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Carrington M, de Gouveia RH, Teixeira R, Corte-Real F, Gonçalves L, Providência R. Sudden death in young South European population: a cross-sectional study of postmortem cases. Sci Rep 2023; 13:22734. [PMID: 38123611 PMCID: PMC10733430 DOI: 10.1038/s41598-023-47502-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023] Open
Abstract
To describe the annual incidence and the leading causes of sudden non-cardiac and cardiac death (SCD) in children and young adult Portuguese population. We retrospectively reviewed autopsy of sudden unexpected deaths reports from the Portuguese National Institute of Legal Medicine and Forensic Sciences' database, between 2012 and 2016, for the central region of Portugal, Azores and Madeira (ages 1-40: 26% of the total population). During a 5-year period, 159 SD were identified, corresponding to an annual incidence of 2,4 (95%confidence interval, 1,5-3,6) per 100.000 people-years. Victims had a mean age of 32 ± 7 years-old, and 72,3% were male. There were 70,4% cardiac, 16,4% respiratory and 7,5% neurologic causes of SD. The most frequent cardiac anatomopathological diagnosis was atherosclerotic coronary artery disease (CAD) (33,0%). There were 15,2% victims with left ventricular hypertrophy, with a diagnosis of hypertrophic cardiomyopathy only possible in 2,7%. The prevalence of cardiac pathological findings of uncertain significance was 30,4%. In conclusion, the annual incidence of SD was low. Atherosclerotic CAD was diagnosed in 33,0% victims, suggesting the need to intensify primary prevention measures in the young. The high prevalence of pathological findings of uncertain significance emphasizes the importance of molecular autopsy and screening of first-degree relatives.
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Affiliation(s)
- Mafalda Carrington
- Department of Cardiology, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
| | - Rosa Henriques de Gouveia
- Forensic Pathology Department, Delegação do Centro, Instituto Nacional de Medicina Legal e Ciências Forenses, Coimbra, Portugal
- Pathology and Histology, Faculty of Life Sciences, University of Madeira, Funchal, Madeira, Portugal
- LANA - Laboratory of Clinical and Anatomical Pathology, Funchal, Madeira, Portugal
| | - Rogério Teixeira
- Medical Faculty, Coimbra University, Coimbra, Portugal
- Cardiology Department of Centro Hospitalar, Universitário de Coimbra, Coimbra, Portugal
| | - Francisco Corte-Real
- Forensic Pathology Department, Delegação do Centro, Instituto Nacional de Medicina Legal e Ciências Forenses, Coimbra, Portugal
- Medical Faculty, Coimbra University, Coimbra, Portugal
| | - Lino Gonçalves
- Medical Faculty, Coimbra University, Coimbra, Portugal
- Cardiology Department of Centro Hospitalar, Universitário de Coimbra, Coimbra, Portugal
| | - Rui Providência
- St Bartholomew's Hospital, Barts Heart Centre, Barts Health NHS Trust, London, UK.
- Institute of Health Informatics Research, University College of London, London, UK.
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Electrophysiology practice in low- and middle-income countries: An updated review on access to care and health delivery. Heart Rhythm O2 2023; 4:69-77. [PMID: 36713042 PMCID: PMC9877398 DOI: 10.1016/j.hroo.2022.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Concurrent with the epidemiological transition to cardiovascular diseases in low- and middle-income countries (LMICs), the burden of arrhythmias is increasing significantly. However, registries of electrophysiological disorders and their management in LMICs are limited. The advancement of telemedicine technology can play a distinctive role in providing accurate diagnoses in resource-limited settings. The estimated pacemaker implantation requirements (1 million per year) demand an alternate source of pacemakers, including reused permanent pacemakers and implantable cardioverter-defibrillators. In addition, the majority of supraventricular tachycardias and atrial fibrillation can be managed with radiofrequency ablation, which not only is cost-effective but is curative for most patients.
