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Chang Y, Wang X, Tian X, Cao Z, Zhen X, Zhao W, Luo B, Gao Y. Novel indel variation of LTBP4 gene associates with risk of sudden cardiac death in Chinese populations with coronary artery disease. Leg Med (Tokyo) 2024; 69:102437. [PMID: 38547642 DOI: 10.1016/j.legalmed.2024.102437] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/10/2024] [Accepted: 03/22/2024] [Indexed: 07/17/2024]
Abstract
The objective of this study is to investigate whether common genetic variants of the LTBP4 gene are linked to the susceptibility of sudden cardiac death in individuals who have atherosclerotic coronary artery disease (SCD-CAD) in Chinese populations. A total of 208 SCD-CAD cases and 638 controls were included in the analysis, and logistic regression was employed to assess the association between a 4-bp insertion/deletion polymorphism (rs34005443) within LTBP4 and the susceptibility to SCD-CAD among Chinese individuals. Logistic regression analysis demonstrated a notable association between the insertion allele of rs34005443 and an escalated susceptibility to SCD-CAD [odds ratio (OR) = 1.434; 95 % confidence interval:1.14-1.80; P = 1.79 × 10-3]. Genotype-phenotype correlation analysis was performed using Genotype-Tissue expression (GTEx) database and further validated by human myocardium using qPCR. Correlation analysis revealed that LTBP4 expression level was lower in samples with the insertion allele. Furthermore, the dual-luciferase activity assays indicated that rs34005443 may play a regulatory role. Additionally, we predicted 30 transcription factors that are likely to bind to rs34005443 and its highly linked genetic variants via 3DSNP database. Subsequent GO and KEGG analysis indicated that these transcription factors have a significant function in regulating gene expression. Finally, PPI network analysis suggested a tight connection between LTBP4 proteins and TGFβs, highlighting these genes as potential hub genes in the context of SCD-CAD. In summary, our study revealed that rs34005443 might contribute to SCD-CAD susceptibility by regulating LTBP4 expression. These findings revealed that this indel could be a potentially functional marker for molecular diagnosis and risk stratification of SCD-CAD.
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Affiliation(s)
- Yafei Chang
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Xiaoshu Wang
- Department of Forensic Medicine, Medical College of Soochow University, Suzhou, China
| | - Xiaoyi Tian
- School of Public Health, Dalian Medical University, Dalian, China
| | - Zhengjun Cao
- Public Security Bureau of Yancheng, Yancheng, China
| | - Xiaoyuan Zhen
- Department of Forensic Medicine, Medical College of Soochow University, Suzhou, China
| | - Wenfeng Zhao
- Department of Forensic Medicine, Medical College of Soochow University, Suzhou, China
| | - Bin Luo
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China.
| | - Yuzhen Gao
- Department of Forensic Medicine, Medical College of Soochow University, Suzhou, China.
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2
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Turkgenc B, Baydar CL, Deniz I, Akcay A, Ergoren MC, Sag SO, Yakicier MC, Temel SG. From Death to Life/Back to the Future: Detailed Premorbid Clinical and Family History Can Save Lives and Address the Final Diagnosis in Sudden Unexplained Deaths With Negative Autopsy. Appl Immunohistochem Mol Morphol 2023; 31:690-696. [PMID: 37796154 DOI: 10.1097/pai.0000000000001163] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 09/10/2023] [Indexed: 10/06/2023]
Abstract
Sudden cardiac death is a sudden, unexpected death developed by one of the many different causes of cardiac arrest that occur within 1 hour of the onset of new symptoms. Sudden unexplained death (SUD) comprises a normal heart at postmortem examination and negative toxicological analysis. SUD often arises from cardiac genetic disease, particularly channelopathies. Channelopathies, or inherited arrhythmia syndromes, are a group of disorders characterized by an increased risk of sudden cardiac death, abnormal cardiac electrical function, and, typically, a structurally normal heart. They share an underlying genetic etiology where disease-causing genetic variants may lead to the absence or dysfunction of proteins involved in the generation and propagation of the cardiac action potential. Our study aimed to evaluate the importance of next-generation sequencing in the postmortem investigations of SUD cases. In this study, 5 forensic SUD cases were investigated for inherited cardiac disorders. We screened a total of 68 cardiac genes for the sibling of case 1, as well as case 2, and 51 genes for cases 3, 4, and 5. Of the 12 variants identified, 2 likely pathogenic variants (16.7%) were the TMEM43 _ c.1000+2T>C splice site mutation and the SCN5A _ p.W703X nonsense mutation. The remaining 10 variants of uncertain significance were detected in the TRPM4 , RANGRF , A KAP9 , KCND3 , KCNE1 , DSG2 , CASQ1 , and SNTA1 genes. Irrespective of genetic testing, all SUD families require detailed clinical testing to identify relatives who may be at risk. Molecular autopsy and detailed premorbid clinical and family histories can survive family members of SUD cases.
