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Monda E, De Michele G, Diana G, Verrillo F, Rubino M, Cirillo A, Fusco A, Amodio F, Caiazza M, Dongiglio F, Palmiero G, Buono P, Russo MG, Limongelli G. Left Ventricular Non-Compaction in Children: Aetiology and Diagnostic Criteria. Diagnostics (Basel) 2024; 14:115. [PMID: 38201424 PMCID: PMC10871098 DOI: 10.3390/diagnostics14010115] [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: 11/13/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
Left ventricular non-compaction (LVNC) is a heterogeneous myocardial disorder characterized by prominent trabeculae protruding into the left ventricular lumen and deep intertrabecular recesses. LVNC can manifest in isolation or alongside other heart muscle diseases. Its occurrence among children is rising due to advancements in imaging techniques. The origins of LVNC are diverse, involving both genetic and acquired forms. The clinical manifestation varies greatly, with some cases presenting no symptoms, while others typically manifesting with heart failure, systemic embolism, and arrhythmias. Diagnosis mainly relies on assessing heart structure using imaging tools like echocardiography and cardiac magnetic resonance. However, the absence of a universally agreed-upon standard and limitations in diagnostic criteria have led to ongoing debates in the scientific community regarding the most reliable methods. Further research is crucial to enhance the diagnosis of LVNC, particularly in early life stages.
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Affiliation(s)
- Emanuele Monda
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
- Institute of Cardiovascular Science, University College London, London WC1N 3JH, UK
| | - Gianantonio De Michele
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Gaetano Diana
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Federica Verrillo
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Marta Rubino
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Annapaola Cirillo
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Adelaide Fusco
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Federica Amodio
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Martina Caiazza
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Francesca Dongiglio
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Giuseppe Palmiero
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Pietro Buono
- Department of Maternal and Child Health, General Directorate for Health, 80131 Naples, Italy
| | - Maria Giovanna Russo
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
| | - Giuseppe Limongelli
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (E.M.); (G.D.M.); (G.D.); (F.V.); (M.R.); (A.C.); (A.F.); (F.A.); (M.C.); (F.D.); (G.P.); (M.G.R.)
- Institute of Cardiovascular Science, University College London, London WC1N 3JH, UK
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Hesaraki M, Bora U, Pahlavan S, Salehi N, Mousavi SA, Barekat M, Rasouli SJ, Baharvand H, Ozhan G, Totonchi M. A Novel Missense Variant in Actin Binding Domain of MYH7 Is Associated With Left Ventricular Noncompaction. Front Cardiovasc Med 2022; 9:839862. [PMID: 35463789 PMCID: PMC9024299 DOI: 10.3389/fcvm.2022.839862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/22/2022] [Indexed: 11/17/2022] Open
Abstract
Cardiomyopathies are a group of common heart disorders that affect numerous people worldwide. Left ventricular non-compaction (LVNC) is a structural disorder of the ventricular wall, categorized as a type of cardiomyopathy that mostly caused by genetic disorders. Genetic variations are underlying causes of developmental deformation of the heart wall and the resultant contractile insufficiency. Here, we investigated a family with several affected members exhibiting LVNC phenotype. By whole-exome sequencing (WES) of three affected members, we identified a novel heterozygous missense variant (c.1963C>A:p.Leu655Met) in the gene encoding myosin heavy chain 7 (MYH7). This gene is evolutionary conserved among different organisms. We identified MYH7 as a highly enriched myosin, compared to other types of myosin heavy chains, in skeletal and cardiac muscles. Furthermore, MYH7 was among a few classes of MYH in mouse heart that highly expresses from early embryonic to adult stages. In silico predictions showed an altered actin-myosin binding, resulting in weaker binding energy that can cause LVNC. Moreover, CRISPR/Cas9 mediated MYH7 knockout in zebrafish caused impaired cardiovascular development. Altogether, these findings provide the first evidence for involvement of p.Leu655Met missense variant in the incidence of LVNC, most probably through actin-myosin binding defects during ventricular wall morphogenesis.
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Affiliation(s)
- Mahdi Hesaraki
- Department of Developmental Biology, School of Basic Sciences and Advanced Technologies in Biology, University of Science and Culture, Tehran, Iran
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Ugur Bora
- Izmir Biomedicine and Genome Center (IBG), Dokuz Eylul University Health, Izmir, Turkey
- Izmir International Biomedicine and Genome Institute (IBG-Izmir), Dokuz Eylul University, Izmir, Turkey
| | - Sara Pahlavan
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Najmeh Salehi
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- School of Biological Science, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
| | - Seyed Ahmad Mousavi
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Maryam Barekat
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Seyed Javad Rasouli
- Department of Tissue Morphogenesis, Max Planck Institute for Molecular Biomedicine, Münster, Germany
| | - Hossein Baharvand
- Department of Developmental Biology, School of Basic Sciences and Advanced Technologies in Biology, University of Science and Culture, Tehran, Iran
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Gunes Ozhan
- Izmir Biomedicine and Genome Center (IBG), Dokuz Eylul University Health, Izmir, Turkey
- Izmir International Biomedicine and Genome Institute (IBG-Izmir), Dokuz Eylul University, Izmir, Turkey
- *Correspondence: Gunes Ozhan
| | - Mehdi Totonchi
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- School of Biological Science, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
- Mehdi Totonchi
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Seecheran RV, Ramdin R, Singh S, Seecheran VK, Persad SA, Peram L, Raza S, Seecheran NA. Isolated Right Ventricular Noncompaction Cardiomyopathy Causing Pulmonary Embolism. J Investig Med High Impact Case Rep 2021; 9:23247096211024027. [PMID: 34121486 PMCID: PMC8207261 DOI: 10.1177/23247096211024027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Ventricular noncompaction is a rare, heterogeneous cardiomyopathy characterized by marked trabeculations and deep intertrabecular spaces with clinical sequelae of heart failure, arrhythmias, and cardioembolic events. In this article, we describe a patient with isolated right ventricular noncompaction who presented with submassive pulmonary embolism, which was managed with long-term direct oral anticoagulation.
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Affiliation(s)
| | - Ryan Ramdin
- North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago
| | - Sonia Singh
- North Central Regional Health Authority, Mt. Hope, Trinidad and Tobago
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Rohde S, Muslem R, Kaya E, Dalinghaus M, van Waning JI, Majoor-Krakauer D, Towbin J, Caliskan K. State-of-the art review: Noncompaction cardiomyopathy in pediatric patients. Heart Fail Rev 2021; 27:15-28. [PMID: 33715140 PMCID: PMC8739285 DOI: 10.1007/s10741-021-10089-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 12/13/2022]
Abstract
Noncompaction cardiomyopathy (NCCM) is a disease characterized by hypertrabeculation, commonly hypothesized due to an arrest in compaction during fetal development. In 2006, NCCM was classified as a distinct form of cardiomyopathy (CMP) by the American Heart Association. NCCM in childhood is more frequently familial than when diagnosed in adulthood and is associated with other congenital heart diseases (CHDs), other genetic CMPs, and neuromuscular diseases (NMDs). It is yet a rare cardiac diseased with an estimated incidence of 0.12 per 100.000 in children up to 10 years of age. Diagnosing NCCM can be challenging due to non-uniform diagnostic criteria, unawareness, presumed other CMPs, and presence of CHD. Therefore, the incidence of NCCM in children might be an underestimation. Nonetheless, NCCM is the third most common cardiomyopathy in childhood and is associated with heart failure, arrhythmias, and/or thromboembolic events. This state-of-the-art review provides an overview on pediatric NCCM. In addition, we discuss the natural history, epidemiology, genetics, clinical presentation, outcome, and therapeutic options of NCCM in pediatric patients, including fetuses, neonates, infants, and children. Furthermore, we provide a simple classification of different forms of the disease. Finally, the differences between the pediatric population and the adult population are described.
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Affiliation(s)
- Sofie Rohde
- Thoraxcenter, Department of Cardiology, Erasmus University Medical Center, Room RG 431, 3015 GD, Rotterdam, The Netherlands
| | - Rahatullah Muslem
- Thoraxcenter, Department of Cardiology, Erasmus University Medical Center, Room RG 431, 3015 GD, Rotterdam, The Netherlands
| | - Emrah Kaya
- Thoraxcenter, Department of Cardiology, Erasmus University Medical Center, Room RG 431, 3015 GD, Rotterdam, The Netherlands
| | - Michel Dalinghaus
- Division of Pediatric Cardiology, Sophia Children's Hospital, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jaap I van Waning
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Jeffery Towbin
- The Heart Institute, Le Bonheur Children's Hospital, Memphis, TN, USA
| | - Kadir Caliskan
- Thoraxcenter, Department of Cardiology, Erasmus University Medical Center, Room RG 431, 3015 GD, Rotterdam, The Netherlands.
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Ross SB, Singer ES, Driscoll E, Nowak N, Yeates L, Puranik R, Sy RW, Rajagopalan S, Barratt A, Ingles J, Bagnall RD, Semsarian C. Genetic architecture of left ventricular noncompaction in adults. Hum Genome Var 2020; 7:33. [PMID: 33082984 PMCID: PMC7566488 DOI: 10.1038/s41439-020-00120-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 12/01/2022] Open
Abstract
The genetic etiology and heritability of left ventricular noncompaction (LVNC) in adults is unclear. This study sought to assess the value of genetic testing in adults with LVNC. Adults diagnosed with LVNC while undergoing screening in the context of a family history of cardiomyopathy were excluded. Clinical data for 35 unrelated patients diagnosed with LVNC at ≥18 years of age were retrospectively analyzed. Left ventricular (LV) dysfunction, electrocardiogram (ECG) abnormalities, cardiac malformations or syndromic features were identified in 25 patients; 10 patients had isolated LVNC in the absence of cardiac dysfunction or syndromic features. Exome sequencing was performed, and analysis using commercial panels targeted 193 nuclear and mitochondrial genes. Nucleotide variants in coding regions or in intron-exon boundaries with predicted impacts on splicing were assessed. Fifty-four rare variants were identified in 35 nuclear genes. Across all 35 LVNC patients, the clinically meaningful genetic diagnostic yield was 9% (3/35), with heterozygous likely pathogenic or pathogenic variants identified in the NKX2-5 and TBX5 genes encoding cardiac transcription factors. No pathogenic variants were identified in patients with isolated LVNC in the absence of cardiac dysfunction or syndromic features. In conclusion, the diagnostic yield of genetic testing in adult index patients with LVNC is low. Genetic testing is most beneficial in LVNC associated with other cardiac and syndromic features, in which it can facilitate correct diagnoses, and least useful in adults with only isolated LVNC without a family history. Cardiac transcription factors are important in the development of LVNC and should be included in genetic testing panels.
