of arrhythmogenic right ventricular cardiomyopathy.
The tissue distribution of amiodarone and desethylamiodarone, its active metabolite, was examined in an autopsied case, an 85-year-old man, with arrhythmogenic right ventricular cardiomyopathy (ARVC) who had been receiving amiodarone for 4 years. High concentrations of amiodarone, a very highly lipophilic compound, were found in adipose and bone marrow tissues. Despite a low dose (100 mg daily), the concentrations of amiodarone were higher in the epicardial fat (570.4 microg/g) and in the right atrium (165.3 microg/g) than previously reported in patients with other cardiac diseases. The ratios of amiodarone/ desethylamiodarone concentrations in both tissues were >1. This unique distribution demonstrates the involvement of histological characteristics of ARVC, such as fatty replacement of myocardium. We anticipate that a low dose of amiodarone would be effective in preventing arrhythmia in some patients with ARVC.
Hosaka
Fumitaka
F
Department of Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University, Japan
Shiga
Tsuyoshi
T
Sakomura
Yasunari
Y
Wakaumi
Michi
M
Matsuda
Naoki
N
Kasanuki
Hiroshi
H
D000273:Adipose Tissue / Q000187:drug effects* / Q000378:metabolism*; D000368:Aged; D000369:Aged, 80 and over; D000638:Amiodarone / Q000378:metabolism / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000378:metabolism / Q000627:therapeutic use*; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000188:drug therapy / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D004562:Electrocardiography; D006352:Heart Ventricles / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008297:Male; D013995:Time; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone