151
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Cardiac transplantation in children. BJA Educ 2019; 19:105-112. [DOI: 10.1016/j.bjae.2019.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2019] [Indexed: 11/30/2022] Open
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152
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Ciuca C, Ragni L, Hasan T, Balducci A, Angeli E, Prandstraller D, Egidy-Assenza G, Donti A, Bonvicini M, Gargiulo GD. Dilated cardiomyopathy in a pediatric population: etiology and outcome predictors - a single-center experience. Future Cardiol 2019; 15:95-107. [PMID: 30848673 DOI: 10.2217/fca-2018-0030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIM The aim of the study was to assess predictors of outcome in patients hospitalized for dilated cardiomyopathy (DCM) and severe left ventricular dysfunction. Patients & methods: 83 pediatric patients hospitalized for heart failure due to DCM with coexistent left ventricular dysfunction were enrolled. RESULTS Overall, 5-year survival free from heart transplantation was 69.8%. Normalization of left ventricular function was achieved in 39.8% of patients during follow-up: younger age, less necessity of inotropic support and other than idiopathic DCM predicted left ventricular function, while familial history for cardiac disease or sudden death and inotropic support during hospitalization were associated with poorer outcome. CONCLUSION Almost 40% of patients with DCM experienced a complete normalization of cardiac function. Outcome was extremely variable according to the type of DCM.
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Affiliation(s)
- Cristina Ciuca
- Pediatric Cardiology & GUCH Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
| | - Luca Ragni
- Pediatric Cardiology & GUCH Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
| | - Tammam Hasan
- Pediatric Cardiology & GUCH Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
| | - Anna Balducci
- Pediatric Cardiology & GUCH Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
| | - Emanuela Angeli
- Pediatric & Grown-up Congenital Cardiac Surgery Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
| | - Daniela Prandstraller
- Pediatric Cardiology & GUCH Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
| | - Gabriele Egidy-Assenza
- Pediatric Cardiology & GUCH Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
| | - Andrea Donti
- Pediatric Cardiology & GUCH Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
| | - Marco Bonvicini
- Pediatric Cardiology & GUCH Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
| | - Gaetano D Gargiulo
- Pediatric & Grown-up Congenital Cardiac Surgery Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
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153
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Handley MT, Reddy K, Wills J, Rosser E, Kamath A, Halachev M, Falkous G, Williams D, Cox P, Meynert A, Raymond ES, Morrison H, Brown S, Allan E, Aligianis I, Jackson AP, Ramsahoye BH, von Kriegsheim A, Taylor RW, Finch AJ, FitzPatrick DR. ITPase deficiency causes a Martsolf-like syndrome with a lethal infantile dilated cardiomyopathy. PLoS Genet 2019; 15:e1007605. [PMID: 30856165 PMCID: PMC6428344 DOI: 10.1371/journal.pgen.1007605] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 03/21/2019] [Accepted: 12/27/2018] [Indexed: 12/30/2022] Open
Abstract
Typical Martsolf syndrome is characterized by congenital cataracts, postnatal microcephaly, developmental delay, hypotonia, short stature and biallelic hypomorphic mutations in either RAB3GAP1 or RAB3GAP2. Genetic analysis of 85 unrelated "mutation negative" probands with Martsolf or Martsolf-like syndromes identified two individuals with different homozygous null mutations in ITPA, the gene encoding inosine triphosphate pyrophosphatase (ITPase). Both probands were from multiplex families with a consistent, lethal and highly distinctive disorder; a Martsolf-like syndrome with infantile-onset dilated cardiomyopathy. Severe ITPase-deficiency has been previously reported with infantile epileptic encephalopathy (MIM 616647). ITPase acts to prevent incorporation of inosine bases (rI/dI) into RNA and DNA. In Itpa-null cells dI was undetectable in genomic DNA. dI could be identified at a low level in mtDNA without detectable mitochondrial genome instability, mtDNA depletion or biochemical dysfunction of the mitochondria. rI accumulation was detectable in proband-derived lymphoblastoid RNA. In Itpa-null mouse embryos rI was detectable in the brain and kidney with the highest level seen in the embryonic heart (rI at 1 in 385 bases). Transcriptome and proteome analysis in mutant cells revealed no major differences with controls. The rate of transcription and the total amount of cellular RNA also appeared normal. rI accumulation in RNA-and by implication rI production-correlates with the severity of organ dysfunction in ITPase deficiency but the basis of the cellulopathy remains cryptic. While we cannot exclude cumulative minor effects, there are no major anomalies in the production, processing, stability and/or translation of mRNA.