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Affiliation(s)
- Samantha Barratt Ross
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Newtown, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Newtown, Australia
- Wiser Healthcare, Sydney, Australia
| | - Emma S. Singer
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Newtown, Australia
| | - Elizabeth Driscoll
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Newtown, Australia
| | - Natalie Nowak
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Newtown, Australia
| | - Laura Yeates
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Newtown, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Newtown, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Rajesh Puranik
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Newtown, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Raymond W. Sy
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Newtown, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
| | | | - Alexandra Barratt
- Wiser Healthcare, Sydney, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jodie Ingles
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Newtown, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Newtown, Australia
- Wiser Healthcare, Sydney, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Richard D. Bagnall
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Newtown, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Newtown, Australia
| | - Christopher Semsarian
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Newtown, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Newtown, Australia
- Wiser Healthcare, Sydney, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
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Hirono K, Hata Y, Miyao N, Okabe M, Takarada S, Nakaoka H, Ibuki K, Ozawa S, Origasa H, Nishida N, Ichida F. Increased Burden of Ion Channel Gene Variants Is Related to Distinct Phenotypes in Pediatric Patients With Left Ventricular Noncompaction. CIRCULATION. GENOMIC AND PRECISION MEDICINE 2020; 13:e002940. [PMID: 32600061 DOI: 10.1161/circgen.119.002940] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Left ventricular noncompaction (LVNC) is a hereditary type of cardiomyopathy. Although it is associated with high morbidity and mortality, the related ion channel gene variants in children have not been fully investigated. This study aimed to elucidate the ion channel genetic landscape of LVNC and identify genotype-phenotype correlations in a large Japanese cohort. METHODS We enrolled 206 children with LVNC from 2002 to 2017 in Japan. LVNC was classified as follows: LVNC with congenital heart defects, arrhythmia, dilated phenotype, or normal function. In the enrolled patients, 182 genes associated with cardiomyopathy were screened using next-generation sequencing. RESULTS We identified 99 pathogenic variants in 40 genes in 87 patients. Of the pathogenic variants, 8.8% were in genes associated with channelopathies, 27% were in sarcomere genes, and 11.5% were in mitochondrial genes. Ion channel gene variants were mostly associated with the arrhythmia classification, whereas sarcomere and mitochondrial gene variants were associated with the dilated phenotype. Echocardiography revealed that the group with ion channel gene variants had almost normal LV ejection fraction and LV diastolic diameter Z scores. Fragmented QRS, old age, and an arrhythmia phenotype were the most significant risk factors for ventricular tachycardia (P=0.165, 0.0428, and 0.0074, respectively). Moreover, the group with ion channel variants exhibited a greater risk of a higher prevalence of arrhythmias such as ventricular tachycardia, rather than congestive heart failure. CONCLUSIONS This is the first study that focused on genotype-phenotype correlations in a large pediatric LVNC patient cohort with ion channel gene variants that were determined using next-generation sequencing. Ion channel gene variants were strongly correlated with arrhythmia phenotypes. Genetic testing and phenotype specification allow for appropriate medical management of specific LVNC targets.
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Affiliation(s)
- Keiichi Hirono
- Departments of Pediatrics (K.H., N.M., M.O., S.T., H.N., K.I., S.O., F.I.), Graduate School of Medicine, University of Toyama, Japan
| | - Yukiko Hata
- Legal Medicine (Y.H., N.N.), Graduate School of Medicine, University of Toyama, Japan
| | - Nariaki Miyao
- Departments of Pediatrics (K.H., N.M., M.O., S.T., H.N., K.I., S.O., F.I.), Graduate School of Medicine, University of Toyama, Japan
| | - Mako Okabe
- Departments of Pediatrics (K.H., N.M., M.O., S.T., H.N., K.I., S.O., F.I.), Graduate School of Medicine, University of Toyama, Japan
| | - Shinya Takarada
- Departments of Pediatrics (K.H., N.M., M.O., S.T., H.N., K.I., S.O., F.I.), Graduate School of Medicine, University of Toyama, Japan
| | - Hideyuki Nakaoka
- Departments of Pediatrics (K.H., N.M., M.O., S.T., H.N., K.I., S.O., F.I.), Graduate School of Medicine, University of Toyama, Japan.,Legal Medicine (Y.H., N.N.), Graduate School of Medicine, University of Toyama, Japan
| | - Keijiro Ibuki
- Departments of Pediatrics (K.H., N.M., M.O., S.T., H.N., K.I., S.O., F.I.), Graduate School of Medicine, University of Toyama, Japan
| | - Sayaka Ozawa
- Departments of Pediatrics (K.H., N.M., M.O., S.T., H.N., K.I., S.O., F.I.), Graduate School of Medicine, University of Toyama, Japan
| | - Hideki Origasa
- Biostatistics and Clinical Epidemiology (H.O.), Graduate School of Medicine, University of Toyama, Japan
| | - Naoki Nishida
- Legal Medicine (Y.H., N.N.), Graduate School of Medicine, University of Toyama, Japan
| | - Fukiko Ichida
- Departments of Pediatrics (K.H., N.M., M.O., S.T., H.N., K.I., S.O., F.I.), Graduate School of Medicine, University of Toyama, Japan
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Diagnostic accuracy of noncompacted-to-compacted wall ratio criteria on CMRI for the diagnosis of left ventricular noncompaction. MARMARA MEDICAL JOURNAL 2019. [DOI: 10.5472/marumj.637581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Krasi G, Precone V, Paolacci S, Stuppia L, Nodari S, Romeo F, Perrone M, Bushati V, Dautaj A, Bertelli M. Genetics and pharmacogenetics in the diagnosis and therapy of cardiovascular diseases. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:7-19. [PMID: 31577248 PMCID: PMC7233637 DOI: 10.23750/abm.v90i10-s.8748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 08/05/2019] [Indexed: 12/20/2022]
Abstract
Cardiovascular diseases are the main cause of death worldwide. The ability to accurately define individual susceptibility to these disorders is therefore of strategic importance. Linkage analysis and genome-wide association studies have been useful for the identification of genes related to cardiovascular diseases. The identification of variants predisposing to cardiovascular diseases contributes to the risk profile and the possibility of tailored preventive or therapeutic strategies. Molecular genetics and pharmacogenetics are playing an increasingly important role in the correct clinical management of patients. For instance, genetic testing can identify variants that influence how patients metabolize medications, making it possible to prescribe personalized, safer and more efficient treatments, reducing medical costs and improving clinical outcomes. In the near future we can expect a great increment in information and genetic testing, which should be acknowledged as a true branch of diagnostics in cardiology, like hemodynamics and electrophysiology. In this review we summarize the genetics and pharmacogenetics of the main cardiovascular diseases, showing the role played by genetic information in the identification of cardiovascular risk factors and in the diagnosis and therapy of these conditions. (www.actabiomedica.it)
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Precone V, Krasi G, Guerri G, Madureri A, Piazzani M, Michelini S, Barati S, Maniscalchi T, Bressan S, Bertelli M. Cardiomyopathies. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:32-43. [PMID: 31577251 PMCID: PMC7233648 DOI: 10.23750/abm.v90i10-s.8755] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 08/05/2019] [Indexed: 01/17/2023]
Abstract
The most common cardiomyopathies often present to primary care physicians with similar symptoms, despite the fact that they involve a variety of phenotypes and etiologies (1). Many have signs and symptoms common in heart failure, such as reduced ejection fraction, peripheral edema, fatigue, orthopnea, exertion dyspnea, paroxysmal nocturnal dyspnea, presyncope, syncope and cardiac ischemia (1). In all cardiomyopathies, the cardiac muscle (myocardium) may be structurally and/or functionally impaired. They can be classified as hypertrophic, dilated, left-ventricular non compaction, restrictive and arrhythmogenic right ventricular cardiomyopathies. (www.actabiomedica.it)
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Loria V, Colizzi C, Vaccarella M, Franceschi F, Aspromonte N. Left Ventricular Noncompaction: Cause or Consequence of Myocardial Disease? A Case Report and Literature Review. Cardiology 2019; 143:100-104. [PMID: 31509846 DOI: 10.1159/000500904] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 05/04/2019] [Indexed: 11/19/2022]
Abstract
A 57-year-old woman presented to the Emergency Department with symptoms of worsening heart failure (HF). She had a past medical history of breast cancer treated with surgery and chemotherapy with anthracyclines and no family history of cardiomyopathy (CMP). In the last year, she received a diagnosis of HF with normal coronary arteries, during hospitalization for acute onset of dyspnea and was treated with medical therapy. After several months, few days before admission to our hospital, an echocardiography (ECHO) showed features of left ventricular noncompaction (LVNC), not described in previous ECHO and further confirmed by cardiac magnetic resonance. This case highlights the current uncertainties regarding the pathogenesis of LVNC and the clinical challenge of cardiologists facing LVNC morphology to decide if they are observing a genetic CMP, a phenotype overlapping with dilated or hypertrophic CMP, or a variant of the left ventricular (LV) wall anatomy. No consensus exists among scientific communities regarding diagnostic criteria of LVNC and in most cases; the key element in the diagnostic decision is not the LVNC by itself, but the associated LV dilation and/or dysfunction, hypertrophy, arrhythmias, and embolic events.
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Affiliation(s)
- Valentina Loria
- Institute of Cardiology, Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Christian Colizzi
- Institute of Cardiac Surgery, Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Marcello Vaccarella
- Institute of Cardiology, Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Francesco Franceschi
- Emergency Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS-Catholic University of the Sacred Heart, Rome, Italy
| | - Nadia Aspromonte
- Institute of Cardiology, Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy,
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11
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Kulikova OV, Meshkov AN, Myasnikov RP, Kiseleva AV, Koretsky SN, Zharikova AA, Kharlap MS, Mershina EA, Sinitsyn VE, Skirko OP, Efimova IA, Pokrovskaya MS, Boytsov SA, Drapkina OM. Pathogenic Variant Rs1471414348of the TTN Gene in the Patient with Familial Left Venticular Noncompaction Cardiomyopathy. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2019. [DOI: 10.20996/1819-6446-2019-15-4-524-529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The clinical, instrumental and molecular-genetic studies for proband and family members for identification of family form of left ventricular noncompaction cardiomyopathy (LVNC) presented in the article. According to the results of the examination, the diagnosis LVNC was made. Drug therapy was adjusted, and a cardioverter defibrillator was implanted for the primary prevention of sudden cardiac death. Given the hereditary nature of the disease, family screening was conducted. By the family screening the disease was diagnosed in the mother of proband. Later, was made exome sequencing in a group of genes related to the development of left ventricular noncompaction cardiomyopathy. One likely pathogenic variant (rs1471414348, stop codon) in the TTN gene was detected. The discovered variant was validated by Sanger sequencing and was detected only in the proband and his mother, and was absent in other relatives. There were no other pathogenic and probably pathogenic variants in genes associated with the development of left ventricular noncompaction and other cardiomyopathies. As a result of family screening the new cases were diagnosed, the pathogenic variant of the TTN gene was identified, that is probably responsible for the development of the LVNC phenotype.
