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Chen KH, Chou YC, Hsiao CY, Chien Y, Wang KL, Lai YH, Chang YL, Niu DM, Yu WC. Amelioration of serum 8-OHdG level by enzyme replacement therapy in patients with Fabry cardiomyopathy. Biochem Biophys Res Commun 2017; 486:293-299. [DOI: 10.1016/j.bbrc.2017.03.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 03/11/2017] [Indexed: 10/20/2022]
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Chong Y, Kim M, Koh ES, Shin SJ, Kim HS, Chung S. Identification of a novel GLA mutation (Y88C) in a Korean family with Fabry nephropathy: a case report. BMC MEDICAL GENETICS 2016; 17:76. [PMID: 27776503 PMCID: PMC5078899 DOI: 10.1186/s12881-016-0338-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 10/17/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Fabry disease is a rare X-linked lysosomal storage disorder caused by α-galactosidase A deficiency. With the advancement of molecular diagnostic tools, more disease-causing mutations in α-galactosidase A (GLA) have been identified in Fabry disease. We found a novel mutation in a Korean family with predominant renal manifestations of the disease. CASE PRESENTATION A 24-year-old man who wanted to donate a kidney to his 28-year-old brother with end-stage renal disease of unknown cause was evaluated. The 24-year-old man underwent percutaneous renal biopsy because of an accidentally found proteinuria. Electron microscopy of his renal biopsy showed numerous electron-dense multi-lamellar inclusions in the epithelial cytoplasm, typical for Fabry disease. Clinical and laboratory evaluation including the assessment of GLA enzyme activity and direct DNA sequencing in four members of the family were performed. Renal biopsy findings in the two affected male patients were described. Re-evaluation of a renal biopsy specimen of his 28-year-old brother obtained when he was diagnosed with renal failure revealed a very focal area of suspicious multilamellated structures in the Bowman's space. DNA sequencing on the young man, his brother, and his mother revealed a novel GLA gene mutation, c.263A > G (p.Tyr88Cys). The three all showed decreased α-galactosidase A activity. CONCLUSION A novel GLA mutation, c.263A > G (p.Tyr88Cys), was found in a Korean family with predominant renal manifestations of Fabry disease.
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Affiliation(s)
- Yosep Chong
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Minyoung Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eun Sil Koh
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seok Joon Shin
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ho-Shik Kim
- Department of Biochemistry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sungjin Chung
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Beirão I, Cabrita A, Torres M, Silva F, Aguiar P, Gomes AM. Anderson-Fabry Disease. JOURNAL OF INBORN ERRORS OF METABOLISM AND SCREENING 2016. [DOI: 10.1177/2326409816669372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Idalina Beirão
- Centro Hospitalar do Porto, Largo Professor Abel Salazar, Porto, Portugal
| | - Ana Cabrita
- Service of Centro Hospitalar do Algarve, Rua Leao Penedo, Faro, Portugal
| | - Márcia Torres
- Centro Hospitalar do Médio Ave, Largo Domingos Moreira, Santo Tirso, Portugal
| | - Fernando Silva
- Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Patricio Aguiar
- Hospital de Santa Maria/Centro Hospitalar Lisboa Norte, Avenida Professor Egas Moniz, Lisboa, Portugal
| | - Ana Marta Gomes
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Fernández A, Politei J. Cardiac Manifestation of Fabry Disease. JOURNAL OF INBORN ERRORS OF METABOLISM AND SCREENING 2016. [DOI: 10.1177/2326409816661352] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Adrián Fernández
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - Juan Politei
- Division of Neurometabolism, Department of Neurology, Foundation for Study of Neurometabolic Diseases (FESEN), Buenos Aires, Argentina
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Silbiger JJ. Abnormalities of the Mitral Apparatus in Hypertrophic Cardiomyopathy: Echocardiographic, Pathophysiologic, and Surgical Insights. J Am Soc Echocardiogr 2016; 29:622-39. [DOI: 10.1016/j.echo.2016.03.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Indexed: 12/30/2022]
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Tanislav C, Guenduez D, Liebetrau C, Giese AK, Eichler S, Sieweke N, Speth M, Bauer T, Hamm C, Rolfs A. Cardiac Troponin I: A Valuable Biomarker Indicating the Cardiac Involvement in Fabry Disease. PLoS One 2016; 11:e0157640. [PMID: 27322070 PMCID: PMC4913911 DOI: 10.1371/journal.pone.0157640] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 06/02/2016] [Indexed: 11/30/2022] Open
Abstract