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Schiavone M, Gobbi C, Gasperetti A, Zuffi A, Forleo GB. Congenital Coronary Artery Anomalies and Sudden Cardiac Death. Pediatr Cardiol 2021; 42:1676-1687. [PMID: 34459947 DOI: 10.1007/s00246-021-02713-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
Coronary artery anomalies (CAAs) are a heterogeneous group of rare congenital diseases whose features and pathophysiological mechanisms are extremely variable, ranging from silent anomalies to sudden cardiac death (SCD) in the most severe cases. Although rare, congenital CAAs confer a high risk of myocardial ischemia and SCD, especially in young, previously "healthy" athletes during or immediately after vigorous exertion. Although some high-risk features that may lead to SCD have been identified, specific pathophysiological mechanisms related to SCD still remain poorly understood. When a CAA is incidentally diagnosed, optimal SCD risk stratification remains challenging, particularly in cases of anomalous aortic origin of a coronary artery arising from the opposite aortic sinus of Valsalva (ACAOS). In recent times, invasive imaging with intravascular ultrasound has gained a role in further identifying high-risk anatomic features; it has been integrated with traditional, non-invasive anatomic imaging evaluations, typically high-quality echocardiography, and cardiac magnetic resonance. Multidisciplinary programs and specific SCD risk scores should be developed in an endeavor to choose the right therapeutic approach, either clinical or interventional/surgical. Intravascular ultrasound is an extremely useful tool to evaluate vessel stenosis, even if prospective studies are still required to further validate this diagnostic strategy. In the present review, we aimed to analyze the pathophysiology and the clinical impact of ACAOS. We also summarized the predominant mechanisms for interference with normal coronary artery function, which might contribute to the onset of life-threatening arrhythmias and SCD.
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Affiliation(s)
- Marco Schiavone
- Cardiology Unit, ASST Fatebenefratelli Sacco - Luigi Sacco University Hospital, University of Milan, Via G.B. Grassi, 74, 20157, Milan, Italy.
| | - Cecilia Gobbi
- Department of Cardiology, Saint Martin Private Hospital Center, Caen, France
| | - Alessio Gasperetti
- Cardiology Unit, ASST Fatebenefratelli Sacco - Luigi Sacco University Hospital, University of Milan, Via G.B. Grassi, 74, 20157, Milan, Italy.,Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrea Zuffi
- Department of Cardiology, Saint Martin Private Hospital Center, Caen, France
| | - Giovanni Battista Forleo
- Cardiology Unit, ASST Fatebenefratelli Sacco - Luigi Sacco University Hospital, University of Milan, Via G.B. Grassi, 74, 20157, Milan, Italy
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Sudden death in the young adult: a Tunisian autopsy-based series. BMC Public Health 2020; 20:1915. [PMID: 33334328 PMCID: PMC7745477 DOI: 10.1186/s12889-020-10012-z] [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: 05/20/2020] [Accepted: 12/06/2020] [Indexed: 12/03/2022] Open
Abstract
Background We aim to study the profile, and pathological characteristics of sudden death in young in purpose of recommendations for prevention. Methods We performed a retrospective cohort study using autopsy data from the Department of Forensic Medicine of Monastir (Tunisia). A review of all autopsies performed for 28 years was done (August 1990 to December 2018). In each case, clinical information, and circumstances of death were obtained. A complete forensic autopsy and histological, and toxicological investigations were performed. We have included all sudden death in persons aged between 18 and 35 years. Results We collected 137 cases of sudden death during the studied period. The mean age of the studied population was 26.47 years. Almost 72% deaths were classified as cardiac death, and was due to ischemic heart disease in 32.32%. Sudden death was attributed to a pleuropulmonary cause in 7.4%, an abdominal cause in 6%, and from a neurological origin in 4.5%. The cause of sudden death in this group was not established by 9.5%. Conclusion In this series, sudden death in young adults occurs mainly in a smoking male, aged between 18 and 24 years old, occurring at rest, in the morning, and early in the week. It is more common, especially in summer. Sudden death is most often the first manifestation of pathologies, especially unsuspected heart diseases. The predominance of cardiovascular causes is the common denominator of almost all studies reported in the literature. Our findings suggest that prevention of sudden death among young adults under the age of 35 years should also focus on evaluation for causes not associated with structural heart disease.
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Tchanana GMK, Ngantcha M, Yuyun MF, Ajijola OA, Mbouh S, Tchameni SCT, Suliman A, Bonny A. Incidence of recreational sports-related sudden cardiac arrest in participants over age 12 in a general African population. BMJ Open Sport Exerc Med 2020; 6:e000706. [PMID: 32879735 PMCID: PMC7445330 DOI: 10.1136/bmjsem-2019-000706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2020] [Indexed: 11/21/2022] Open
Abstract
Background The incidence of sports-related sudden cardiac arrest (SrSCA) in sub-Saharan Africa is unknown. Objective To determine the incidence of sudden cardiac arrest (SCA) in non-competitive athletes in an urban population of Cameroon, a country in sub-Saharan Africa. Methods Two study populations in Cameroon were used. A 12-month, multisource surveillance system of 86 189 inhabitants over 12 years old recorded all deaths in two administrative districts of Douala City. All fields of sports, emergency medical service, local medical examiners and district hospital mortuaries were surveyed. Two blinded cardiologists used a verbal autopsy protocol to determine the cause of death. SCA was identified for all deaths occurring within 1 hour of onset of symptoms. A cross-sectional study was conducted among 793 persons in Yaoundé City, which is the second study population aimed at determining the proportion of people who are physically active. Results The mean age in the cross-sectional study was 27.3±10.7, with more men (56.2%). The cross-sectional study showed that 69.0% (95% CI 65.8 to 72.2) of the population could be considered to have at least 3 hours of physical activity per week. The surveillance found that among 288 all-cause deaths, 27 (9.4%) were due to SCA. One SrSCA was registered in a 35-year-old woman while running. Merging both sources revealed an SrSCA incidence of 1.7 (95% CI 0.2 to 12.0) cases per 100 000 athletes per year. Conclusion This pioneer study reports the incidence estimates of SrSCA in a sub-Saharan African general population and should be regarded as a first step to a big problem.
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Affiliation(s)
| | | | - Matthew F Yuyun
- Harvard Medical School and VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Olujimi A Ajijola
- UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine, Los Angeles, California, USA
| | - Samuel Mbouh
- Youth and Sport Institute, University of Yaoundé 1, Yaoundé, Cameroon
| | | | | | - Aimé Bonny
- Medicine, Centre Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil, Île-de-France, France.,Cardiology Department, University of Douala, Douala, Cameroon
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Mkoko P, Bahiru E, Ajijola OA, Bonny A, Chin A. Cardiac arrhythmias in low- and middle-income countries. Cardiovasc Diagn Ther 2020; 10:350-360. [PMID: 32420117 PMCID: PMC7225444 DOI: 10.21037/cdt.2019.09.21] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 09/26/2019] [Indexed: 01/04/2023]
Abstract
Many low- and middle-income countries (LMICs) are undergoing an epidemiological transition. With an improvement in socioeconomic conditions and an aging population, cardiovascular diseases (CVDs), like cardiac arrhythmias, are expected to increase in these countries. However, there are limited studies on the epidemiology and management of cardiac arrhythmias in LMICs. This review will highlight the unique challenges and opportunities that these countries face when managing cardiac arrhythmias.
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Affiliation(s)
- Philasande Mkoko
- The Cardiac Clinic, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Ehete Bahiru
- UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Olujimi A. Ajijola
- UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Aime Bonny
- Department of internal medicine, District hospital Bonassama, University of Douala, Douala, Cameroon
- Service de cardiologie, Hôpital Forcilles, Ferolles-Attilly, France, Unité de rythmologie, Centre hospitalier Le Raincy-Montfermeil, Montfermeil, France
| | - Ashley Chin
- The Cardiac Clinic, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
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7
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Bonny A, Ngantcha M, Scholtz W, Chin A, Nel G, Anzouan-Kacou JB, Karaye KM, Damasceno A, Crawford TC. Cardiac Arrhythmias in Africa: Epidemiology, Management Challenges, and Perspectives. J Am Coll Cardiol 2019; 73:100-109. [PMID: 30621939 DOI: 10.1016/j.jacc.2018.09.084] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/12/2018] [Accepted: 09/13/2018] [Indexed: 11/28/2022]
Abstract
Africa is experiencing an increasing burden of cardiac arrhythmias. Unfortunately, the expanding need for appropriate care remains largely unmet because of inadequate funding, shortage of essential medical expertise, and the high cost of diagnostic equipment and treatment modalities. Thus, patients receive suboptimal care. A total of 5 of 34 countries (15%) in Sub-Saharan Africa (SSA) lack a single trained cardiologist to provide basic cardiac care. One-third of the SSA countries do not have a single pacemaker center, and more than one-half do not have a coronary catheterization laboratory. Only South Africa and several North African countries provide complete services for cardiac arrhythmias, leaving more than hundreds of millions of people in SSA without access to arrhythmia care considered standard in other parts of the world. Key strategies to improve arrhythmia care in Africa include greater government health care funding, increased emphasis on personnel training through fellowship programs, and greater focus on preventive care.