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Affiliation(s)
- Mark T. Handley
- MRC Human Genetics Unit, Institute of Genomic and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
- Section of Genetics, Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, United Kigndom
| | - Kaalak Reddy
- MRC Human Genetics Unit, Institute of Genomic and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
- University of Florida College of Medicine, Center for NeuroGenetics, Gainesville, United States of America
| | - Jimi Wills
- Edinburgh Cancer Research Centre, MRC Institute of Genomic and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Elisabeth Rosser
- Department of Clinical Genetics, Great Ormond St Hospital, London, United Kingdom
| | - Archith Kamath
- Medical School, University of Oxford, John Radcliffe Hospital Oxford United Kingdom
| | - Mihail Halachev
- MRC Human Genetics Unit, Institute of Genomic and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Gavin Falkous
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Denise Williams
- Department of Clinical Genetics, Birmingham Women's and Children's NHSFT, Birmingham, United Kingdom
| | - Phillip Cox
- Department of Histopathology, Birmingham Women's and Children's NHSFT, Birmingham United Kingdom
| | - Alison Meynert
- MRC Human Genetics Unit, Institute of Genomic and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Eleanor S. Raymond
- MRC Human Genetics Unit, Institute of Genomic and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Harris Morrison
- MRC Human Genetics Unit, Institute of Genomic and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Stephen Brown
- MRC Human Genetics Unit, Institute of Genomic and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Emma Allan
- CBS-IGMM Transgenic Unit, University of Edinburgh, Edinburgh, United Kingdom
| | - Irene Aligianis
- MRC Human Genetics Unit, Institute of Genomic and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Andrew P. Jackson
- MRC Human Genetics Unit, Institute of Genomic and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Bernard H. Ramsahoye
- Centre for Genetic and Experimental Medicine, Institute of Genomic and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Alex von Kriegsheim
- Edinburgh Cancer Research Centre, MRC Institute of Genomic and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Robert W. Taylor
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Andrew J. Finch
- Edinburgh Cancer Research Centre, MRC Institute of Genomic and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - David R. FitzPatrick
- MRC Human Genetics Unit, Institute of Genomic and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
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154
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You H, Jiang W, Jiao M, Wang X, Jia L, You S, Li Y, Wen H, Jiang H, Yuan H, Huang J, Qiao B, Yang Y, Jin M, Wang Y, Du J. Association of Soluble ST2 Serum Levels With Outcomes in Pediatric Dilated Cardiomyopathy. Can J Cardiol 2019; 35:727-735. [PMID: 31151708 DOI: 10.1016/j.cjca.2019.02.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/18/2019] [Accepted: 02/18/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Prognosis in patients with pediatric dilated cardiomyopathy (PDCM) is urgently required to identify high-risk patients. Elevated soluble ST2 (sST2) is associated with prognosis in adult patients with heart failure. This study aimed to assess the prognostic value of sST2 in PDCM. METHODS Ninety-four patients with PDCM were enrolled after admission from 2 centres in China and followed up for adverse events (death, cardiac transplantation, and heart-failure-related rehospitalization). B-type natriuretic peptide (BNP) and sST2 levels were measured. RESULTS Over a median of 678 (interquartile range [IQR]: 533-785) days, 28 (29.8%) adverse events occurred. Patients in the highest tertile of sST2 levels had increased risk of short-term (< 6 months) (adjusted hazard ratio [HR]: 8.36, 95% confidence interval [CI], 1.02-73.52; P < 0.05) and long-term adverse events (2 years) (adjusted HR: 4.23; 95% CI, 1.32-13.60; P < 0.01) than those in lower tertiles. The C-statistic was increased with addition of sST2 to BNP from 0.697 (95% CI, 0.541-0.852) to 0.812 (95% CI, 0.697-0.939) for short-term and from 0.712 (95% CI, 0.604-0.819) to 0.798 (95% CI, 0.697-0.899) for prediction of long-term adverse events. An intermediate-risk subgroup was identified, and 24% had adverse events. When serial measurements were taken in a nested case-control subgroup, sST2 levels were constantly high in patients with late adverse events (> 6 months) but gradually decreased in nonadverse-event controls compared with 3-month and 6-month baseline levels. CONCLUSIONS In patients with PDCM, serum sST2 levels are associated with adverse events and have robust prognostic value. Serial measurements of sST2 could help in managing patients for monitoring outcomes of treatment.
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Affiliation(s)
- Hongzhao You
- Beijing Anzhen Hospital, Capital Medical University; Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education; Beijing Collaborative Innovation Centre for Cardiovascular Disorders; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China; State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute, Fuwai Hospital and National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenxi Jiang
- Beijing Anzhen Hospital, Capital Medical University; Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education; Beijing Collaborative Innovation Centre for Cardiovascular Disorders; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Meng Jiao
- Beijing Anzhen Hospital, Capital Medical University; Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education; Beijing Collaborative Innovation Centre for Cardiovascular Disorders; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China; Department of Pediatric Heart Centre, Beijing Anzhen Hospital, Capital Medical University; Beijing Pediatric Heart Centre, Beijing, China
| | - Xue Wang
- Beijing Anzhen Hospital, Capital Medical University; Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education; Beijing Collaborative Innovation Centre for Cardiovascular Disorders; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Lixin Jia
- Beijing Anzhen Hospital, Capital Medical University; Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education; Beijing Collaborative Innovation Centre for Cardiovascular Disorders; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Shijie You
- State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute, Fuwai Hospital and National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yulin Li
- Beijing Anzhen Hospital, Capital Medical University; Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education; Beijing Collaborative Innovation Centre for Cardiovascular Disorders; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Haichu Wen
- Beijing Anzhen Hospital, Capital Medical University; Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education; Beijing Collaborative Innovation Centre for Cardiovascular Disorders; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Hongfeng Jiang
- Beijing Anzhen Hospital, Capital Medical University; Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education; Beijing Collaborative Innovation Centre for Cardiovascular Disorders; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Hui Yuan
- Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Jie Huang
- State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute, Fuwai Hospital and National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bokang Qiao
- Beijing Anzhen Hospital, Capital Medical University; Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education; Beijing Collaborative Innovation Centre for Cardiovascular Disorders; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Ya Yang
- Beijing Anzhen Hospital, Capital Medical University; Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education; Beijing Collaborative Innovation Centre for Cardiovascular Disorders; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Mei Jin
- Beijing Anzhen Hospital, Capital Medical University; Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education; Beijing Collaborative Innovation Centre for Cardiovascular Disorders; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China; Department of Pediatric Heart Centre, Beijing Anzhen Hospital, Capital Medical University; Beijing Pediatric Heart Centre, Beijing, China.
| | - Yuan Wang
- Beijing Anzhen Hospital, Capital Medical University; Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education; Beijing Collaborative Innovation Centre for Cardiovascular Disorders; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.
| | - Jie Du
- Beijing Anzhen Hospital, Capital Medical University; Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education; Beijing Collaborative Innovation Centre for Cardiovascular Disorders; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.
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155
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Gudenschwager EK, Abbott JA, LeRoith T. Dilated cardiomyopathy with endocardial fibroelastosis in a juvenile Pallas cat. J Vet Diagn Invest 2019; 31:289-293. [PMID: 30694111 DOI: 10.1177/1040638719827061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Dilated cardiomyopathy (DCM) is a myocardial disease characterized by ventricular chamber dilation associated with systolic myocardial dysfunction in the absence of other cardiac lesions. DCM occasionally develops in conjunction with proliferation of fibroelastic fibers in the endocardium, producing endocardial fibroelastosis (EFE). Although early reports describe EFE as a primary disease, evidence now suggests that EFE may develop as a response to myocardial dysfunction. Echocardiographic evaluation of a 4-wk-old Pallas cat ( Otocolobus manul) with respiratory distress revealed enlargement of both atria, enlarged end-systolic left ventricular dimension, and left ventricular dilation. DCM was diagnosed, and the cat was euthanized, given the poor prognosis. Postmortem examination revealed pericardial effusion and biventricular and biatrial enlargement. The interventricular septum and free walls of ventricles were thin. Histologically, the endocardium of the left and right ventricles was diffusely thickened; Verhoeff-Van Gieson staining of the left ventricular endocardium revealed a moderate amount of endocardial accumulation of elastin and collagen. These fibers were more prominent in papillary muscles and around coronary blood vessels. Based on these findings, we diagnosed DCM with EFE. Cardiac diseases are rarely diagnosed in wild felids.
