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Wei X, Zhao L, Xie J, Liu Y, Du Z, Zhong X, Ye W, Wang Y, Chen Y, Lu M, Liu H. Cardiac Phenotype Characterization at MRI in Patients with Danon Disease: A Retrospective Multicenter Case Series. Radiology 2021; 299:303-310. [PMID: 33754825 DOI: 10.1148/radiol.2021203996] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Danon disease (DD) is a rare X-chromosome-linked dominant lysosomal glycogen storage disease. Its features have seldom been reported by using cardiac MRI. This case series aimed to evaluate cardiac features of DD on the basis of MRI observations from five centers in China. From January 2010 to May 2019, 16 patients with DD (13 male patients [81%]; median age, 19 years; age range, 14-44 years) underwent MRI. The most frequent DD cardiomyopathy manifestation was symmetric hypertrophy cardiomyopathy (HCM) phenotype (nine of 16; 56%), followed by asymmetric HCM phenotype (six of 16; 38%) and dilated cardiomyopathy phenotype (one of 16; 6%). The characteristic late gadolinium enhancement features included midbasal septum sparing (14 of 16; 88%) and apex involvement (16 of 16; 100%) with a base-to-apex increasing tendency, free wall involvement (15 of 16; 94%), and extensive subendocardium involvement (14 of 16; 88%). Abnormal T2 signal (seven of 16; 44%) and resting perfusion defect (14 of 16; 88%) were not uncommon in patients with DD. Furthermore, the cardiac MRI features of DD cohort in this study were compared with those of DD in previous literature and with genetically confirmed sarcomeric HCM.
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Affiliation(s)
- Xiaoyu Wei
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Lei Zhao
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Jiajun Xie
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Yang Liu
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Zhicheng Du
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Xiaomei Zhong
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Weitao Ye
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Yining Wang
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Yucheng Chen
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Minjie Lu
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
| | - Hui Liu
- From the Department of Radiology (X.W., X.Z., W.Y., H.L.) and Guangdong Cardiovascular Institute (Y.L.), Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhong Shan Er Lu, Guangzhou, Guangdong Province 510080, China; School of Medicine, South China University of Technology, Guangzhou, China (X.W., H.L.); Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, China (L.Z.); Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China (J.X.); Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Z.D.); Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (Y.W.); Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China (Y.C.); Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.L.); The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China (H.L.)
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Liu Y, Chen X, Wang F, Liang Y, Deng H, Liao H, Zhang Q, Zhang B, Zhan X, Fang X, Shehata M, Wang X, Xue Y, Wu S. Prevalence and clinical characteristics of Danon disease among patients with left ventricular hypertrophy and concomitant electrocardiographic preexcitation. Mol Genet Genomic Med 2019; 7:e638. [PMID: 30929317 PMCID: PMC6503070 DOI: 10.1002/mgg3.638] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/17/2019] [Accepted: 02/18/2019] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Cardiac involvement in Danon disease typically manifests as left ventricular hypertrophy (LVH) and ventricular preexcitation. This study aimed to identify patients with Danon disease among patients with LVH and concurrent electrocardiographic preexcitation. METHODS Electrocardiographic preexcitation was identified in 10 of 197 patients with unexplained LVH in whom genetic testing was performed using next-generation sequencing. RESULTS Three (3/10, 30%) patients with Danon disease were found in association with different mutations in the gene of lysosome-associated membrane protein 2 (LAMP2). Compared to seven patients without Danon disease, these three patients presented with distinctive clinical phenotypes, including onset at an earlier age (20 ± 2 years vs. 53 ± 9 years, p < 0.001), more neurological involvements (100% vs. 0, p = 0.008), higher electrocardiographic voltages (10 ± 1 mV vs. 5 ± 1 mV, p < 0.001), wider QRS complexes (163 ± 5 ms vs. 115 ± 20 ms, p = 0.006), less common asymmetric hypertrophy (0% vs. 86%, p = 0.033), and more frequent elevation of three serum enzymes (creatine kinase, aspartate aminotransferase, and lactate dehydrogenase). Intracellular vacuoles accumulation with deficiencies of LAMP2 protein was found in both cardiac and skeletal myocytes of patients with Danon disease. CONCLUSION In patients with coexistent LVH and ventricular preexcitation, Danon disease is common with distinctive clinical presentations. Comprehensive assessment of these resemble patients can provide valuable findings for early identification and clinical decision making of patients with Danon disease.
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Affiliation(s)
- Yang Liu
- Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xin Chen
- Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Feng Wang
- Department of Geriatrics, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yingcong Liang
- Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hai Deng
- Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hongtao Liao
- Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Qianhuan Zhang
- Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Bin Zhang
- Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xianzhang Zhan
- Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xianhong Fang
- Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Michael Shehata
- Heart Institute, Cedars Sinai Medical Center, Los Angeles, California
| | - Xunzhang Wang
- Heart Institute, Cedars Sinai Medical Center, Los Angeles, California
| | - Yumei Xue
- Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shulin Wu
- Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Pharmacology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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