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Affiliation(s)
- O. V. Kulikova
- National Medical Research Center for Preventive Medicine
| | - A. N. Meshkov
- National Medical Research Center for Preventive Medicine
| | | | - A. V. Kiseleva
- National Medical Research Center for Preventive Medicine
| | - S. N. Koretsky
- National Medical Research Center for Preventive Medicine
| | | | - M. S. Kharlap
- National Medical Research Center for Preventive Medicine
| | | | | | - O. P. Skirko
- National Medical Research Center for Preventive Medicine
| | - I. A. Efimova
- National Medical Research Center for Preventive Medicine
| | | | | | - O. M. Drapkina
- National Medical Research Center for Preventive Medicine
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12
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Abstract
See Article by Shijie Li et al.
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13
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van Waning JI, Caliskan K, Hoedemaekers YM, van Spaendonck-Zwarts KY, Baas AF, Boekholdt SM, van Melle JP, Teske AJ, Asselbergs FW, Backx APCM, du Marchie Sarvaas GJ, Dalinghaus M, Breur JMPJ, Linschoten MPM, Verlooij LA, Kardys I, Dooijes D, Lekanne Deprez RH, IJpma AS, van den Berg MP, Hofstra RMW, van Slegtenhorst MA, Jongbloed JDH, Majoor-Krakauer D. Genetics, Clinical Features, and Long-Term Outcome of Noncompaction Cardiomyopathy. J Am Coll Cardiol 2019; 71:711-722. [PMID: 29447731 DOI: 10.1016/j.jacc.2017.12.019] [Citation(s) in RCA: 204] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 12/08/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND The clinical outcomes of noncompaction cardiomyopathy (NCCM) range from asymptomatic to heart failure, arrhythmias, and sudden cardiac death. Genetics play an important role in NCCM. OBJECTIVES This study investigated the correlations among genetics, clinical features, and outcomes in adults and children diagnosed with NCCM. METHODS A retrospective multicenter study from 4 cardiogenetic centers in the Netherlands classified 327 unrelated NCCM patients into 3 categories: 1) genetic, with a mutation in 32% (81 adults; 23 children) of patients; 2) probably genetic, familial cardiomyopathy without a mutation in 16% (45 adults; 8 children) of patients; or 3) sporadic, no family history, without mutation in 52% (149 adults; 21 children) of patients. Clinical features and major adverse cardiac events (MACE) during follow-up were compared across the children and adults. RESULTS MYH7, MYBPC3, and TTN mutations were the most common mutations (71%) found in genetic NCCM. The risk of having reduced left ventricular (LV) systolic dysfunction was higher for genetic patients compared with the probably genetic and sporadic cases (p = 0.024), with the highest risk in patients with multiple mutations and TTN mutations. Mutations were more frequent in children (p = 0.04) and were associated with MACE (p = 0.025). Adults were more likely to have sporadic NCCM. High risk for cardiac events in children and adults was related to LV systolic dysfunction in mutation carriers, but not in sporadic cases. Patients with MYH7 mutations had low risk for MACE (p = 0.03). CONCLUSIONS NCCM is a heterogeneous condition, and genetic stratification has a role in clinical care. Distinguishing genetic from nongenetic NCCM complements prediction of outcome and may lead to management and follow-up tailored to genetic status.
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Affiliation(s)
- Jaap I van Waning
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Kadir Caliskan
- Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Yvonne M Hoedemaekers
- Department of Clinical Genetics, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Annette F Baas
- Department of Clinical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Joost P van Melle
- Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands
| | - Arco J Teske
- Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Folkert W Asselbergs
- Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Ad P C M Backx
- Department of Pediatrics, Amsterdam Medical Center, Amsterdam, the Netherlands
| | | | - Michiel Dalinghaus
- Department of Pediatrics, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | | | - Laura A Verlooij
- Department of Clinical Genetics, University Medical Center Groningen, Groningen, the Netherlands
| | - Isabella Kardys
- Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Dennis Dooijes
- Department of Clinical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Arne S IJpma
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Maarten P van den Berg
- Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands
| | - Robert M W Hofstra
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Jan D H Jongbloed
- Department of Clinical Genetics, University Medical Center Groningen, Groningen, the Netherlands
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14
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Clinical and genetic insights into non-compaction: a meta-analysis and systematic review on 7598 individuals. Clin Res Cardiol 2019; 108:1297-1308. [PMID: 30980206 DOI: 10.1007/s00392-019-01465-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 03/19/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Left ventricular non-compaction has been increasingly diagnosed in recent years. However, it is still debated whether non-compaction is a pathological condition or a physiological trait. In this meta-analysis and systematic review, we compare studies, which investigated these two different perspectives. Furthermore, we provide a comprehensive overview on the clinical outcome as well as genetic background of left ventricular non-compaction cardiomyopathy in adult patients. METHODS AND RESULTS We retrieved PubMed/Medline literatures in English language from 2000 to 19/09/2018 on clinical outcome and genotype of patients with non-compaction. We summarized and extensively reviewed all studies that passed selection criteria and performed a meta-analysis on key phenotypic parameters. Altogether, 35 studies with 2271 non-compaction patients were included in our meta-analysis. The mean age at diagnosis was the mid of their fifth decade. Two-thirds of patients were male. Congenital heart diseases including atrial or ventricular septum defect or Ebstein anomaly were reported in 7% of patients. Twenty-four percent presented with family history of cardiomyopathy. The mean frequency of neuromuscular diseases was 5%. Heart rhythm abnormalities were reported frequently: conduction disease in 26%, supraventricular tachycardia in 17%, and sustained or non-sustained ventricular tachycardia in 18% of patients. Three important outcome measures were reported including systemic thromboembolic events with a mean frequency of 9%, heart transplantation with 4%, and adequate ICD therapy with 15%. Nine studies investigated the genetics of non-compaction cardiomyopathy. The most frequently mutated gene was TTN with a pooled frequency of 11%. The average frequency of MYH7 mutations was 9%, for MYBPC3 mutations 5%, and for CASQ2 and LDB3 3% each. TPM1, MIB1, ACTC1, and LMNA mutations had an average frequency of 2% each. Mutations in PLN, HCN4, TAZ, DTNA, TNNT2, and RBM20 were reported with a frequency of 1% each. We also summarized the results of eight studies investigating the non-compaction in altogether 5327 athletes, pregnant women, patients with sickle cell disease, as well as individuals from population-based cohorts, in which the presence of left ventricular hypertrabeculation ranged from 1.3 to 37%. CONCLUSION The summarized data indicate that non-compaction may lead to unfavorable outcome in different cardiomyopathy entities. The presence of key features in a multimodal diagnostic approach could distinguish between benign morphological trait and manifest cardiomyopathy.
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15
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Fennira S, Tekaya MA, Kraiem S. [Left ventricular non-compaction: What should be known!]. Ann Cardiol Angeiol (Paris) 2019; 68:120-124. [PMID: 30290909 DOI: 10.1016/j.ancard.2018.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 08/23/2018] [Indexed: 06/08/2023]
Abstract
Isolated non-compaction of the left ventricle (NCVG) is a rare congenital cardiomyopathy resulting from the shutdown of normal embryogenesis of the myocardium. Its main feature is the existence of many deep heart-related ventricular trabeculations, generally located at the level of the apex of the left ventricle. Diagnosis is based on echocardiography and magnetic resonance imaging (MRI), and may be difficult in the atypical forms. The clinical presentation and the prognosis are very variable. Familial forms are not rare, ordering a family screening.
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Affiliation(s)
- S Fennira
- Service de cardiologie, hôpital Habib Thameur, Tunis 2040, Tunisie; Faculté de médecine de Tunis, Tunisie.
| | - M A Tekaya
- Service de cardiologie, hôpital Habib Thameur, Tunis 2040, Tunisie; Faculté de médecine de Tunis, Tunisie
| | - S Kraiem
- Service de cardiologie, hôpital Habib Thameur, Tunis 2040, Tunisie; Faculté de médecine de Tunis, Tunisie
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16
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Richard P, Ader F, Roux M, Donal E, Eicher JC, Aoutil N, Huttin O, Selton-Suty C, Coisne D, Jondeau G, Damy T, Mansencal N, Casalta AC, Michel N, Haentjens J, Faivre L, Lavoute C, Nguyen K, Tregouët DA, Habib G, Charron P. Targeted panel sequencing in adult patients with left ventricular non-compaction reveals a large genetic heterogeneity. Clin Genet 2018; 95:356-367. [PMID: 30471092 DOI: 10.1111/cge.13484] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 09/06/2018] [Accepted: 09/18/2018] [Indexed: 12/31/2022]
Abstract
Left ventricular non-compaction (LVNC) is a cardiomyopathy that may be of genetic origin; however, few data are available about the yield of mutation, the spectrum of genes and allelic variations. The aim of this study was to better characterize the genetic spectrum of isolated LVNC in a prospective cohort of 95 unrelated adult patients through the molecular investigation of 107 genes involved in cardiomyopathies and arrhythmias. Fifty-two pathogenic or probably pathogenic variants were identified in 40 patients (42%) including 31 patients (32.5%) with single variant and 9 patients with complex genotypes (9.5%). Mutated patients tended to have younger age at diagnosis than patients with no identified mutation. The most prevalent genes were TTN, then HCN4, MYH7, and RYR2. The distribution includes 13 genes previously reported in LVNC and 10 additional candidate genes. Our results show that LVNC is basically a genetic disease and support genetic counseling and cardiac screening in relatives. There is a large genetic heterogeneity, with predominant TTN null mutations and frequent complex genotypes. The gene spectrum is close to the one observed in dilated cardiomyopathy but with specific genes such as HCN4. We also identified new candidate genes that could be involved in this sub-phenotype of cardiomyopathy.