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Affiliation(s)
- Erwin K Gudenschwager
- Departments of Biomedical Sciences and Pathobiology (Gudenschwager, LeRoith), Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA.,Small Animal Clinical Sciences (Abbott), Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA
| | - Jonathan A Abbott
- Departments of Biomedical Sciences and Pathobiology (Gudenschwager, LeRoith), Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA.,Small Animal Clinical Sciences (Abbott), Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA
| | - Tanya LeRoith
- Departments of Biomedical Sciences and Pathobiology (Gudenschwager, LeRoith), Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA.,Small Animal Clinical Sciences (Abbott), Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA
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156
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Abstract
See Article by Allan et al
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Affiliation(s)
- Dianne L Atkins
- 1 Stead Family Department of Pediatrics Carver College of Medicine University of Iowa Iowa City IA
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157
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Connell PS, Jeewa A, Kearney DL, Tunuguntla H, Denfield SW, Allen HD, Landstrom AP. A 14-year-old in heart failure with multiple cardiomyopathy variants illustrates a role for signal-to-noise analysis in gene test re-interpretation. Clin Case Rep 2019; 7:211-217. [PMID: 30656044 PMCID: PMC6332775 DOI: 10.1002/ccr3.1920] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 10/17/2018] [Accepted: 10/24/2018] [Indexed: 11/09/2022] Open
Abstract
Variants of unknown significance in cardiomyopathic disease should be analyzed systematically based on the prevalence of the variant in the population compared to prevalence of disease, evidence that other variants in the gene are pathologic, consistency of prediction software on pathogenicity, and the current clinical consensus.
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Affiliation(s)
- Patrick S. Connell
- Department of Pediatrics, Section of Pediatric CardiologyBaylor College of MedicineHoustonTexas
| | - Aamir Jeewa
- Department of Pediatrics, Division of Pediatric CardiologyThe Hospital for Sick ChildrenTorontoOntarioCanada
| | - Debra L. Kearney
- Department of Pathology & ImmunologyBaylor College of MedicineHoustonTexas
| | - Hari Tunuguntla
- Department of Pediatrics, Section of Pediatric CardiologyBaylor College of MedicineHoustonTexas
| | - Susan W. Denfield
- Department of Pediatrics, Section of Pediatric CardiologyBaylor College of MedicineHoustonTexas
| | - Hugh D. Allen
- Department of Pediatrics, Section of Pediatric CardiologyBaylor College of MedicineHoustonTexas
| | - Andrew P. Landstrom
- Department of Pediatrics, Section of Pediatric CardiologyBaylor College of MedicineHoustonTexas
- Division of Pediatric Cardiology, Department of PediatricsDuke University School of MedicineDurhamNorth Carolina
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158
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Favilli S, Prandstraller D, Spaziani G, Calabri GB, Lombardi M, Balducci A, Vairo U. Age-related issues: From fetus to adolescent. PROGRESS IN PEDIATRIC CARDIOLOGY 2018. [DOI: 10.1016/j.ppedcard.2018.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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159
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160
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Coppini R, Ferrantini C, Cerbai E. Novel pharmacological approaches for paediatric hypertrophic cardiomyopathy. PROGRESS IN PEDIATRIC CARDIOLOGY 2018. [DOI: 10.1016/j.ppedcard.2018.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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161
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Cardiogenic Shock Beyond The Neonatal Period. CLINICAL PEDIATRIC EMERGENCY MEDICINE 2018. [DOI: 10.1016/j.cpem.2018.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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162
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Pierpont ME, Brueckner M, Chung WK, Garg V, Lacro RV, McGuire AL, Mital S, Priest JR, Pu WT, Roberts A, Ware SM, Gelb BD, Russell MW. Genetic Basis for Congenital Heart Disease: Revisited: A Scientific Statement From the American Heart Association. Circulation 2018; 138:e653-e711. [PMID: 30571578 PMCID: PMC6555769 DOI: 10.1161/cir.0000000000000606] [Citation(s) in RCA: 349] [Impact Index Per Article: 58.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This review provides an updated summary of the state of our knowledge of the genetic contributions to the pathogenesis of congenital heart disease. Since 2007, when the initial American Heart Association scientific statement on the genetic basis of congenital heart disease was published, new genomic techniques have become widely available that have dramatically changed our understanding of the causes of congenital heart disease and, clinically, have allowed more accurate definition of the pathogeneses of congenital heart disease in patients of all ages and even prenatally. Information is presented on new molecular testing techniques and their application to congenital heart disease, both isolated and associated with other congenital anomalies or syndromes. Recent advances in the understanding of copy number variants, syndromes, RASopathies, and heterotaxy/ciliopathies are provided. Insights into new research with congenital heart disease models, including genetically manipulated animals such as mice, chicks, and zebrafish, as well as human induced pluripotent stem cell-based approaches are provided to allow an understanding of how future research breakthroughs for congenital heart disease are likely to happen. It is anticipated that this review will provide a large range of health care-related personnel, including pediatric cardiologists, pediatricians, adult cardiologists, thoracic surgeons, obstetricians, geneticists, genetic counselors, and other related clinicians, timely information on the genetic aspects of congenital heart disease. The objective is to provide a comprehensive basis for interdisciplinary care for those with congenital heart disease.