Objectives Assessment of the clinical severity of Fabry disease (FD), an X-linked, rare, progressive disorder based on a genetic defect in alpha-galactosidase is challenging, especially regarding cardiac involvement. The aim of the study was to evaluate the diagnostic value of cardiac troponin I (cTnI) in discriminating FD patients with cardiac involvement in a large FD patient cohort. Methods cTnI levels were measured with a contemporary sensitive assay in plasma samples taken routinely from FD patients. The assay was calibrated to measure cTnI levels ≥0.01 ng/ml. Elevated cTnI values (cut-off ≥0.04 ng/ml) were correlated with clinical data. Results cTnI was assessed in 62 FD patients (median age: 47 years, males: 36%). Elevated cTnI levels were detected in 23 (37%) patients. Patients with a cTnI elevation were older (median 55 years versus 36 years, p<0.001). Elevated cTnI levels were associated with the presence of a LVH (16/23 versus 1/39; OR 65.81, CI: 6.747–641.859; p<0.001). In almost all patients with a left ventricular hypertrophy (LVH) elevated cTnI levels were detected (16/17, 94%). Absolute cTnI levels in patients with LVH were higher than in those without (median 0.23 ng/ml versus 0.02 ng/ml; p<0.001). A cTnI level <0.04ng/ml had a high negative predictive value regarding the presence of a LVH (38/39, 97%). In a control group of non-FD patients (n = 17) with LVH (due to hypertension) none showed cTnI levels ≥0.01 ng/ml. Conclusions Elevated cTnI levels are common in FD patients, reflecting cardiac involvement. FD patients might benefit from a continuous cTnI monitoring.
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Affiliation(s)
- Christian Tanislav
- Department of Neurology, Justus Liebig University, Giessen, Germany
- * E-mail: (CT); (DG)
| | - Dursun Guenduez
- Department of Cardiology and Angiology, Justus Liebig University, Giessen, Germany
- * E-mail: (CT); (DG)
| | - Christoph Liebetrau
- Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany
- German Centre for Cardiovascular Research (DZHK), partner site RheinMain, Frankfurt am Main, Germany
| | - Anne Kathrin Giese
- Albrecht-Kossel Institute for Neuroregeneration, University of Rostock, Rostock, Germany
| | - Sabrina Eichler
- Albrecht-Kossel Institute for Neuroregeneration, University of Rostock, Rostock, Germany
- Centogene, Rostock, Germany
| | - Nicole Sieweke
- Department of Neurology, Justus Liebig University, Giessen, Germany
| | - Maria Speth
- Department of Clinical Chemistry, Justus Liebig University, Giessen, Germany
| | - Timm Bauer
- Department of Cardiology and Angiology, Justus Liebig University, Giessen, Germany
| | - Christian Hamm
- Department of Cardiology and Angiology, Justus Liebig University, Giessen, Germany
- Kerckhoff Heart and Thorax Center, Department of Cardiology, Bad Nauheim, Germany
- German Centre for Cardiovascular Research (DZHK), partner site RheinMain, Frankfurt am Main, Germany
| | - Arndt Rolfs
- Albrecht-Kossel Institute for Neuroregeneration, University of Rostock, Rostock, Germany
- Centogene, Rostock, Germany
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Reduced Right Ventricular Native Myocardial T1 in Anderson-Fabry Disease: Comparison to Pulmonary Hypertension and Healthy Controls. PLoS One 2016; 11:e0157565. [PMID: 27305064 PMCID: PMC4909219 DOI: 10.1371/journal.pone.0157565] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 06/01/2016] [Indexed: 11/19/2022] Open
Abstract
AIMS Anderson-Fabry disease (AFD) is characterized by progressive multiorgan accumulation of intracellular sphingolipids due to α-galactosidase A enzyme deficiency, resulting in progressive ventricular hypertrophy, heart failure, arrhythmias, and death. Decreased native (non-contrast) left ventricular (LV) T1 (longitudinal relaxation time) with MRI discriminates AFD from healthy controls or other presentations of concentric hypertrophy, but the right ventricle (RV) has not been studied. The aims of the current study were to evaluate native RV T1 values in AFD, with a goal of better understanding the pathophysiology of RV involvement. METHODS AND RESULTS Native T1 values were measured in the inferior RV wall (RVI), interventricular septum (IVS), and inferior LV (LVI) in patients with AFD, patients with pulmonary hypertension, who provided an alternative RV pathological process for comparison, and healthy controls. A minimum wall thickness of 4 mm was selected to minimize partial volume errors in tissue T1 analysis. T1 analysis was performed in 6 subjects with AFD, 6 subjects with PH, and 21 controls. Native T1 values were shorter (adjusted p<0.05 for all comparisons), independent of location, in subjects with AFD (RVI-T1 = 1096±49 ms, IVS-T1 = 1053±41 ms, LVI-T1 = 1072±44 ms) compared to both PH (RVI-T1 = 1239±41 ms, IVS-T1 = 1280±123 ms, LVI-T1 = 1274±57 ms) and HC (IVS-T1 = 1180±60 ms, LVI-T1 = 1183±45 ms). RVI measurements were not possible in controls due to insufficient wall thickness. CONCLUSION Native T1 values appear similarly reduced in the left and right ventricles of individuals with AFD and RV wall thickening, suggesting a common pathology. In contrast, individuals with PH and thickened RVs showed increased native T1 values in both ventricles, suggestive of fibrosis.