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Affiliation(s)
- Aimé Bonny
- Hôpital de District de Bonassama, Douala, Cameroon; University of Douala, Douala, Cameroon; Cameroon Cardiovascular Research Network, Douala, Cameroon.
| | | | - Wihan Scholtz
- Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Ashley Chin
- The Cardiac Clinic, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - George Nel
- Pan-African Society of Cardiology (PASCAR), Department of Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Kamilu M Karaye
- Department of Cardiology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
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Wu Y, Ai M, Bardeesi ASA, Zhang L, Wu Q, Yin K, Zheng J, Zheng D, Huang L, Xu L, Cheng J. The forensic pathological analysis of sport-related sudden cardiac death in Southern China. Forensic Sci Res 2017; 5:47-54. [PMID: 32490310 PMCID: PMC7241569 DOI: 10.1080/20961790.2017.1319785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Accepted: 04/12/2017] [Indexed: 12/02/2022] Open
Abstract
Studies regarding sport-related sudden cardiac death (SCD) mainly focus on competitive athletes; similar data are rare in the general population, especially in China. We conducted a retrospective study (from September 1998 to August 2013) to investigate the aetiological distribution and epidemiological features of sport-related SCD in Southern China. Selections of cases are based on details, and two subgroups were established: one was the sport-related SCD group, and the other was the disease-free accident victims group which was matched with the sport-related SCD group in gender, age and year of death. Among the 3770 sudden-death cases, 1656 cases were SCD cases. A total of 65 cases (57 males) out of 1 656 SCD cases were sport-related. The age range of the 65 sport-related SCD cases was from 12 to 68 years old with a mean (35.92 ± 14.23) years old. Only two of these cases were competitive athletes. The most common circumstances of the 65 sport-related SCD cases were heavy physical labour (46.15%) and running (30.77%). The three leading forensic diagnoses were the coronary atherosclerotic disease (CAD, 28 cases), cardiomyopathy (CM, 14 cases) and sudden unexplained death (7 cases). CM was the most common forensic diagnosis in those ≤35 years old, while CAD was the most common one in those >35 years old. Left anterior descending in which atherosclerotic plaques was most commonly found was the principal artery branch associated with sport-related SCD. There was a statistically significant difference in the weight of hearts between the 65 sport-related SCD cases and 65 diseases-free accidental cases. This study highlights the need to attract public attention to sport-related SCD and to issue a prevention strategy to the public, and to make the SCD-related genetic sequencing a routine tool in both forensic pathological examination and clinic screening.
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Affiliation(s)
- Yeda Wu
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Mei Ai
- Forensic Science Center of Waston, Guangzhou, China
| | - Adham Sameer A Bardeesi
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Liyong Zhang
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Qiuping Wu
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Kun Yin
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Jingjing Zheng
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Da Zheng
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Lei Huang
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Lunwu Xu
- Branch Office of Yanping, Public Security Bureau of Nanping, Nanping, China
| | - Jianding Cheng
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
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Teofilovski-Parapid G, Jankovic R, Kanjuh V, Virmani R, Danchin N, Prates N, Simic D, Parapid B. Myocardial bridges, neither rare nor isolated—Autopsy study. Ann Anat 2017; 210:25-31. [DOI: 10.1016/j.aanat.2016.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 09/25/2016] [Accepted: 09/26/2016] [Indexed: 02/06/2023]