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Affiliation(s)
- Pascale Richard
- APHP, Functional Unit of Cardiogénétique et Myogénétique, Service de Biochimie Métabolique, Hôpitaux Universitaires de la Pitié-Salpêtrière-Charles Foix, Paris, France.,Sorbonne Universités, UPMC Univ. Paris 06, INSERM, UMR_S 1166 and ICAN Institute for Cardiometabolism and Nutrition, Paris, France
| | - Flavie Ader
- APHP, Functional Unit of Cardiogénétique et Myogénétique, Service de Biochimie Métabolique, Hôpitaux Universitaires de la Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Maguelonne Roux
- Sorbonne Universités, UPMC Univ. Paris 06, INSERM, UMR_S 1166 and ICAN Institute for Cardiometabolism and Nutrition, Paris, France
| | - Erwan Donal
- Service de Cardiologie, Centre Hospitalier Régional Universitaire Pontchaillou, Rennes, France
| | - Jean-Christophe Eicher
- Service de Cardiologie, CHU Dijon Bourgogne - Hôpital François Mitterrand, 2 bd Maréchal de Lattre de Tassigny, Dijon, France
| | - Nadia Aoutil
- APHP, Functional Unit of Cardiogénétique et Myogénétique, Service de Biochimie Métabolique, Hôpitaux Universitaires de la Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Olivier Huttin
- Service de Cardiologie, CHU de Nancy, Hôpitaux de Brabois, rue du Morvan, Vandœuvre-lès-Nancy, France
| | - Christine Selton-Suty
- Service de Cardiologie, CHU de Nancy, Hôpitaux de Brabois, rue du Morvan, Vandœuvre-lès-Nancy, France
| | - Damien Coisne
- Service de Cardiologie, CHU de Poitiers, Poitiers, France
| | - Guillaume Jondeau
- APHP, Service Cardiologie, CHU Paris Nord-Val de Seine - Hôpital Xavier Bichat-Claude Bernard, Paris, France
| | - Thibaud Damy
- APHP, Service Cardiologie, CHU Henri Mondor, Créteil, France
| | - Nicolas Mansencal
- APHP, Service de Cardiologie, CHU Ambroise Paré, Boulogne Billancourt, France
| | | | - Nicolas Michel
- Cardiology Department, APHM, La Timone Hospital, Marseille, France
| | - Julie Haentjens
- Cardiology Department, APHM, La Timone Hospital, Marseille, France
| | - Laurence Faivre
- Service de Génétique, CHU Dijon Bourgogne - Hôpital François Mitterrand, Dijon, France
| | - Cecile Lavoute
- Cardiology Department, APHM, La Timone Hospital, Marseille, France
| | - Karine Nguyen
- APHM, Département de Génétique Médicale, APHM, La Timone Hospital, Marseille, France
| | - David-Alexandre Tregouët
- Sorbonne Universités, UPMC Univ. Paris 06, INSERM, UMR_S 1166 and ICAN Institute for Cardiometabolism and Nutrition, Paris, France
| | - Gilbert Habib
- Cardiology Department, APHM, La Timone Hospital, Marseille, France.,Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - Philippe Charron
- Sorbonne Universités, UPMC Univ. Paris 06, INSERM, UMR_S 1166 and ICAN Institute for Cardiometabolism and Nutrition, Paris, France.,APHP, Centre de référence pour les maladies cardiaques héréditaires, Hôpital Pitié-Salpêtrière, Paris, France.,Université de Versailles Saint Quentin, Service de Génétique, Hôpital Ambroise Paré, Boulogne-Billancourt, France
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17
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Salman OF, El-Rayess HM, Abi Khalil C, Nemer G, Refaat MM. Inherited Cardiomyopathies and the Role of Mutations in Non-coding Regions of the Genome. Front Cardiovasc Med 2018; 5:77. [PMID: 29998127 PMCID: PMC6028572 DOI: 10.3389/fcvm.2018.00077] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 06/04/2018] [Indexed: 01/16/2023] Open
Abstract
Cardiomyopathies (CMs) are a group of cardiac pathologies caused by an intrinsic defect within the myocardium. The relative contribution of genetic mutations in the pathogenesis of certain CMs, such as hypertrophic cardiomyopathy (HCM), arrythmogenic right/left ventricular cardiomyopathy (ARVC) and left ventricular non-compacted cardiomyopathy (LVNC) has been established in comparison to dilated cardiomyopathy (DCM) and restrictive cardiomyopathy (RCM). The aim of this article is to review mutations in the non-coding parts of the genome, namely, microRNA, promoter elements, enhancer/silencer elements, 3′/5′UTRs and introns, that are involved in the pathogenesis CMs. Additionally, we will explore the role of some long non-coding RNAs in the pathogenesis of CMs.
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Affiliation(s)
- Oday F Salman
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Hebah M El-Rayess
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Charbel Abi Khalil
- Department of Genetic Medicine, Weill Cornell Medical College, Doha, Qatar
| | - Georges Nemer
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Marwan M Refaat
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.,Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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18
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Miszalski-Jamka K, Jefferies JL, Mazur W, Głowacki J, Hu J, Lazar M, Gibbs RA, Liczko J, Kłyś J, Venner E, Muzny DM, Rycaj J, Białkowski J, Kluczewska E, Kalarus Z, Jhangiani S, Al-Khalidi H, Kukulski T, Lupski JR, Craigen WJ, Bainbridge MN. Novel Genetic Triggers and Genotype-Phenotype Correlations in Patients With Left Ventricular Noncompaction. ACTA ACUST UNITED AC 2018; 10:CIRCGENETICS.117.001763. [PMID: 28798025 DOI: 10.1161/circgenetics.117.001763] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 05/15/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND Left ventricular noncompaction (LVNC) is a genetically and phenotypically heterogeneous disease and, although increasingly recognized in clinical practice, there is a lack of widely accepted diagnostic criteria. We sought to identify novel genetic causes of LVNC and describe genotype-phenotype correlations. METHODS AND RESULTS A total of 190 patients from 174 families with left ventricular hypertrabeculation (LVHT) or LVNC were referred for cardiac magnetic resonance and whole-exome sequencing. A total of 425 control individuals were included to identify variants of interest (VOIs). We found an excess of 138 VOIs in 102 (59%) unrelated patients in 54 previously identified LVNC or other known cardiomyopathy genes. VOIs were found in 68 of 90 probands with LVNC and 34 of 84 probands with LVHT (76% and 40%, respectively; P<0.001). We identified 0, 1, and ≥2 VOIs in 72, 74, and 28 probands, respectively. We found increasing number of VOIs in a patient strongly correlated with several markers of disease severity, including ratio of noncompacted to compacted myocardium (P<0.001) and left ventricular ejection fraction (P=0.01). The presence of sarcomeric gene mutations was associated with increased occurrence of late gadolinium enhancement (P=0.004). CONCLUSIONS LVHT and LVNC likely represent a continuum of genotypic disease with differences in severity and variable phenotype explained, in part, by the number of VOIs and whether mutations are present in sarcomeric or nonsarcomeric genes. Presence of VOIs is common in patients with LVHT. Our findings expand the current clinical and genetic diagnostic approaches for patients with LVHT and LVNC.
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19
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Towbin JA, Jefferies JL. Cardiomyopathies Due to Left Ventricular Noncompaction, Mitochondrial and Storage Diseases, and Inborn Errors of Metabolism. Circ Res 2017; 121:838-854. [PMID: 28912186 DOI: 10.1161/circresaha.117.310987] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The normal function of the human myocardium requires the proper generation and utilization of energy and relies on a series of complex metabolic processes to achieve this normal function. When metabolic processes fail to work properly or effectively, heart muscle dysfunction can occur with or without accompanying functional abnormalities of other organ systems, particularly skeletal muscle. These metabolic derangements can result in structural, functional, and infiltrative deficiencies of the heart muscle. Mitochondrial and enzyme defects predominate as disease-related etiologies. In this review, left ventricular noncompaction cardiomyopathy, which is often caused by mutations in sarcomere and cytoskeletal proteins and is also associated with metabolic abnormalities, is discussed. In addition, cardiomyopathies resulting from mitochondrial dysfunction, metabolic abnormalities, storage diseases, and inborn errors of metabolism are described.
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Affiliation(s)
- Jeffrey A Towbin
- From the Le Bonheur Children's Hospital, St Jude Children's Research Hospital, University of Tennessee Health Science Center, Memphis; and Cincinnati Children's Hospital Medical Center, University of Cincinnati, OH.
| | - John Lynn Jefferies
- From the Le Bonheur Children's Hospital, St Jude Children's Research Hospital, University of Tennessee Health Science Center, Memphis; and Cincinnati Children's Hospital Medical Center, University of Cincinnati, OH
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20
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Weintraub RG, Semsarian C, Macdonald P. Dilated cardiomyopathy. Lancet 2017; 390:400-414. [PMID: 28190577 DOI: 10.1016/s0140-6736(16)31713-5] [Citation(s) in RCA: 362] [Impact Index Per Article: 51.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 09/09/2016] [Accepted: 09/14/2016] [Indexed: 12/18/2022]
Abstract
Dilated cardiomyopathy is defined by the presence of left ventricular dilatation and contractile dysfunction. Genetic mutations involving genes that encode cytoskeletal, sarcomere, and nuclear envelope proteins, among others, account for up to 35% of cases. Acquired causes include myocarditis and exposure to alcohol, drugs and toxins, and metabolic and endocrine disturbances. The most common presenting symptoms relate to congestive heart failure, but can also include circulatory collapse, arrhythmias, and thromboembolic events. Secondary neurohormonal changes contribute to reverse remodelling and ongoing myocyte damage. The prognosis is worst for individuals with the lowest ejection fractions or severe diastolic dysfunction. Treatment of chronic heart failure comprises medications that improve survival and reduce hospital admission-namely, angiotensin converting enzyme inhibitors and β blockers. Other interventions include enrolment in a multidisciplinary heart failure service, and device therapy for arrhythmia management and sudden death prevention. Patients who are refractory to medical therapy might benefit from mechanical circulatory support and heart transplantation. Treatment of preclinical disease and the potential role of stem-cell therapy are being investigated.
