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Legendre A, Khraiche D, Ou P, Mauvais FX, Madrange M, Guemann AS, Jais JP, Bonnet D, Hamel Y, de Lonlay P. Cardiac function and exercise adaptation in 8 children with LPIN1 mutations. Mol Genet Metab 2018; 123:375-381. [PMID: 29325813 DOI: 10.1016/j.ymgme.2017.12.429] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 12/13/2017] [Accepted: 12/13/2017] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Lipin-1 deficiency is a major cause of rhabdomyolysis that are precipitated by febrile illness. The prognosis is poor, with one-third of patients dying from cardiac arrest during a crisis episode. Apart from acute rhabdomyolysis, most patients are healthy, showing normal clinical and cardiac ultrasound parameters. PATIENTS AND METHODS We report cardiac and exercise examinations of 8 children carrying two LPIN1 mutations. The examinations were performed outside of a myolysis episode, but one patient presented with fever during one examination. RESULTS All but one patient displayed normal resting cardiac function, as determined by echocardiography. One patient exhibited slight left ventricular dysfunction at rest and a lack of increased stroke volume during cycle ramp exercise. During exercise, peripheral muscle adaptation was impaired in 2 patients compared to healthy controls: they presented an abnormal increase in cardiac output relative to oxygen uptake: dQ/dVO2=8.2 and 9.5 (>2DS of controls population). One patient underwent 2 exercise tests; during one test, the patient was febrile, leading to acute rhabdomyolysis in the following hours. He exhibited changes in recovery muscle reoxygenation parameters and an increased dQ/dVO2 during exercise compared with that under normothermia (7.9 vs 6), which did not lead to acute rhabdomyolysis. The four patients assessed by cardiac 1H-magnetic resonance spectroscopy exhibited signs of intracardiac steatosis. CONCLUSION We observed abnormal haemodynamic profiles during exercise in 3/8 patients with lipin-1 deficiency, suggesting impaired muscle oxidative phosphorylation during exercise. Fever appeared to be an aggravating factor. One patient exhibited moderate cardiac dysfunction, which was possibly related to intracardiac stored lipid toxicity.
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Affiliation(s)
- Antoine Legendre
- Pediatric Cardiology, Centre de Référence des Malformations Cardiaques Congénitales Complexes-M3C, Necker Hospital for Sick Children, Paris, France.
| | - Diala Khraiche
- Pediatric Cardiology, Centre de Référence des Malformations Cardiaques Congénitales Complexes-M3C, Necker Hospital for Sick Children, Paris, France
| | - Phalla Ou
- Pediatric Cardiology, Centre de Référence des Malformations Cardiaques Congénitales Complexes-M3C, Necker Hospital for Sick Children, Paris, France; Department of Radiology, Hospital Bichat, APHP, University Paris Diderot, Paris, France
| | - François-Xavier Mauvais
- Reference Centre of Inherited Metabolic Diseases, Hospital Necker Enfants Malades, APHP, Institute Imagine, University Paris Descartes, Paris, France; Institut National de la Sante et de la Recherche Médicale, Unité 1151, Paris 75015, France
| | - Marine Madrange
- Reference Centre of Inherited Metabolic Diseases, Hospital Necker Enfants Malades, APHP, Institute Imagine, University Paris Descartes, Paris, France
| | - Anne-Sophie Guemann
- Reference Centre of Inherited Metabolic Diseases, Hospital Necker Enfants Malades, APHP, Institute Imagine, University Paris Descartes, Paris, France
| | - Jean-Philippe Jais
- Université Paris Descartes, Department of Biostatistics and Medical Informatics, Paris, France
| | - Damien Bonnet
- Pediatric Cardiology, Centre de Référence des Malformations Cardiaques Congénitales Complexes-M3C, Necker Hospital for Sick Children, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Yamina Hamel
- Reference Centre of Inherited Metabolic Diseases, Hospital Necker Enfants Malades, APHP, Institute Imagine, University Paris Descartes, Paris, France
| | - Pascale de Lonlay
- Reference Centre of Inherited Metabolic Diseases, Hospital Necker Enfants Malades, APHP, Institute Imagine, University Paris Descartes, Paris, France
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