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Chappex N, Schlaepfer J, Fellmann F, Bhuiyan ZA, Wilhelm M, Michaud K. Sudden cardiac death among general population and sport related population in forensic experience. J Forensic Leg Med 2015; 35:62-8. [PMID: 26344462 DOI: 10.1016/j.jflm.2015.07.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 06/19/2015] [Accepted: 07/23/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE The goal of the study was to assess the causes and analyze the cases of sudden cardiac death (SCD) victims referred to the department of forensic medicine in Lausanne, with a particular focus on sports-related fatalities including also leisure sporting activities. To date, no such published assessment has been done nor for Switzerland nor for the central Europe. METHODS This is a retrospective study based on autopsy records of SCD victims, from 10 to 50 years of age, performed at the University Centre of Legal Medicine in Lausanne from 1995 to 2010. The study population was divided into two groups: sport-related (SR) and not sport-related (NSR) SCDs. RESULTS During the study period, 188 cases of SCD were recorded: 166 (88%) were NSR and 22 (12%) SR. The mean age of the 188 victims was 37.3 ± 10.1 years, with the majority of the cases being male (79%). A cause of death was established in 84%, and the pathology responsible for death varied according to the age of the victims. In the NSR group, the mean age was 38.2 ± 9.2 years and there was 82% of male. Coronary artery disease (CAD) was the main diagnosis in the victims aged 30-50 years. The majority of morphologically normal hearts were observed in the 15-29 year age range. There was no case in the 10-14 year age range. In the SR group, 91% of victims died during leisure sporting activities. In this group the mean age was 30.5 ± 13.5 years, with the majority being male (82%). The main cause of death was CAD, with 6 cases (27%) and a mean age of 40.8 ± 5.5 years. The youngest victim with CAD was 33 years old. A morphologically normal heart was observed in 5 cases (23%), with a mean age of 24.4 ± 14.9 years. The most frequently implicated sporting activities were hiking (26%) and swimming (17%). CONCLUSION In this study, CAD was the most common cause of death in both groups. Although this pathology most often affects adults over 35 years of age, there were also some victims under 35 years of age in both groups. SCDs during sport are mostly related to leisure sporting activities, for which preventive measures are not yet usually established. This study highlights also the need to inform both athletes and non athletes of the cardiovascular risks during sport activities and the role of a forensic autopsy and registries involving forensic pathologists for SR SCD.
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Affiliation(s)
- Nina Chappex
- University Center of Legal Medicine, Lausanne and Geneva, Chemin de la Vulliette 4, 1000 Lausanne 25, Switzerland
| | - Jürg Schlaepfer
- Department of Cardiology, University Hospital of Lausanne, 1011 Lausanne, Switzerland
| | - Florence Fellmann
- University Hospital of Lausanne, Service of Medical Genetics, 1011 Lausanne, Switzerland
| | - Zahurul A Bhuiyan
- University Hospital of Lausanne, Service of Medical Genetics, 1011 Lausanne, Switzerland
| | - Matthias Wilhelm
- Department of Cardiology, Inselspital, University Hospital Bern, 3010 Bern, Switzerland
| | - Katarzyna Michaud
- University Center of Legal Medicine, Lausanne and Geneva, Chemin de la Vulliette 4, 1000 Lausanne 25, Switzerland.
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Jaafar N, Girolami F, Zairi I, Kraiem S, Hammami M, Olivotto I. Genetic profile of hypertrophic cardiomyopathy in Tunisia: Is it different? Glob Cardiol Sci Pract 2015; 2015:16. [PMID: 26779504 PMCID: PMC4448072 DOI: 10.5339/gcsp.2015.16] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 02/28/2015] [Indexed: 11/23/2022] Open
Abstract
We recently performed next generation sequencing (NGS) genetic screening in 11 consecutive and unrelated Tunisian HCM probands seen at Habib Thameur Hospital in Tunis in the first 6 months of 2014, as part of a cooperative study between our Institutions. The clinical diagnosis of HCM was made according to standard criteria. Using the Illumina platform, a panel of 12 genes was analyzed including myosin binding protein C (MYBPC3), beta-myosin heavy chain (MYH7), regulatory and essential light chains (MYL2 and MYL3), troponin-T (TNNT2), troponin-I (TNNI3), troponin-C (TNNC1), alpha-tropomyosin (TPM1), alpha-actin (ACTC1), alpha-actinin-2 (ACTN2) as well as alfa-galactosidase (GLA), 5′-AMP-activated protein (PKRAG2), transthyretin (TTR) and lysosomal-associated membrane protein-2 (LAMP2) for exclusion of phenocopies. Our preliminary data, despite limitations inherent to the small sample size, suggest that HCM in Tunisia may have a peculiar genetic background which privileges rare genes overs the classic HCM-associated MHY7 and MYBPC3 genes.