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Affiliation(s)
- Robert G Weintraub
- Department of Cardiology, Royal Children's Hospital, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
| | - Christopher Semsarian
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute and Sydney Medical School, University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Peter Macdonald
- St Vincent's Hospital, Sydney, NSW, Australia; Victor Chang Cardiac Research Institute, Sydney, NSW, Australia
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21
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Handlos P, Gruszka T, Staňková M, Marecová K, Joukal M. Biventricular noncompaction cardiomyopathy with malignant arrhythmia as a cause of sudden death. Forensic Sci Med Pathol 2017; 13:495-499. [PMID: 28616812 DOI: 10.1007/s12024-017-9889-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2017] [Indexed: 01/10/2023]
Affiliation(s)
- Petr Handlos
- Forensic Medicine, University Hospital Ostrava, CZ-708 52, Ostrava, Czech Republic
- Department of Intensive Medicine and Forensic Studies, Ostrava University, CZ-703 00, Ostrava, Czech Republic
- Department of Anatomy, Faculty of Medicine, Masaryk University, CZ-625 00, Brno, Czech Republic
| | - Tomáš Gruszka
- Pediatric Medicine, University Hospital Ostrava, CZ-708 52, Ostrava, Czech Republic
| | - Marie Staňková
- Forensic Medicine, University Hospital Ostrava, CZ-708 52, Ostrava, Czech Republic
- Department of Intensive Medicine and Forensic Studies, Ostrava University, CZ-703 00, Ostrava, Czech Republic
| | - Klára Marecová
- Department of Forensic Medicine and Medical Law, Faculty Hospital Olomouc, CZ-779 00, Olomouc, Czech Republic
| | - Marek Joukal
- Department of Anatomy, Faculty of Medicine, Masaryk University, CZ-625 00, Brno, Czech Republic.
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Bozkurt B, Colvin M, Cook J, Cooper LT, Deswal A, Fonarow GC, Francis GS, Lenihan D, Lewis EF, McNamara DM, Pahl E, Vasan RS, Ramasubbu K, Rasmusson K, Towbin JA, Yancy C. Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association. Circulation 2016; 134:e579-e646. [PMID: 27832612 DOI: 10.1161/cir.0000000000000455] [Citation(s) in RCA: 440] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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23
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Caselli S, Ferreira D, Kanawati E, Di Paolo F, Pisicchio C, Attenhofer Jost C, Spataro A, Jenni R, Pelliccia A. Prominent left ventricular trabeculations in competitive athletes: A proposal for risk stratification and management. Int J Cardiol 2016; 223:590-595. [PMID: 27561165 DOI: 10.1016/j.ijcard.2016.08.272] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 08/16/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Recently, an unexpectedly large prevalence of Left Ventricular Non Compaction (LVNC) has been reported in athletes, raising the question of the appropriateness of current diagnostic criteria. We sought to describe prevalence and clinical characteristics of athletes with suspected LVNC in a large cohort of Olympic athletes. METHODS Over 29months, 2501 consecutive athletes underwent a cardiac evaluation including physical examination, ECG, exercise test and echocardiography. Additional investigations (Cardiac Magnetic Resonance and/or genetic testing) were selectively performed in athletes with abnormal ECGs, ventricular arrhythmias, borderline LV dysfunction or positive family history. RESULTS Of the 2501 athletes, 36 (1.4%) showed prominent trabeculations suggestive for LVNC. Of these, 3 (0.1%) were considered to be affected by LVNC, based on presence of LV dysfunction (ejection fraction<50%) and/or positive family history and genetic testing; these athletes were cautiously restricted from competitions and entered a clinical follow-up program. The remaining 33 athletes, in the absence of LV impairment or familial cardiac diseases, were considered normal (n=24) or unlikely affected (n=9), regardless of the extent of the trabeculations. CONCLUSIONS In a large athlete population, a marked LV trabecular pattern was seen in 1.4%. Only a small subset of these athletes (0.1%) showed familial, clinical and morphologic changes supporting the diagnosis of LVNC. In the vast majority of the athletes, the increased trabeculations were not associated with LV dysfunction and/or positive family history, likely representing a morphologic LV variant, deprived of clinical significance.
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Affiliation(s)
| | | | - Eyad Kanawati
- Institute of Sports Medicine and Science, Rome, Italy
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Wilsbacher L, McNally EM. Genetics of Cardiac Developmental Disorders: Cardiomyocyte Proliferation and Growth and Relevance to Heart Failure. ANNUAL REVIEW OF PATHOLOGY 2016; 11:395-419. [PMID: 26925501 PMCID: PMC8978617 DOI: 10.1146/annurev-pathol-012615-044336] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Cardiac developmental disorders represent the most common of human birth defects, and anomalies in cardiomyocyte proliferation drive many of these disorders. This review highlights the molecular mechanisms of prenatal cardiac growth. Trabeculation represents the initial ventricular growth phase and is necessary for embryonic survival. Later in development, the bulk of the ventricular wall derives from the compaction process, yet the arrest of this process can still be compatible with life. Cardiomyocyte proliferation and growth form the basis of both trabeculation and compaction, and mouse models indicate that cardiomyocyte interactions with the surrounding environment are critical for these proliferative processes. The human genetics of left ventricular noncompaction cardiomyopathy suggest that cardiomyocyte cell-autonomous mechanisms contribute to the compaction process. Understanding the determinants of prenatal or early postnatal cardiomyocyte proliferation and growth provides critical information that identifies risk factors for cardiovascular disease, including heart failure and its associated complications of arrhythmias and thromboembolic events.
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Affiliation(s)
- Lisa Wilsbacher
- Department of Medicine, Center for Genetic Medicine, and Feinberg Cardiovascular Research Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611; ,
| | - Elizabeth M McNally
- Department of Medicine, Center for Genetic Medicine, and Feinberg Cardiovascular Research Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611; ,
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Choi Y, Kim SM, Lee SC, Chang SA, Jang SY, Choe YH. Quantification of left ventricular trabeculae using cardiovascular magnetic resonance for the diagnosis of left ventricular non-compaction: evaluation of trabecular volume and refined semi-quantitative criteria. J Cardiovasc Magn Reson 2016; 18:24. [PMID: 27142637 PMCID: PMC4855408 DOI: 10.1186/s12968-016-0245-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 04/21/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Left ventricular non-compaction (LVNC) is an unclassified cardiomyopathy and there is no consensus on the diagnosis of LVNC. The aims of this study were to establish quantitative methods to diagnose LVNC using cardiovascular magnetic resonance (CMR) and to suggest refined semi-quantitative methods to diagnose LVNC. METHODS This retrospective study included 145 subjects with mild to severe trabeculation of the left ventricle myocardium [24 patients with isolated LVNC, 33 patients with non-isolated LVNC, 30 patients with dilated cardiomyopathy (DCM) with non-compaction (DCMNC), 27 patients with DCM, and 31 healthy control subjects with mild trabeculation]. The left ventricular (LV) ejection fraction, global LV myocardial volume, trabeculated LV myocardial volume, and number of segments with late gadolinium enhancement were measured. In addition, the most prominent non-compacted (NC), compacted (C), normal mid-septum, normal mid-lateral wall, and apical trabeculation thicknesses on the end-diastolic frames of the long-axis slices were measured. RESULTS In the patients with isolated LVNC, the percentage of trabeculated LV volume (TV%, 42.6 ± 13.8 %) relative to total LV myocardial volume was 1.4 times higher than in those with DCM (30.3 ± 14.3 %, p < 0.001), and 1.7 times higher than in the controls (24.8 ± 7.1 %, p < 0.001). However, there was no significant difference in TV% between the isolated LVNC and DCMNC groups (47.1 ± 17.3 % in the DCMNC group; p = 0.210). The receiver operating characteristic curve analysis using Jenni's method for CMR classification as the standard diagnostic criteria revealed that a value of TV% above 34.6 % was predictive of NC with a specificity of 89.7 % (CI: 74.2 - 98.0 %) and a sensitivity of 66.1 % (CI: 52.6 - 77.9 %). A value of NC/septum over 1.27 was considered predictive for NC with a specificity of 82.8 % (CI: 64.2 - 94.2 %) and a sensitivity of 57.6 % (CI: 44.1 - 70.4 %). In addition, a value of apex/C above 3.15 was considered predictive of NC with a specificity of 93.1 % (CI: 77.2 - 99.2 %) and a sensitivity of 69.5 % (CI: 56.1 - 80.8 %). CONCLUSIONS A trabeculated LV myocardial volume above 35 % of the total LV myocardial volume is diagnostic for LVNC with high specificity. Also, the apex/C and NC/septum ratios could be useful as supplementary diagnostic criteria.
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Affiliation(s)
- Yeonu Choi
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Sung Mok Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
- HVSI Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang-Chol Lee
- HVSI Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung-A Chang
- HVSI Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Shin Yi Jang
- HVSI Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yeon Hyeon Choe
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.
- HVSI Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Coris EE, Moran BK, De Cuba R, Farrar T, Curtis AB. Left Ventricular Non-Compaction in Athletes: To Play or Not to Play. Sports Med 2016; 46:1249-59. [DOI: 10.1007/s40279-016-0512-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Abbasi Y, Jabbari J, Jabbari R, Yang RQ, Risgaard B, Køber L, Haunsø S, Tfelt-Hansen J. The pathogenicity of genetic variants previously associated with left ventricular non-compaction. Mol Genet Genomic Med 2015; 4:135-42. [PMID: 27066506 PMCID: PMC4799875 DOI: 10.1002/mgg3.182] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 09/29/2015] [Accepted: 09/29/2015] [Indexed: 12/05/2022] Open
Abstract
Background Left ventricular non‐compaction (LVNC) is a rare cardiomyopathy. Many genetic variants have been associated with LVNC. However, the number of the previous LVNC‐associated variants that are common in the background population remains unknown. The aim of this study was to provide an updated list of previously reported LVNC‐associated variants with biologic description and investigate the prevalence of LVNC variants in healthy general population to find false‐positive LVNC‐associated variants. Methods and Results The Human Gene Mutation Database and PubMed were systematically searched to identify all previously reported LVNC‐associated variants. Thereafter, the Exome Sequencing Project (ESP) and the Exome Aggregation Consortium (ExAC), that both represent the background population, was searched for all variants. Four in silico prediction tools were assessed to determine the functional effects of these variants. The prediction results of those identified in the ESP and ExAC and those not identified in the ESP and ExAC were compared. In 12 genes, 60 LVNC‐associated missense/nonsense variants were identified. MYH7 was the predominant gene, encompassing 24 of the 60 LVNC‐associated variants. The ESP only harbored nine and ExAC harbored 18 of the 60 LVNC‐associated variants. In total, eight out of nine ESP‐positive variants overlapped with the 18 variants identified in ExAC database. Conclusions In this article, we identified 9 ESP‐positive and 18 ExAC‐positive variants of 60 previously reported LVNC‐associated variants, suggesting that these variants are not necessarily the monogenic cause of LVNC.