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Rodda OA, Lynch M, Parsons S. Sudden death following AV node ablation in a man with Fabry disease mimicking hypertrophic cardiomyopathy. J Forensic Leg Med 2016; 42:8-10. [PMID: 27213840 DOI: 10.1016/j.jflm.2016.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 05/04/2016] [Indexed: 11/25/2022]
Abstract
We present a case of Fabry disease with an uncommon pattern of asymmetrical hypertrophy with septal prominence resulting in an erroneous diagnosis of hypertrophic cardilmyopathy clinically. The deceased presented for a medicolegal autopsy following his sudden death after an AV node ablation. Fabry disease continues to be an important misdiagnosis of hypertrophic cardiomyopathy in a clinical setting. Early diagnosis of Fabry disease is essential so that early treatment can be instituted.
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Affiliation(s)
- Odette A Rodda
- Victorian Institute of Forensic Medicine, Melbourne, Australia
| | - Matthew Lynch
- Victorian Institute of Forensic Medicine, Melbourne, Australia; Department of Forensic Medicine, Monash University, Melbourne, Australia
| | - Sarah Parsons
- Victorian Institute of Forensic Medicine, Melbourne, Australia; Department of Forensic Medicine, Monash University, Melbourne, Australia.
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Namdar M. Electrocardiographic Changes and Arrhythmia in Fabry Disease. Front Cardiovasc Med 2016; 3:7. [PMID: 27047943 PMCID: PMC4805598 DOI: 10.3389/fcvm.2016.00007] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 03/08/2016] [Indexed: 01/28/2023] Open
Abstract
Fabry disease is an X-chromosome-linked lysosomal storage disease characterized by a deficient activity or, in most males, absence of the enzyme α-galactosidase A (a-Gal A) leading to systemic, primary lysosomal accumulation of globotriaosylceramide (Gb3) (1). Recent literature refers to an overall birth prevalence of 1:40,000–170,000; however, such data do not allow an estimation on an actual patient number suffering from Fabry disease (2). Multisystem morbidity commonly develops in childhood and, with progression of the disease, life-threatening complications often occur in adulthood, including renal failure, cardiovascular dysfunction, neuropathy, and stroke (3–6). Life expectancy is reduced by an average of 15 years in female patients and 20 years in male patients (7, 8). The pathognomonic Gb3 accumulation has been repeatedly observed over the past decades by many groups in vascular endothelial and smooth muscle cells, cardiomyocytes, cardiac conduction tissue, and valvular fibroblasts (3). Although incompletely described, it is likely that inflammatory and neurohormonal mechanisms are involved in subsequent cellular and vascular dysfunction, leading to tissue ischemia, hypertrophy, and fibrosis (9). Furthermore, recently published works on cardiomyocyte dysfunction and conduction tissue involvement have suggested that cardiac dysfunction may reflect increased myocardial nitric oxide production with oxidative damage of cardiomyocyte myofilaments and DNA, causing cell dysfunction and death, and accelerated conduction with prolonged refractoriness and electric instability (10, 11).