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163
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Vasilescu C, Ojala TH, Brilhante V, Ojanen S, Hinterding HM, Palin E, Alastalo TP, Koskenvuo J, Hiippala A, Jokinen E, Jahnukainen T, Lohi J, Pihkala J, Tyni TA, Carroll CJ, Suomalainen A. Genetic Basis of Severe Childhood-Onset Cardiomyopathies. J Am Coll Cardiol 2018; 72:2324-2338. [DOI: 10.1016/j.jacc.2018.08.2171] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 08/09/2018] [Accepted: 08/12/2018] [Indexed: 11/26/2022]
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164
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Ware SM. Cardiomyopathy in Children. J Am Coll Cardiol 2018; 72:2339-2341. [DOI: 10.1016/j.jacc.2018.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 09/01/2018] [Indexed: 11/26/2022]
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165
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Bansal N, Barach P, Amdani SM, Lipshultz SE. When is early septal myectomy in children with hypertrophic cardiomyopathy justified? Transl Pediatr 2018; 7:362-366. [PMID: 30460188 PMCID: PMC6212380 DOI: 10.21037/tp.2018.09.08] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 09/08/2018] [Indexed: 11/06/2022] Open
Affiliation(s)
- Neha Bansal
- Division of Pediatric Cardiology, Children’s Hospital at Montefiore, Bronx, NY, USA
| | - Paul Barach
- Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA
| | - Shahnawaz M. Amdani
- Division of Pediatric Cardiology, Saint Louis Children’s Hospital, Washington University School of Medicine, Saint Louis, MO, USA
| | - Steven E. Lipshultz
- Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA
- Children’s Research Center of Michigan, Children’s Hospital of Michigan, Detroit, MI, USA
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166
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Bondue A, Arbustini E, Bianco A, Ciccarelli M, Dawson D, De Rosa M, Hamdani N, Hilfiker-Kleiner D, Meder B, Leite-Moreira AF, Thum T, Tocchetti CG, Varricchi G, Van der Velden J, Walsh R, Heymans S. Complex roads from genotype to phenotype in dilated cardiomyopathy: scientific update from the Working Group of Myocardial Function of the European Society of Cardiology. Cardiovasc Res 2018; 114:1287-1303. [PMID: 29800419 PMCID: PMC6054212 DOI: 10.1093/cvr/cvy122] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 05/05/2018] [Accepted: 05/16/2018] [Indexed: 12/14/2022] Open
Abstract
Dilated cardiomyopathy (DCM) frequently affects relatively young, economically, and socially active adults, and is an important cause of heart failure and transplantation. DCM is a complex disease and its pathological architecture encounters many genetic determinants interacting with environmental factors. The old perspective that every pathogenic gene mutation would lead to a diseased heart, is now being replaced by the novel observation that the phenotype depends not only on the penetrance-malignancy of the mutated gene-but also on epigenetics, age, toxic factors, pregnancy, and a diversity of acquired diseases. This review discusses how gene mutations will result in mutation-specific molecular alterations in the heart including increased mitochondrial oxidation (sarcomeric gene e.g. TTN), decreased calcium sensitivity (sarcomeric genes), fibrosis (e.g. LMNA and TTN), or inflammation. Therefore, getting a complete picture of the DCM patient will include genomic data, molecular assessment by preference from cardiac samples, stratification according to co-morbidities, and phenotypic description. Those data will help to better guide the heart failure and anti-arrhythmic treatment, predict response to therapy, develop novel siRNA-based gene silencing for malignant gene mutations, or intervene with mutation-specific altered gene pathways in the heart.This article is part of the Mini Review Series from the Varenna 2017 meeting of the Working Group of Myocardial Function of the European Society of Cardiology.