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Affiliation(s)
- Yeganeh Abbasi
- The Danish National Research Foundation Center for Cardiac Arrhythmia (DARC)CopenhagenDenmark; Laboratory of Molecular CardiologyDepartment of CardiologyThe Heart CentreCopenhagen University Hospital RigshospitaletCopenhagenDenmark; Department of CardiologyThe Heart CenterRigshospitaletCopenhagenDenmark
| | - Javad Jabbari
- The Danish National Research Foundation Center for Cardiac Arrhythmia (DARC)CopenhagenDenmark; Laboratory of Molecular CardiologyDepartment of CardiologyThe Heart CentreCopenhagen University Hospital RigshospitaletCopenhagenDenmark; Department of CardiologyThe Heart CenterRigshospitaletCopenhagenDenmark
| | - Reza Jabbari
- The Danish National Research Foundation Center for Cardiac Arrhythmia (DARC)CopenhagenDenmark; Laboratory of Molecular CardiologyDepartment of CardiologyThe Heart CentreCopenhagen University Hospital RigshospitaletCopenhagenDenmark; Department of CardiologyThe Heart CenterRigshospitaletCopenhagenDenmark
| | - Ren-Qiang Yang
- The Danish National Research Foundation Center for Cardiac Arrhythmia (DARC)CopenhagenDenmark; Laboratory of Molecular CardiologyDepartment of CardiologyThe Heart CentreCopenhagen University Hospital RigshospitaletCopenhagenDenmark; Department of CardiologyInstitute of Cardiovascular DiseaseThe Heart CenterThe Second Affiliated HospitalNanchang UniversityNanchangChina
| | - Bjarke Risgaard
- The Danish National Research Foundation Center for Cardiac Arrhythmia (DARC)CopenhagenDenmark; Laboratory of Molecular CardiologyDepartment of CardiologyThe Heart CentreCopenhagen University Hospital RigshospitaletCopenhagenDenmark; Department of CardiologyThe Heart CenterRigshospitaletCopenhagenDenmark
| | - Lars Køber
- Department of CardiologyThe Heart CenterRigshospitaletCopenhagenDenmark; Department of Clinical MedicineFaculty of Health and Medical ScienceUniversity of CopenhagenCopenhagenDenmark
| | - Stig Haunsø
- The Danish National Research Foundation Center for Cardiac Arrhythmia (DARC)CopenhagenDenmark; Laboratory of Molecular CardiologyDepartment of CardiologyThe Heart CentreCopenhagen University Hospital RigshospitaletCopenhagenDenmark; Department of CardiologyThe Heart CenterRigshospitaletCopenhagenDenmark; Department of Clinical MedicineFaculty of Health and Medical ScienceUniversity of CopenhagenCopenhagenDenmark
| | - Jacob Tfelt-Hansen
- The Danish National Research Foundation Center for Cardiac Arrhythmia (DARC)CopenhagenDenmark; Laboratory of Molecular CardiologyDepartment of CardiologyThe Heart CentreCopenhagen University Hospital RigshospitaletCopenhagenDenmark; Department of CardiologyThe Heart CenterRigshospitaletCopenhagenDenmark; Department of Clinical MedicineFaculty of Health and Medical ScienceUniversity of CopenhagenCopenhagenDenmark
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Muhammad E, Levitas A, Singh SR, Braiman A, Ofir R, Etzion S, Sheffield VC, Etzion Y, Carrier L, Parvari R. PLEKHM2 mutation leads to abnormal localization of lysosomes, impaired autophagy flux and associates with recessive dilated cardiomyopathy and left ventricular noncompaction. Hum Mol Genet 2015; 24:7227-40. [PMID: 26464484 DOI: 10.1093/hmg/ddv423] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 10/05/2015] [Indexed: 01/10/2023] Open
Abstract
Gene mutations, mostly segregating with a dominant mode of inheritance, are important causes of dilated cardiomyopathy (DCM), a disease characterized by enlarged ventricular dimensions, impaired cardiac function, heart failure and high risk of death. Another myocardial abnormality often linked to gene mutations is left ventricular noncompaction (LVNC) characterized by a typical diffuse spongy appearance of the left ventricle. Here, we describe a large Bedouin family presenting with a severe recessive DCM and LVNC. Homozygosity mapping and exome sequencing identified a single gene variant that segregated as expected and was neither reported in databases nor in Bedouin population controls. The PLEKHM2 cDNA2156_2157delAG variant causes the frameshift p.Lys645AlafsTer12 and/or the skipping of exon 11 that results in deletion of 30 highly conserved amino acids. PLEKHM2 is known to interact with several Rabs and with kinesin-1, affecting endosomal trafficking. Accordingly, patients' primary fibroblasts exhibited abnormal subcellular distribution of endosomes marked by Rab5, Rab7 and Rab9, as well as the Golgi apparatus. In addition, lysosomes appeared to be concentrated in the perinuclear region, and autophagy flux was impaired. Transfection of wild-type PLEKHM2 cDNA into patient's fibroblasts corrected the subcellular distribution of the lysosomes, supporting the causal effect of PLEKHM2 mutation. PLEKHM2 joins LAMP-2 and BAG3 as a disease gene altering autophagy resulting in an isolated cardiac phenotype. The association of PLEKHM2 mutation with DCM and LVNC supports the importance of autophagy for normal cardiac function.
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Affiliation(s)
- Emad Muhammad
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel
| | - Aviva Levitas
- Department of Pediatric Cardiology, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel
| | - Sonia R Singh
- Department of Experimental Pharmacology and Toxicology, Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany, DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Germany
| | - Alex Braiman
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel
| | - Rivka Ofir
- Regenerative Medicine and Stem Cell Research Center, Beer-Sheva 84105, Israel
| | - Sharon Etzion
- Regenerative Medicine and Stem Cell Research Center, Beer-Sheva 84105, Israel
| | - Val C Sheffield
- Department of Pediatrics, Division of Medical Genetics and Hughes Medical Institute, University of Iowa, Iowa City, IA 52242, USA
| | - Yoram Etzion
- Regenerative Medicine and Stem Cell Research Center, Beer-Sheva 84105, Israel, Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel and
| | - Lucie Carrier
- Department of Experimental Pharmacology and Toxicology, Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany, DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Germany
| | - Ruti Parvari
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel, National Institute for Biotechnology in the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Left Ventricular Noncompaction Diagnosis and Management Relevant to Pre-participation Screening of Athletes. Am J Cardiol 2015; 116:801-8. [PMID: 26141199 DOI: 10.1016/j.amjcard.2015.05.055] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 05/23/2015] [Accepted: 05/23/2015] [Indexed: 01/26/2023]
Abstract
Left ventricular noncompaction (LVNC) has been extensively studied over the last years, and an increasing number of cases have been reported worldwide, with a large proportion comprising young and asymptomatic subjects, including athletes. The current epidemic of LVNC is likely the consequence of several causes, that is, the increased awareness of the disease and the refined cardiovascular imaging techniques. The current diagnostic methods, based uniquely on definition of morphologic findings, do not always resolve the overlap of a physiological myocardial architecture comprising a prominent trabecular pattern from a mild phenotypic expression of the real disease. Appropriate criteria for identification and management of LVNC in athletes have, therefore, become a novel challenge for cardiologists and sport physicians, who are required to solve the question of diagnosis and appropriate management in the setting of pre-participation cardiovascular screening. Indeed, although it is important to timely identify a true myocardial disease, to reduce the burden of adverse cardiac event in a young athlete, in contrast, a misdiagnosis of LVNC may lead to unwarranted restriction of the athlete lifestyle, with detrimental psychological, social, and economic consequences. This review report has been planned, therefore, to help physicians in diagnosing and managing athletes presenting with a morphologic pattern suggestive of LVNC with specific focus on criteria for advising sport participation.
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Abstract
Left ventricular non-compaction, the most recently classified form of cardiomyopathy, is characterised by abnormal trabeculations in the left ventricle, most frequently at the apex. It can be associated with left ventricular dilation or hypertrophy, systolic or diastolic dysfunction, or both, or various forms of congenital heart disease. Affected individuals are at risk of left or right ventricular failure, or both. Heart failure symptoms can be induced by exercise or be persistent at rest, but many patients are asymptomatic. Patients on chronic treatment for compensated heart failure sometimes present acutely with decompensated heart failure. Other life-threatening risks of left ventricular non-compaction are ventricular arrhythmias or complete atrioventricular block, presenting clinically as syncope, and sudden death. Genetic inheritance arises in at least 30-50% of patients, and several genes that cause left ventricular non-compaction have been identified. These genes seem generally to encode sarcomeric (contractile apparatus) or cytoskeletal proteins, although, in the case of left ventricular non-compaction with congenital heart disease, disturbance of the NOTCH signalling pathway seems part of a final common pathway for this form of the disease. Disrupted mitochondrial function and metabolic abnormalities have a causal role too. Treatments focus on improvement of cardiac efficiency and reduction of mechanical stress in patients with systolic dysfunction. Further, treatment of arrhythmia and implantation of an automatic implantable cardioverter-defibrillator for prevention of sudden death are mainstays of therapy when deemed necessary and appropriate. Patients with left ventricular non-compaction and congenital heart disease often need surgical or catheter-based interventions. Despite progress in diagnosis and treatment in the past 10 years, understanding of the disorder and outcomes need to be improved.
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Affiliation(s)
- Jeffrey A Towbin
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Angela Lorts
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - John Lynn Jefferies
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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31
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Biventricular Noncompaction Cardiomyopathy in an Adult with Unique Facial Dysmorphisms: Case Report and Brief Review. Case Rep Cardiol 2015; 2015:831341. [PMID: 26266056 PMCID: PMC4523653 DOI: 10.1155/2015/831341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 07/08/2015] [Indexed: 11/18/2022] Open
Abstract
Left ventricular noncompaction (LVNC) is a rare cardiomyopathy that is believed it to arise from an arrest in embryonic endomyocardial development. More recent studies suggest that it can be acquired later on in life sporadically. It may be accompanied by life-threatening complications, which are most commonly heart failure, arrhythmias, and thromboembolic events. We report a case of biventricular noncompaction cardiomyopathy in a 36-year-old man presenting for the first time with clinical heart failure as well as atrial arrhythmia. Transthoracic echocardiography (TTE) revealed LVNC with depressed ejection fraction (EF). Cardiac magnetic resonance imaging (MRI) further revealed a left atrial appendage thrombus as well as right ventricular noncompaction involvement. His physical exam was unique for a characteristic facial dysmorphisms pattern and developmental delays reminiscent of the earliest descriptions of LVNC in the pediatric population and it was rarely described in adult patients. This unique presentation underscores the importance of a better understanding of the genetics and natural course of LVNC. This will help us to elucidate the uncertainty surrounding its clinical management, discussed in a brief review of the literature following the case.