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Affiliation(s)
- Mehdi Namdar
- Service de Cardiologie, Hôpitaux Universitaires de Genève , Geneva , Switzerland
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Left Ventricular Geometry and Blood Pressure as Predictors of Adverse Progression of Fabry Cardiomyopathy. PLoS One 2015; 10:e0140627. [PMID: 26600044 PMCID: PMC4658091 DOI: 10.1371/journal.pone.0140627] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 09/28/2015] [Indexed: 01/18/2023] Open
Abstract
Background In spite of several research studies help to describe the heart in Fabry disease (FD), the cardiomyopathy is not entirely understood. In addition, the impact of blood pressure and alterations in geometry have not been systematically evaluated. Methods In 74 FD patients (mean age 36±12 years; 45 females) the extent of myocardial fibrosis and its progression were quantified using cardiac magnetic-resonance-imaging with late enhancement technique (LE). Results were compared to standard echocardiography complemented by 2D-speckle-tracking, 3D-sphericity-index (SI) and standardized blood pressure measurement. At baseline, no patient received enzyme replacement therapy (ERT). After 51±24 months, a follow-up examination was performed. Results Systolic blood pressure (SBP) was higher in patients with vs. without LE: 123±17 mmHg vs. 115±13 mmHg; P = 0.04. A positive correlation was found between SI and the amount of LE-positive myocardium (r = 0.51; P<0.001) indicating an association of higher SI in more advanced stages of the cardiomyopathy. SI at baseline was positively associated with the increase of LE-positive myocardium during follow-up. The highest SBP (125±19 mmHg) and also the highest SI (0.32±0.05) was found in the subgroup with a rapidly increasing LE (ie, ≥0.2% per year; n = 16; P = 0.04). Multivariate logistic regression analysis including SI, SBP, EF, left ventricular volumes, wall thickness and NT-proBNP adjusted for age and sex showed SI as the most powerful parameter to detect rapid progression of LE (AUC = 0.785; P<0.05). Conclusions LV geometry as assessed by the sphericity index is altered in relation to the stage of the Fabry cardiomyopathy. Although patients with FD are not hypertensive, the SBP has a clear impact on the progression of the cardiomyopathy.
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Evaluation of Proinflammatory Prognostic Biomarkers for Fabry Cardiomyopathy With Enzyme Replacement Therapy. Can J Cardiol 2015; 32:1221.e1-1221.e9. [PMID: 26919792 DOI: 10.1016/j.cjca.2015.10.033] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/12/2015] [Accepted: 10/28/2015] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Fabry disease (FD) causes progressive glycosphingolipid accumulation and damage in various organs, and several proinflammatory processes may be involved in this disease. Enzyme replacement therapy (ERT) can reduce the severity of Fabry cardiomyopathy (FC), but whether ERT could attenuate proinflammatory cytokines in FC remains unclear. In this study, we attempted to evaluate the efficacy of ERT on proinflammatory cytokines and vascular cell adhesion biomarkers. METHODS We enrolled 25 patients with FC and administered ERT to them according to the present clinical guideline. We analyzed and compared echocardiographic and blood examination results between 25 patients with FD without left ventricular hypertrophy (LVH), 25 patients with FC with LVH who were receiving ERT, and 25 healthy age- and sex-matched controls. The parameters of cardiac function at baseline and 12 months after ERT were assessed through echocardiography, and the expression profiles of proinflammatory biomarkers were determined. RESULTS Left ventricular mass (LVM), LVM index (LVMI), interventricular septal thickness at diastole, and serum levels of globotriaosylsphingosine (Gb3) were elevated in patients with FC. Meanwhile, several proinflammatory cytokines, including interleukin (IL)-6, IL-2, IL-1b, tumor necrosis factor-α, intercellular adhesion molecule, soluble vascular cell adhesion molecule, and monocyte chemoattractant protein-1 (MCP-1) were concomitantly increased. ERT significantly reduced these transthoracic echocardiographic parameters and lyso-Gb3 and proinflammatory cytokine levels. The changes in IL-6, MCP-1, and lyso-Gb3 levels were positively correlated with the change in LVMI. CONCLUSIONS Our study has revealed that proinflammatory biomarkers, particularly IL-6 and MCP-1, may represent effective biomarkers for evaluating ERT outcomes in patients with FC.