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Affiliation(s)
- Antoine Bondue
- Department of Cardiology, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Eloisa Arbustini
- Centre for Inherited Cardiovascular Diseases, IRCCS Foundation, University Hospital Policlinico San Matteo, Pavia, Italy
| | - Anna Bianco
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
- Department of Cardiology, Maastricht University Medical Center & CARIM, Maastricht University, Maastricht, The Netherlands
| | - Michele Ciccarelli
- School of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Dana Dawson
- School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK
| | - Matteo De Rosa
- School of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Nazha Hamdani
- Department of Systems Physiology, Ruhr University Bochum, Bochum, Germany
| | - Denise Hilfiker-Kleiner
- Molecular Cardiology, Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Benjamin Meder
- Department of Cardiology, Heidelberg University, Heidelberg, Germany
- Department of Genetics, Stanford University School of Medicine, Genome Technology Center, Palo Alto, CA, USA
| | - Adelino F Leite-Moreira
- Cardiovascular R&D Unit, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Cardiothoracic Surgery, Hospital of S. João, Porto, Portugal
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Hannover, Germany
| | - Carlo G Tocchetti
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Gilda Varricchi
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Jolanda Van der Velden
- Department of Physiology, VU University Medical Centre, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
- Netherlands Heart Institute, Utrecht, The Netherlands
| | - Roddy Walsh
- Cardiovascular Research Center, Royal Brompton and Harefield NHS Foundation Trust and Imperial College London, London, UK
| | - Stephane Heymans
- Department of Cardiology, Maastricht University Medical Center & CARIM, Maastricht University, Maastricht, The Netherlands
- Netherlands Heart Institute, Utrecht, The Netherlands
- Department of Cardiovascular Sciences, Leuven University, Leuven, Belgium
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167
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Liu Y, Chen H, Shou W. Potential Common Pathogenic Pathways for the Left Ventricular Noncompaction Cardiomyopathy (LVNC). Pediatr Cardiol 2018; 39:1099-1106. [PMID: 29766225 PMCID: PMC6093786 DOI: 10.1007/s00246-018-1882-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 04/24/2018] [Indexed: 01/01/2023]
Abstract
Ventricular trabeculation and compaction are two essential morphogenetic events for generating a functionally competent ventricular wall. A significant reduction in trabeculation is usually associated with hypoplastic wall and ventricular compact zone deficiencies, which commonly leads to embryonic heart failure and early embryonic lethality. In contrast, the arrest of ventricular wall compaction (noncompaction) is believed to be causative to the left ventricular noncompaction (LVNC), a genetically heterogeneous disorder and the third most common cardiomyopathy among pediatric patients. After critically reviewing recent findings from genetically engineered mouse models, we suggest a model which proposes that defects in myofibrillogenesis and polarization in trabecular cardiomyocytes underly the common pathogenic mechanism for ventricular noncompaction.
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Affiliation(s)
- Ying Liu
- Riley Heart Research Center, Herman B. Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Hanying Chen
- Riley Heart Research Center, Herman B. Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Weinian Shou
- Riley Heart Research Center, Herman B. Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
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168
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Novel ALPK3 mutation in a Tunisian patient with pediatric cardiomyopathy and facio-thoraco-skeletal features. J Hum Genet 2018; 63:1077-1082. [DOI: 10.1038/s10038-018-0492-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 07/03/2018] [Accepted: 07/05/2018] [Indexed: 11/08/2022]
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169
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Farr SL, Downing KF, Riehle-Colarusso T, Abarbanell G. Functional limitations and educational needs among children and adolescents with heart disease. CONGENIT HEART DIS 2018; 13:633-639. [PMID: 30033554 DOI: 10.1111/chd.12621] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 02/28/2018] [Accepted: 04/19/2018] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To examine how cognitive and motor limitations in children with heart disease are associated with education and participation in extracurricular activities. DESIGN Using 2009-2010 parent-reported data from the National Survey of Children with Special Health Care Needs (NS-CSHCN), we examined prevalence of five functional limitations (learning/concentration, communication, self-care, gross motor skills, and fine motor skills) by diagnosed heart disease status using chi-square tests and multivariable logistic regression. Among CSHCN with heart disease, we examined the associations between severity of each functional limitation and missing ≥11 days of school in the past year, receiving special education services, and interference with extracurricular activities. RESULTS CSHCN with heart disease (n = 1,416), compared to CSHCN without (n = 28,385), more commonly had "a lot" of difficulty in the five functional areas (P < .01; adjusted odds ratios: 1.8-3.3). Among CSHCN with heart disease, "a lot" of difficulty with learning/concentration was most common (35%), followed by communication (21%), self-care (14%), gross motor skills (12%), and fine motor skills (10%). Among CSHCN with heart disease, compared to those without, respectively, 27% and 15% missed ≥11 days of school, 45% and 29% received special education services, and 49% and 29% experienced interference with extracurricular activities (P < .01 for all). Level of difficulty with the five functional areas was associated with receipt of special education services and participation in extracurricular activities (P < .001). CONCLUSION These results support the American Heart Association recommendations to screen children with congenital heart disease for age-appropriate development and provide services when needed.