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Hussein A, Karimianpour A, Collier P, Krasuski RA. Isolated Noncompaction of the Left Ventricle in Adults. J Am Coll Cardiol 2015; 66:578-85. [DOI: 10.1016/j.jacc.2015.06.017] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 06/09/2015] [Accepted: 06/10/2015] [Indexed: 10/23/2022]
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Russell M, Roberts AE, Abrams DJ, Murphy AM, Towbin JA, Chung WK. How to effectively utilize genetic testing in the care of children with cardiomyopathies. PROGRESS IN PEDIATRIC CARDIOLOGY 2015. [DOI: 10.1016/j.ppedcard.2015.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Abstract
Left ventricular noncompaction (LVNC) is a newly recognized form of cardiomyopathy that has been associated with heart failure, arrhythmias, thromboembolic events, and sudden death. Both ventricular and supraventricular arrhythmias are now well described as prominent clinical components of LVNC. Throughout the spectrum of age, these arrhythmias have been associated with prognosis and outcome, and their clinical management is therefore an important aspect of patient care. The risk of sudden death seems to be associated with ventricular dilation, systolic dysfunction, and the presence of arrhythmias. Proposed management strategies shown to have efficacy include antiarrhythmic therapy, ablation techniques, and implantable cardioverter-defibrillator implantation.
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Affiliation(s)
- Christina Y Miyake
- Section of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, 6621 Fannin Street, Houston, TX 77030, USA
| | - Jeffrey J Kim
- Section of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, 6621 Fannin Street, Houston, TX 77030, USA.
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Arbustini E, Weidemann F, Hall JL. Left ventricular noncompaction: a distinct cardiomyopathy or a trait shared by different cardiac diseases? J Am Coll Cardiol 2014; 64:1840-50. [PMID: 25443708 DOI: 10.1016/j.jacc.2014.08.030] [Citation(s) in RCA: 145] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 08/22/2014] [Accepted: 08/29/2014] [Indexed: 01/13/2023]
Abstract
Whether left ventricular noncompaction (LVNC) is a distinct cardiomyopathy or a morphologic trait shared by different cardiomyopathies remains controversial. Current guidelines from professional organizations recommend different strategies for diagnosing and treating patients with LVNC. This state-of-the-art review discusses new insights into the basic mechanisms leading to LVNC, its clinical manifestations, treatment modalities, anatomy and pathology, embryology, genetics, epidemiology, and imaging. Three markers currently define LVNC: prominent left ventricular trabeculae, deep intertrabecular recesses, and a thin compacted layer. Although new genetic data from mice and humans supports LVNC as a distinct cardiomyopathy, evidence for LVNC as a shared morphological trait is not ruled out. Criteria supporting LVNC as a shared morphological trait may depend on consensus guidelines from the multiple professional organizations. Enhanced imaging and increased use of genetics are both predicted to significantly impact our overall understanding of the basic mechanisms causing LVNC and its optimal management.
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Affiliation(s)
- Eloisa Arbustini
- Centre for Inherited Cardiovascular Disease, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - Frank Weidemann
- Department of Internal Medicine, University Hospital Würzburg, and Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany
| | - Jennifer L Hall
- Lillehei Heart Institute and Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
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Abstract
Cardiomyopathies (ie, diseases of the heart muscle) are major causes of morbidity and mortality. A significant percentage of patients with cardiomyopathies have genetic-based, inheritable disease and, over the past 2 decades the genetic causes of these disorders have been increasingly discovered. The genes causing these disorders when they are mutated appear to encode proteins that frame a "final common pathway" for that specific disorder, but the specifics of the phenotype, including age of onset, severity, and outcome is variable for reasons not yet understood. The "final common pathways" for the classified forms of cardiomyopathy include the sarcomere in the primarily diastolic dysfunction disorders hypertrophic cardiomyopathy and restrictive cardiomyopathy, the linkage of the sarcomere and sarcolemma in the systolic dysfunction disorder dilated cardiomyopathy, and the desmosome in arrhythmogenic cardiomyopathy. Left ventricular noncompaction cardiomyopathy (LVNC) is an overlap disorder and it appears that any of these "final common pathways" can be involved depending on the specific form of LVNC. The genetics and mechanisms responsible for these clinical phenotypes will be described.
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Affiliation(s)
- Jeffrey A Towbin
- The Heart Institute, Cincinnati Children's Hospital Medical Center
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38
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Kannan A, Das A, Janardhanan R. An interesting case of cryptogenic stroke in a young man due to left ventricular non-compaction: role of cardiac MRI in the accurate diagnosis. BMJ Case Rep 2014; 2014:bcr-2014-204230. [PMID: 24962593 DOI: 10.1136/bcr-2014-204230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
A 28-year-old man arrived for an outpatient cardiac MRI (CMR) study to evaluate cardiac structure. At the age of 24 the patient presented with acute onset expressive aphasia and was diagnosed with ischaemic stroke. Echocardiography at that time was reported as 'apical wall thickening consistent with apical hypertrophic cardiomyopathy'. CMR revealed a moderately dilated left ventricle with abnormal appearance of the left ventricular (LV) apical segments. Further evaluation was consistent with a diagnosis of LV non-compaction (LVNC) cardiomyopathy with a ratio of non-compacted to compacted myocardium measuring 3. There was extensive delayed hyperenhancement signal involving multiple segments representing a significant myocardial scar which is shown to have a prognostic role. Our patient, with no significant cerebrovascular risk factors, would likely have had an embolic stroke. This case demonstrates the role of CMR in accurately diagnosing LVNC in a patient with young stroke where prior echocardiography was non-diagnostic.
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Affiliation(s)
- Arun Kannan
- Department of Inpatient Medicine, University of Arizona, Tucson, Arizona, USA
| | - Anindita Das
- Department of Inpatient Medicine, University of Arizona, Tucson, Arizona, USA
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Udeoji DU, Philip KJ, Morrissey RP, Phan A, Schwarz ER. Left ventricular noncompaction cardiomyopathy: updated review. Ther Adv Cardiovasc Dis 2014; 7:260-73. [PMID: 24132556 DOI: 10.1177/1753944713504639] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The first case of noncompaction was described in 1932 after an autopsy performed on a newborn infant with aortic atresia/coronary-ventricular fistula. Isolated noncompaction cardiomyopathy was first described in 1984. A review on selected/relevant medical literature was conducted using Pubmed from 1984 to 2013 and the pathogenesis, clinical features, and management are discussed. Left ventricular noncompaction (LVNC) is a relatively rare congenital condition that results from arrest of the normal compaction process of the myocardium during fetal development. LVNC shows variability in its genetic pattern, pathophysiologic findings, and clinical presentations. The genetic heterogeneity, phenotypical overlap, and variety in clinical presentation raised the suspicion that LVNC might just be a morphological variant of other cardiomyopathies, but the American Heart Association classifies LVNC as a primary genetic cardiomyopathy. The familiar type is common and follows a X-linked, autosomal-dominant, or mitochondrial-inheritance pattern (in children). LVNC can occur in isolation or coexist with other cardiac and/or systemic anomalies. The clinical presentations are variable ranging from asymptomatic patients to patients who develop ventricular arrhythmias, thromboembolism, heart failure, and sudden cardiac death. Increased awareness over the last 25 years and improvements in technology have increased the identification of this illness and improved the clinical outcome and prognosis. LVNC is commonly diagnosed by echocardiography. Other useful diagnostic techniques for LVNC include cardiac magnetic resonance imaging, computerized tomography, and left ventriculography. Management is symptom based and patients with symptoms have a poorer prognosis. LVNC is a genetically heterogeneous disorder which can be associated with other anomalies. Making the correct diagnosis is important because of the possible associations and the need for long-term management and screening of living relatives.
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Affiliation(s)
- Dioma U Udeoji
- Cedars Sinai Medical Center, Los Angeles, California, USA
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Meyer S, van der Meer P, van Tintelen JP, van den Berg MP. Sex differences in cardiomyopathies. Eur J Heart Fail 2014; 16:238-47. [PMID: 24464619 DOI: 10.1002/ejhf.15] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 09/26/2013] [Accepted: 10/01/2013] [Indexed: 12/16/2022] Open
Abstract
Cardiomyopathies are a heterogeneous group of heart muscle diseases with a variety of specific phenotypes. According to the contemporary European Society of Cardiology classification, they are classified into hypertrophic (HCM), dilated (DCM), arrhythmogenic right ventricular (ARVC), restrictive (RCM), and unclassified cardiomyopathies. Each class is aetiologically further categorized into inherited (familial) and non-inherited (non-familial) forms. There is substantial evidence that biological sex is a strong modulator of the clinical manifestation of these cardiomyopathies, and sex-specific characteristics are detectable in all classes. For the clinician, it is important to know the sex-specific aspects of clinical disease expression and the potential modes of inheritance or the hereditary influences underlying the development of cardiomyopathies, since these may aid in diagnosing such diseases in both sexes.
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Affiliation(s)
- Sven Meyer
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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41
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Delgado A, Moreira D, Rodrigues B, Correia E, Gama P, Cabral C, Marinho A, Santos O. Hypertrophic cardiomyopathy associated with left ventricular noncompaction cardiomyopathy and coronary fistulae: a case report. One genotype, three phenotypes? Rev Port Cardiol 2013; 32:919-24. [PMID: 24268868 DOI: 10.1016/j.repc.2013.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 05/21/2013] [Accepted: 05/22/2013] [Indexed: 01/10/2023] Open
Abstract
The authors present a rare case of hypertrophic cardiomyopathy associated with left ventricular noncompaction cardiomyopathy and coronary artery-left ventricular fistulae in a 42-year-old woman presenting with non-ST-elevation myocardial infarction. Coronary angiography, transthoracic echocardiography and cardiac magnetic resonance revealed the structural abnormalities of the left ventricle and the coronary tree.
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Affiliation(s)
- Anne Delgado
- Serviço de Cardiologia, Centro Hospitalar Tondela-Viseu, Viseu, Portugal.