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Baptista A, Magalhães P, Leão S, Carvalho S, Mateus P, Moreira I. Screening for Fabry disease in left ventricular hypertrophy: documentation of a novel mutation. Arq Bras Cardiol 2015; 105:139-44. [PMID: 26269958 PMCID: PMC4559122 DOI: 10.5935/abc.20150090] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Fabry disease is a lysosomal storage disease caused by enzyme α-galactosidase A deficiency as a result of mutations in the GLA gene. Cardiac involvement is characterized by progressive left ventricular hypertrophy. OBJECTIVE To estimate the prevalence of Fabry disease in a population with left ventricular hypertrophy. METHODS The patients were assessed for the presence of left ventricular hypertrophy defined as a left ventricular mass index ≥ 96 g/m2 for women or ≥ 116 g/m2 for men. Severe aortic stenosis and arterial hypertension with mild left ventricular hypertrophy were exclusion criteria. All patients included were assessed for enzyme α-galactosidase A activity using dry spot testing. Genetic study was performed whenever the enzyme activity was decreased. RESULTS A total of 47 patients with a mean left ventricular mass index of 141.1 g/m2 (± 28.5; 99.2 to 228.5 g/m2] were included. Most of the patients were females (51.1%). Nine (19.1%) showed decreased α-galactosidase A activity, but only one positive genetic test - [GLA] c.785G>T; p.W262L (exon 5), a mutation not previously described in the literature. This clinical investigation was able to establish the association between the mutation and the clinical presentation. CONCLUSION In a population of patients with left ventricular hypertrophy, we documented a Fabry disease prevalence of 2.1%. This novel case was defined in the sequence of a mutation of unknown meaning in the GLA gene with further pathogenicity study. Thus, this study permitted the definition of a novel causal mutation for Fabry disease - [GLA] c.785G>T; p.W262L (exon 5).
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Affiliation(s)
- Ana Baptista
- Unidade de Vila Real, Centro Hospitalar de Trás-os-Montes e Alto Douro, PT
| | - Pedro Magalhães
- Unidade de Vila Real, Centro Hospitalar de Trás-os-Montes e Alto Douro, PT
| | - Sílvia Leão
- Unidade de Vila Real, Centro Hospitalar de Trás-os-Montes e Alto Douro, PT
| | - Sofia Carvalho
- Unidade de Vila Real, Centro Hospitalar de Trás-os-Montes e Alto Douro, PT
| | - Pedro Mateus
- Unidade de Vila Real, Centro Hospitalar de Trás-os-Montes e Alto Douro, PT
| | - Ilídio Moreira
- Unidade de Vila Real, Centro Hospitalar de Trás-os-Montes e Alto Douro, PT
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Goláň L, Goker-Alpan O, Holida M, Kantola I, Klopotowski M, Kuusisto J, Linhart A, Musial J, Nicholls K, Gonzalez-Rodriguez D, Sharma R, Vujkovac B, Chang P, Wijatyk A. Evaluation of the efficacy and safety of three dosing regimens of agalsidase alfa enzyme replacement therapy in adults with Fabry disease. DRUG DESIGN DEVELOPMENT AND THERAPY 2015; 9:3435-44. [PMID: 26185417 PMCID: PMC4501226 DOI: 10.2147/dddt.s80928] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Purpose Efficacy and safety of agalsidase alfa at 0.2 mg/kg weekly were compared with 0.2 mg/kg every other week (EOW). Exploratory analyses were performed for 0.4 mg/kg weekly. Patients and methods This was a 53-week, Phase III/IV, multicenter, open-label study (NCT01124643) in treatment-naïve adults (≥18 years) with Fabry disease. Inclusion criteria were left ventricular hypertrophy at baseline, defined as left ventricular mass indexed to height >50 g/m2.7 for males and >47 g/m2.7 for females. Primary endpoint was reduction of left ventricular mass indexed to height as assessed by echocardiography. Secondary endpoints included cardiac (peak oxygen consumption, 6-minute walk test, Minnesota Living with Heart Failure Questionnaire, New York Heart Association classification), renal (Modification of Diet in Renal Disease, estimated glomerular filtration rate), and biomarker (plasma globotriaosylceramide) assessments. Safety endpoints were adverse events and anti–agalsidase alfa antibodies. Results Twenty patients were randomized to 0.2 mg/kg EOW (mean age, 50.3 years; 70% male), 19 to 0.2 mg/kg weekly (51.8 years; 53% male), and 5 to 0.4 mg/kg weekly (49.4 years; 40% male). The mean change in left ventricular mass indexed to height by Week 53 in the 0.2-mg/kg EOW and weekly groups was 3.2 g/m2.7 and 0.5 g/m2.7, with no significant difference between groups. No clinically meaningful changes by Week 53 were found within or between the 0.2-mg/kg groups for peak oxygen consumption, 6-minute walk test, or Minnesota Living with Heart Failure Questionnaire. Two patients in each group improved by ≥1 New York Heart Association classification. No significant differences were found between 0.2 mg/kg EOW and weekly for mean change in estimated glomerular filtration rate (−1.21 mL/min/1.73 m2 vs −3.32 mL/min/1.73 m2) or plasma globotriaosylceramide (−1.05 nmol/mL vs −2.13 nmol/mL), respectively. Infusion-related adverse events were experienced by 25% and 21% in the 0.2-mg/kg EOW and weekly groups. Tachycardia, fatigue, and hypotension were experienced by two or more patients overall. Anti–agalsidase alfa antibodies were detected in 11.4% of patients and neutralizing antibodies in 6.8%. Infusion-related reactions did not appear to be correlated with antibody status. Conclusion No efficacy or safety differences were found when the approved EOW dosage of agalsidase alfa was increased to weekly administration. Exploratory analyses for 0.4 mg/kg weekly showed similar results.