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Affiliation(s)
- Sherry L Farr
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Karrie F Downing
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Tiffany Riehle-Colarusso
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ginnie Abarbanell
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Division of Pediatric Cardiology, Department of Pediatrics, Washington University School of Medicine/St. Louis Children's Hospital, St. Louis, Missouri, USA
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170
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Kiselev A, Vaz R, Knyazeva A, Khudiakov A, Tarnovskaya S, Liu J, Sergushichev A, Kazakov S, Frishman D, Smolina N, Pervunina T, Jorholt J, Sjoberg G, Vershinina T, Rudenko D, Arner A, Sejersen T, Lindstrand A, Kostareva A. De novo mutations in FLNC
leading to early-onset restrictive cardiomyopathy and congenital myopathy. Hum Mutat 2018; 39:1161-1172. [DOI: 10.1002/humu.23559] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 05/22/2018] [Accepted: 05/30/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Artem Kiselev
- Almazov National Medical Research Centre; Saint Petersburg Russia
| | - Raquel Vaz
- Department of Molecular Medicine and Surgery and Center for molecular medicine; Karolinska Institutet; Stockholm Sweden
| | | | | | - Svetlana Tarnovskaya
- Almazov National Medical Research Centre; Saint Petersburg Russia
- Peter the Great St.Petersburg Polytechnic University; Saint Petersburg Russia
| | - Jiao Liu
- Department of Physiology and Pharmacology; Karolinska Institutet; Stockholm Sweden
| | | | | | - Dmitrij Frishman
- Peter the Great St.Petersburg Polytechnic University; Saint Petersburg Russia
- Department of Bioinformatics; Technische Universität München; Wissenschaftszentrum Weihenstephan; Freising Germany
| | - Natalia Smolina
- Almazov National Medical Research Centre; Saint Petersburg Russia
- ITMO University; Saint Petersburg Russia
- Department of Women's and Children's Health and Center for Molecular Medicine; Karolinska Institute; Stockholm Sweden
| | | | - John Jorholt
- Department of Women's and Children's Health and Center for Molecular Medicine; Karolinska Institute; Stockholm Sweden
| | - Gunnar Sjoberg
- Department of Women's and Children's Health and Center for Molecular Medicine; Karolinska Institute; Stockholm Sweden
| | | | | | - Anders Arner
- Department of Physiology and Pharmacology; Karolinska Institutet; Stockholm Sweden
| | - Thomas Sejersen
- Department of Women's and Children's Health and Center for Molecular Medicine; Karolinska Institute; Stockholm Sweden
| | - Anna Lindstrand
- Department of Molecular Medicine and Surgery and Center for molecular medicine; Karolinska Institutet; Stockholm Sweden
- Clinical Genetics; Karolinska University Laboratory; Karolinska University Hospital; Stockholm Sweden
| | - Anna Kostareva
- Almazov National Medical Research Centre; Saint Petersburg Russia
- Department of Women's and Children's Health and Center for Molecular Medicine; Karolinska Institute; Stockholm Sweden
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171
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Abstract
PURPOSE OF REVIEW Heart failure is a rare but morbid diagnosis in the pediatric patient presenting to the emergency department (ED). Familiarity of the ED physician with the presentation, work-up, and management of pediatric heart failure is essential as accurate diagnosis is reliant on a high degree of suspicion. RECENT FINDINGS Studies evaluating pediatric heart failure are limited by its rarity and the heterogeneity of underlying conditions. However, recent reports have provided new data on the epidemiology, presentation, and outcomes of children with heart failure. SUMMARY The recent studies reviewed here highlight the significant diagnostic and management challenges that pediatric heart failure presents given the variety and lack of specificity of its presenting signs, symptoms, and diagnostic work-up. This review provides the ED physician with a framework for understanding of pediatric heart failure to allow for efficient diagnosis and management of these patients. The primary focus of this review is heart failure in structurally normal hearts.