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42
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Delgado A, Moreira D, Rodrigues B, Correia E, Gama P, Cabral C, Marinho A, Santos O. Hypertrophic cardiomyopathy associated with left ventricular noncompaction cardiomyopathy and coronary fistulae – A case report. One genotype, three phenotypes? REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2013. [DOI: 10.1016/j.repce.2013.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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43
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Ganga HV, Thompson PD. Sports participation in non-compaction cardiomyopathy: a systematic review. Br J Sports Med 2013; 48:1466-71. [DOI: 10.1136/bjsports-2012-091855] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Mipinda JB, Ibaba J, Nkoghe DD, Kombila PA. [Family form of isolated left ventricular noncompaction; case of a mother and her son observed in Gabon]. Ann Cardiol Angeiol (Paris) 2013; 62:56-59. [PMID: 21676376 DOI: 10.1016/j.ancard.2011.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Accepted: 04/17/2011] [Indexed: 05/30/2023]
Abstract
We describe a case report of a young Gabonese lady who presented an acute pulmonary oedema and we suspected a paripartum cardiomyopathy. Subsequent investigations showed isolated left ventricular noncompaction. A few months later, the same disease was disclosed at her 9 year-old son who presented a cardiac insufficiency. Therefore, we suspect a family form of left ventricular noncompaction. And it is the first description in subsaharan Africa. The hereditary character of this new form of cardiomyopathy linked to a genetic mutation on the X chromosome is well known. This disease is associated with heart failure, high incidence of systemic thromboembolism complications or ventricular arrhythmia. The echocardiography and the cardiac magnetic resonance imaging has been reported to be tools for diagnosis. In Africa, access to these techniques remains a privilege. So the discovery of illness is often late and the family screening are special. In our area, the therapeutic management is the medical treatment of heart failure. Implatable cardioverter defibrillator or heart transplantation are not available. So long-term prognosis of our patients with congestive heart failure stays poor. With best equipment in our hospitals and good training of African cardiologists, we should improve the management of our patients.
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Affiliation(s)
- J B Mipinda
- Service de cardiologie, centre hospitalier de Libreville, B.P. 6392 Libreville, Gabon.
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Liu Q, Qi XF, Ye F, Yao J, Xu J. Lack of mutations of G4.5 in three families from China with noncompaction of the ventricular myocardium. GENETICS AND MOLECULAR RESEARCH 2013; 12:53-8. [PMID: 23359024 DOI: 10.4238/2013.january.22.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
To find the underlying cause of noncompaction of the ventricular myocardium (NVM), three Chinese families with probands who presented this problem were studied. After the family members were evaluated by echocardiography, the gene G4.5 (taffazin) was scanned by sequencing. Although X-linked inheritance could not be ruled out, NVM were thought to have a vague rule of inheritance in our data from 8 patients and 28 family members. We also did not identify any mutations in G4.5 in all samples. Our data suggest that other genes are responsible for the familial form of this disease.
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Affiliation(s)
- Q Liu
- Department of Gastroenterology, First Affiliated Hospital, Soochow University, Suzhou, China
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Lopes LR, Elliott PM. Genetics of heart failure. Biochim Biophys Acta Mol Basis Dis 2013; 1832:2451-61. [PMID: 23298545 DOI: 10.1016/j.bbadis.2012.12.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2012] [Revised: 12/04/2012] [Accepted: 12/22/2012] [Indexed: 12/27/2022]
Abstract
Heart failure (HF) occurs when the cardiac output, no longer compensated by endogenous mechanisms, fails to meet the metabolic demands of the body. In most populations, the prevalence of heart failure continues to rise, constituting a major public health burden, especially in developed countries. There is some evidence that the risk of HF in the general population depends on genetic predisposition, necessarily characterised by a very complex architecture. In a small, but probably underestimated proportion, HF is caused by Mendelian inherited forms of myocardial disease. The genetic background of these genetic conditions is a matter of intensive research that is already shedding light onto the genetics of common sporadic forms of HF. In this review, we briefly review the insights provided by candidate gene and genome-wide association approaches in common HF and then describe the main genetic causes of inherited heart muscle disease. Finally we present the current challenges and future research needs for both forms of HF. This article is part of a Special Issue entitled: Heart failure pathogenesis and emerging diagnostic and therapeutic interventions.
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Affiliation(s)
- Luís R Lopes
- UCL Institute of Cardiovascular Science, London, UK
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Chang B, Gorbea C, Lezin G, Li L, Shan L, Sakai N, Kogaki S, Otomo T, Okinaga T, Hamaoka A, Yu X, Hata Y, Nishida N, Yost HJ, Bowles NE, Brunelli L, Ichida F. 14-3-3ε gene variants in a Japanese patient with left ventricular noncompaction and hypoplasia of the corpus callosum. Gene 2012; 515:173-80. [PMID: 23266643 DOI: 10.1016/j.gene.2012.12.049] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 12/02/2012] [Indexed: 01/07/2023]
Abstract
BACKGROUND Left ventricular noncompaction (LVNC) is a cardiomyopathy characterized by a prominent trabecular meshwork and deep intertrabecular recesses, and is thought to be due to an arrest of normal endomyocardial morphogenesis. However, the genes contributing to this process remain poorly understood. 14-3-3ε, encoded by YWHAE, is an adapter protein belonging to the 14-3-3 protein family which plays important roles in neuronal development and is involved in Miller-Dieker syndrome. We recently showed that mice lacking this gene develop LVNC. Therefore, we hypothesized that variants in YWHAE may contribute to the pathophysiology of LVNC in humans. METHODS AND RESULTS In 77 Japanese patients with LVNC, including the probands of 29 families, mutation analysis of YWHAE by direct DNA sequencing identified 7 novel variants. One of them, c.-458G>T, in the YWHAE promoter, was identified in a familial patient with LVNC and hypoplasia of the corpus callosum. The -458G>T variant is located within a regulatory CCAAT/enhancer binding protein (C/EBP) response element of the YWHAE promoter, and it reduced promoter activity by approximately 50%. Increased binding of an inhibitory C/EBPβ isoform was implicated in decreasing YWHAE promoter activity. Interestingly, we had previously shown that C/EBPβ is a key regulator of YWHAE. CONCLUSIONS These data suggest that the -458G>T YWHAE variant contributes to the abnormal myocardial morphogenesis characteristic of LVNC as well as abnormal brain development, and implicate YWHAE as a novel candidate gene in pediatric cardiomyopathies.
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Affiliation(s)
- Bo Chang
- Department of Pediatrics, University of Toyama, Toyama, Japan
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Piga A, Longo F, Musallam KM, Veltri A, Ferroni F, Chiribiri A, Bonamini R. Left ventricular noncompaction in patients with β-thalassemia: uncovering a previously unrecognized abnormality. Am J Hematol 2012; 87:1079-83. [PMID: 22965286 DOI: 10.1002/ajh.23323] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2012] [Revised: 07/25/2012] [Accepted: 08/06/2012] [Indexed: 12/27/2022]
Abstract
Left ventricular noncompaction (LVNC) is a rare cardiomyopathy with potentially serious outcomes. It results in multiple and excessive trabeculations, deep intertrabecular recesses, and a thickened ventricular myocardium with two distinct layers, compacted and noncompacted. The condition is most commonly congenital; however, acquired forms have also been described. A recent report of LVNC detected in a β-thalassemia twin suggested an association with cardiac siderosis. In a cross-sectional study of 135 transfusion-dependent patients with β-thalassemia (130 major and 5 intermedia, mean age 29.6 ± 7.7 years, 49.6% males) presenting for cardiac iron assessment by magnetic resonance imaging (MRI), we evaluated the prevalence and risk factors for LVNC. None of the patients had neuromuscular or congenital heart disease. Eighteen patients (13.3%; 95% confidence interval [CI] = 8.6-20.1) fulfilled the preassigned strict criteria for LVNC on cardiac MRI. There were no statistically significant differences between patients with and without LVNC with respect to demographics; hemoglobin levels; splenectomy status; systemic, hepatic, and cardiac iron overload indices; hepatic disease and infection studies; or iron chelator type. Patients with LVNC were more likely to have heart failure (adjusted odds ratio = 1.77; 95% CI = 0.29-10.89); although with high uncertainty. Patients with β-thalassemia have a higher prevalence of LVNC than normal individuals. As this finding could not be explained by conventional risk factors in this patient population, further investigation of the underlying mechanisms of LVNC is warranted. This remains crucial for an entity with adverse cardiac outcomes, especially in patients with β-thalassemia where cardiac disease remains a primary cause of mortality.
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Affiliation(s)
- Antonio Piga
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.
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Tanaka H, Kimura T, Miyamoto S. Aortic valve replacement for aortic regurgitation with rare left ventricular non-compaction. Ann Thorac Cardiovasc Surg 2012. [PMID: 23196658 DOI: 10.5761/atcs.cr.12.01939] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Left ventricular noncompaction cardiomyopathy is a rare type of congenital cardiomyopathy characterized by prematurely arrested compaction of the endocardial and myocardial fibers and the progressive deterioration of left ventricular contractility. This entity is a genetically heterogeneous disorder and has a wide spectrum of presentation from no symptoms to critical disabling congestive heart failure, which can appear at any age. The prognosis is therefore varied. An elderly patient with left ventricular noncompaction underwent aortic valve replacement for associated aortic regurgitation.Follow-up at two years after surgery revealed an improved clinical condition and recovered cardiac function. This is the fourth known aortic valve replacement in a patient with left ventricular noncompaction.
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Affiliation(s)
- Hideyuki Tanaka
- Department of Cardiovascular Surgery, Shinbeppu Hospital, Beppu, Oita, Japan
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Yim SM, Jang SW, Chun HJ, Kim SJ, Choi KY, Kwon BJ, Kim DB, Cho EJ, Lee MY, Rho TH, Kim JH. A case of left ventricular noncompaction accompanying fasciculo-ventricular accessory pathway and atrial flutter. Korean Circ J 2012; 42:705-8. [PMID: 23170100 PMCID: PMC3493809 DOI: 10.4070/kcj.2012.42.10.705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 02/15/2012] [Accepted: 02/22/2012] [Indexed: 11/11/2022] Open
Abstract
Left ventricular hypertrabeculation/noncompaction (LVHT) is an uncommon type of genetic cardiomyopathy characterized by trabeculations and recesses within the ventricular myocardium. LVHT is associated with diastolic or systolic dysfunction, thromboembolic complications, and arrhythmias, including atrial fibrillation, ventricular arrhythmias, atrioventricular block and Wolff-Parkinson-White syndrome. Herein, we describe a patient who presented with heart failure and wide-complex tachycardia. Echocardiography showed LVHT accompanied with severe mitral regurgitation. The electrophysiologic study revealed a fasciculo-ventricular accessory pathway and atrial flutter (AFL). The AFL was successfully treated with catheter ablation.
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Affiliation(s)
- Sun Mie Yim
- Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
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