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Affiliation(s)
- Nawel Jaafar
- Biochemistry Laboratory, LR12ES05 'Nutrition-Functional Food & Vascular Health', USCR Mass Spectrometry, Faculty of Medicine, University of Monastir, Tunisia
| | | | - Ihsen Zairi
- Department of Cardiology, Habib Thameur Hospital, Tunis, Tunisia
| | - Sondes Kraiem
- Department of Cardiology, Habib Thameur Hospital, Tunis, Tunisia
| | - Mohamed Hammami
- Biochemistry Laboratory, LR12ES05 'Nutrition-Functional Food & Vascular Health', USCR Mass Spectrometry, Faculty of Medicine, University of Monastir, Tunisia
| | - Iacopo Olivotto
- Referral Center for Cardiomyopathies, Careggi University Hospital, Florence, Italy
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12
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Huang J, Wang X, Hao B, Chen Y, Liu H, Quan L, Tang D, Sheng L, Li M, Huang E, Liu C, Luo B. Genetic variants in KCNE1, KCNQ1, and NOS1AP in sudden unexplained death during daily activities in Chinese Han population. J Forensic Sci 2015; 60:351-6. [PMID: 25639344 DOI: 10.1111/1556-4029.12687] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 04/02/2014] [Accepted: 04/15/2014] [Indexed: 11/29/2022]
Abstract
Fifty-six sudden unexplained death (SUD) cases were collected from Chinese Han population, which occurred during daily activities and were autopsy negative in comprehensive postmortem autopsy. The coding exons of potassium channel genes KCNE1, KCNQ1, and nitric oxide synthase gene NOS1AP were sequenced. A synonymous mutation, KCNE1 F54F T>C was identified in 2 SUD cases, which was absent in the control subjects. Neither genotype nor allele frequencies of KCNE1 and KCNQ1 exhibited a significant difference between the SUD and control group. In contrast, the allele frequency (p = 2.7 × 10(-10)) and genotype frequency (p = 5.9 × 10(-7)) of rs3751284, and the genotype frequency (p = 2.9 × 10(-2)) of rs348624 in NOS1AP of SUD were significantly different from that of controls (p < 0.05). Our study suggested that rs3751284 and rs348624 might be susceptibility loci for SUD during daily activities. Larger sample sizes and further molecular studies are needed to confirm or exclude an effect of the NOS1AP SNPs on SUD risk.
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Affiliation(s)
- Jinglu Huang
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China
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13
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Higgins JP, Andino A. Soccer and Sudden Cardiac Death in Young Competitive Athletes: A Review. JOURNAL OF SPORTS MEDICINE (HINDAWI PUBLISHING CORPORATION) 2013; 2013:967183. [PMID: 26464886 PMCID: PMC4590894 DOI: 10.1155/2013/967183] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 01/08/2013] [Indexed: 01/02/2023]
Abstract
Sudden cardiac death (SCD) in young competitive athletes (<35 years old) is a tragic event that has been brought to public attention in the past few decades. The incidence of SCD is reported to be 1-2/100,000 per year, with athletes at a 2.5 times higher risk. Soccer is the most popular sport in the world, played by people of all ages. However, unfortunately it is cardiovascular diseases such as hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy that have subtly missed screening and claimed the lives of soccer stars such as Marc Vivien Foe and Antonio Puerta during live action on the field and on an internationally televised stage. This paper covers the physiological demands of soccer and the relationship between soccer and SCD. It also reviews the most common causes of SCD in young athletes, discusses the current guidelines in place by The Fédération Internationale de Football Association (FIFA) for screening among professional soccer players, and the precautions that have been put in place to prevent SCD on the field in professional soccer.
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Affiliation(s)
- John P. Higgins
- Exercise Physiology, Memorial Hermann-Texas Medical Institute, The University of Texas Health Science Center at Houston, 6431 Fannin, Houston, TX 77030, USA
- Lyndon B. Johnson General Hospital, The University of Texas Medical School at Houston, UT Annex-Room 104, 5656 Kelley Street Houston, TX 77026, USA
| | - Aldo Andino
- The University of Texas Medical School at Houston, 6431 Fannin, Houston, TX 77030, USA
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