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172
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173
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Nasr VG, Twite MD, Walker SG, Kussman BD, Motta P, Mittnacht AJC, Mossad EB. Selected 2017 Highlights in Congenital Cardiac Anesthesia. J Cardiothorac Vasc Anesth 2018; 32:1546-1555. [PMID: 29699846 DOI: 10.1053/j.jvca.2018.03.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Vivian G Nasr
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA
| | - Mark D Twite
- Department of Anesthesiology, University of Colorado and Children's Hospital Colorado, Anschutz Medical Campus, Aurora, CO
| | - Scott G Walker
- Department of Anesthesiology, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, IN
| | - Barry D Kussman
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA
| | - Pablo Motta
- Division of Pediatric Cardiovascular Anesthesia, Baylor College of Medicine, Texas Children's Hospital, Houston, TX
| | - Alexander J C Mittnacht
- Department of Anesthesiology, Perioperative and Pain Medicine, the Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Emad B Mossad
- Division of Pediatric Cardiovascular Anesthesia, Baylor College of Medicine, Texas Children's Hospital, Houston, TX
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174
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Glotzbach K, May L, Wray J. Health related quality of life and functional outcomes in pediatric cardiomyopathy. PROGRESS IN PEDIATRIC CARDIOLOGY 2018. [DOI: 10.1016/j.ppedcard.2018.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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175
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Louw JJ, Nunes Bastos R, Chen X, Verdood C, Corveleyn A, Jia Y, Breckpot J, Gewillig M, Peeters H, Santoro MM, Barr F, Devriendt K. Compound heterozygous loss-of-function mutations in KIF20A are associated with a novel lethal congenital cardiomyopathy in two siblings. PLoS Genet 2018; 14:e1007138. [PMID: 29357359 PMCID: PMC5794171 DOI: 10.1371/journal.pgen.1007138] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 02/01/2018] [Accepted: 11/28/2017] [Indexed: 11/25/2022] Open
Abstract
Congenital or neonatal cardiomyopathies are commonly associated with a poor prognosis and have multiple etiologies. In two siblings, a male and female, we identified an undescribed type of lethal congenital restrictive cardiomyopathy affecting the right ventricle. We hypothesized a novel autosomal recessive condition. To identify the cause, we performed genetic, in vitro and in vivo studies. Genome-wide SNP typing and parametric linkage analysis was done in a recessive model to identify candidate regions. Exome sequencing analysis was done in unaffected and affected siblings. In the linkage regions, we selected candidate genes that harbor two rare variants with predicted functional effects in the patients and for which the unaffected sibling is either heterozygous or homozygous reference. We identified two compound heterozygous variants in KIF20A; a maternal missense variant (c.544C>T: p.R182W) and a paternal frameshift mutation (c.1905delT: p.S635Tfs*15). Functional studies confirmed that the R182W mutation creates an ATPase defective form of KIF20A which is not able to support efficient transport of Aurora B as part of the chromosomal passenger complex. Due to this, Aurora B remains trapped on chromatin in dividing cells and fails to translocate to the spindle midzone during cytokinesis. Translational blocking of KIF20A in a zebrafish model resulted in a cardiomyopathy phenotype. We identified a novel autosomal recessive congenital restrictive cardiomyopathy, caused by a near complete loss-of-function of KIF20A. This finding further illustrates the relationship of cytokinesis and congenital cardiomyopathy.
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Affiliation(s)
- Jacoba J. Louw
- Department of Congenital and Pediatric Cardiology, University Hospitals Leuven, Leuven, Belgium
- Center for Human Genetics, University Hospitals and KU Leuven, Leuven, Belgium
| | | | - Xiaowen Chen
- Laboratory of Endothelial Molecular Biology, VIB Center for Cancer Biology, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Céline Verdood
- Center for Human Genetics, University Hospitals and KU Leuven, Leuven, Belgium
| | - Anniek Corveleyn
- Center for Human Genetics, University Hospitals and KU Leuven, Leuven, Belgium
| | - Yaojuan Jia
- Center for Human Genetics, University Hospitals and KU Leuven, Leuven, Belgium
| | - Jeroen Breckpot
- Center for Human Genetics, University Hospitals and KU Leuven, Leuven, Belgium
| | - Marc Gewillig
- Department of Congenital and Pediatric Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Hilde Peeters
- Center for Human Genetics, University Hospitals and KU Leuven, Leuven, Belgium
| | | | - Francis Barr
- Department of Biochemistry, University of Oxford, Oxford, United Kingdom
| | - Koenraad Devriendt
- Center for Human Genetics, University Hospitals and KU Leuven, Leuven, Belgium
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176
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Abstract
The nonischemic cardiomyopathies are a diverse group of cardiac disorders that frequently cause heart failure and death and are now recognized with increasing frequency. There has been substantial progress in the clinical recognition and understanding of the natural history of these conditions. Well-established and new techniques of cardiac imaging are also helpful in this regard. Basic scientists are elucidating the pathogenesis and pathobiology of individual cardiomyopathies. In this compendium, some of the most important advances in this field are reviewed. Scientific opportunities to enhance further collaborative research to accelerate progress are identified.
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Affiliation(s)
- Eugene Braunwald
- From the TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
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