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Affiliation(s)
- Lubor Goláň
- First Faculty of Medicine, Department of Cardiovascular Medicine, Charles University, Prague, Czech Republic
| | | | - Myrl Holida
- Stead Family Department of Pediatrics, Division of Medical Genetics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Ikka Kantola
- Division of Medicine, Turku University Hospital, Turku, Finland
| | | | - Johanna Kuusisto
- Department of Medicine, Center for Medicine and Clinical Research, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Aleš Linhart
- First Faculty of Medicine, Department of Cardiovascular Medicine, Charles University, Prague, Czech Republic
| | - Jacek Musial
- Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Kathleen Nicholls
- Department of Nephrology, Royal Melbourne Hospital and the University of Melbourne, VIC, Australia
| | | | | | - Bojan Vujkovac
- General Hospital Slovenj Gradec, Slovenj Gradec, Slovenia
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Rodrigues P, Santos M, Marinho A, Cabral S, Vieira M, Reis H, Palma P, Torres S. Facing the challenges of ventricular hypertrophy: the eyes don't lie. Rev Port Cardiol 2014; 33:647.e1-5. [PMID: 25282716 DOI: 10.1016/j.repc.2014.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 02/09/2014] [Accepted: 03/31/2014] [Indexed: 11/29/2022] Open
Abstract
We describe the case of a 47-year-old man with new-onset heart failure who was found to have severe biventricular wall thickening. We present comprehensive data from invasive and non-invasive multimodality imaging, genetic and histologic tests, and briefly describe their importance in the final diagnosis. To our knowledge, this is the first case of the Portuguese variant of familial amyloid polyneuropathy presenting with heart failure in the fifth decade of life. This is an unusual case report, but also an illustration of how to approach any patient with suspected infiltrative cardiomyopathy.
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Affiliation(s)
| | - Mário Santos
- Cardiology Department, Centro Hospitalar do Porto, Porto, Portugal
| | - António Marinho
- Internal Medicine Department, Centro Hospitalar do Porto, Porto, Portugal
| | - Sofia Cabral
- Cardiology Department, Centro Hospitalar do Porto, Porto, Portugal
| | - Miguel Vieira
- Cardiology Department, Centro Hospitalar do Porto, Porto, Portugal
| | - Hipólito Reis
- Cardiology Department, Centro Hospitalar do Porto, Porto, Portugal
| | - Paulo Palma
- Cardiology Department, Centro Hospitalar do Porto, Porto, Portugal
| | - Severo Torres
- Cardiology Department, Centro Hospitalar do Porto, Porto, Portugal
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Facing the challenges of ventricular hypertrophy: The eyes don’t lie. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2014. [DOI: 10.1016/j.repce.2014.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Comprehensive clinical evaluation of a large Spanish family with Anderson-Fabry disease, novel GLA mutation and severe cardiac phenotype. Med Clin (Barc) 2014; 142:497-504. [DOI: 10.1016/j.medcli.2014.01.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 01/20/2014] [Accepted: 01/23/2014] [Indexed: 11/21/2022]
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Mawatari K, Yasukawa H, Oba T, Nagata T, Togawa T, Tsukimura T, Kyogoku S, Ohshima H, Minami T, Sugi Y, Sakuraba H, Imaizumi T. Screening for Fabry disease in patients with left ventricular hypertrophy. Int J Cardiol 2013; 167:1059-61. [DOI: 10.1016/j.ijcard.2012.10.076] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 10/28/2012] [Indexed: 11/27/2022]
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