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Affiliation(s)
| | - Cetin L Baydar
- Department of Mortuary, Ministry of Justice
- Department of Forensic Medicine, Suleyman Demirel University, Isparta
| | - Idris Deniz
- Department of Forensic Medicine, Dr. Burhan Nalbantoglu State Hospital, Nicosia
| | - Arzu Akcay
- Department of Forensic Medicine, Ministry of Justice, Council of Forensic Medicine
| | | | | | - Mustafa C Yakicier
- Department of Molecular Biology and Genetics, Acibadem University, Istanbul
| | - Sehime G Temel
- Department of Medical Genetics, Uludag University
- Department of Histology and Embryology, Uludag University, Bursa, Turkey
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3
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Paz-Cruz E, Ruiz-Pozo VA, Cadena-Ullauri S, Guevara-Ramirez P, Tamayo-Trujillo R, Ibarra-Castillo R, Laso-Bayas JL, Onofre-Ruiz P, Domenech N, Ibarra-Rodriguez AA, Zambrano AK. Associations of MYPN, TTN, SCN5A, MYO6 and ELN Mutations With Arrhythmias and Subsequent Sudden Cardiac Death: A Case Report of an Ecuadorian Individual. Cardiol Res 2023; 14:409-415. [PMID: 37936622 PMCID: PMC10627373 DOI: 10.14740/cr1552] [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: 07/14/2023] [Accepted: 08/02/2023] [Indexed: 11/09/2023] Open
Abstract
Cardiac pathologies are among the most frequent causes of death worldwide. Regarding cardiovascular deaths, it is estimated that 5 million cases are caused by sudden cardiac death (SCD) annually. The primary cause of SCD is ventricular arrhythmias. Genomic studies have provided pathogenic, likely pathogenic, and variants of uncertain significance that may predispose individuals to cardiac causes of sudden death. In this study, we describe the case of a 43-year-old individual who experienced an episode of aborted SCD. An implantable cardioverter defibrillator was placed to prevent further SCD episodes. The diagnosis was ventricular fibrillation. Genomic analysis revealed some variants in the MYPN (pathogenic), GCKR (likely pathogenic), TTN (variant of uncertain significance), SCN5A (variant of uncertain significance), MYO6 (variant of uncertain significance), and ELN (variant of uncertain significance) genes, which could be associated with SCD episodes. In addition, a protein-protein interaction network was obtained, with proteins related to ventricular arrhythmia and the biological processes involved. Therefore, this study identified genetic variants that may be associated with and trigger SCD in the individual. Moreover, genetic variants of uncertain significance, which have not been reported, could contribute to the genetic basis of the disease.
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Affiliation(s)
- Elius Paz-Cruz
- Centro de Investigacion Genetica y Genomica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
- These authors contributed equally to this work and share first authorship
| | - Viviana A Ruiz-Pozo
- Centro de Investigacion Genetica y Genomica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
- These authors contributed equally to this work and share first authorship
| | - Santiago Cadena-Ullauri
- Centro de Investigacion Genetica y Genomica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Patricia Guevara-Ramirez
- Centro de Investigacion Genetica y Genomica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Rafael Tamayo-Trujillo
- Centro de Investigacion Genetica y Genomica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | | | | | - Paul Onofre-Ruiz
- Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Nieves Domenech
- Instituto de Investigacion Biomedica de A Coruna (INIBIC) - CIBERCV, Complexo Hospitalario Universitario de A Coruna (CHUAC), Sergas, Universidad da Coruna (UDC), Spain
| | | | - Ana Karina Zambrano
- Centro de Investigacion Genetica y Genomica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
- These authors contributed equally to this work and share first authorship
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4
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Kelly KL, Lin PT, Basso C, Bois M, Buja LM, Cohle SD, d'Amati G, Duncanson E, Fallon JT, Firchau D, Fishbein G, Giordano C, Leduc C, Litovsky SH, Mackey-Bojack S, Maleszewski JJ, Michaud K, Padera RF, Papadodima SA, Parsons S, Radio SJ, Rizzo S, Roe SJ, Romero M, Sheppard MN, Stone JR, Tan CD, Thiene G, van der Wal AC, Veinot JP. Sudden cardiac death in the young: A consensus statement on recommended practices for cardiac examination by pathologists from the Society for Cardiovascular Pathology. Cardiovasc Pathol 2023; 63:107497. [PMID: 36375720 DOI: 10.1016/j.carpath.2022.107497] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 11/13/2022] Open
Abstract
Sudden cardiac death is, by definition, an unexpected, untimely death caused by a cardiac condition in a person with known or unknown heart disease. This major international public health problem accounts for approximately 15-20% of all deaths. Typically more common in older adults with acquired heart disease, SCD also can occur in the young where the cause is more likely to be a genetically transmitted process. As these inherited disease processes can affect multiple family members, it is critical that these deaths are appropriately and thoroughly investigated. Across the United States, SCD cases in those less than 40 years of age will often fall under medical examiner/coroner jurisdiction resulting in scene investigation, review of available medical records and a complete autopsy including toxicological and histological studies. To date, there have not been consistent or uniform guidelines for cardiac examination in these cases. In addition, many medical examiner/coroner offices are understaffed and/or underfunded, both of which may hamper specialized examinations or studies (e.g., molecular testing). Use of such guidelines by pathologists in cases of SCD in decedents aged 1-39 years of age could result in life-saving medical intervention for other family members. These recommendations also may provide support for underfunded offices to argue for the significance of this specialized testing. As cardiac examinations in the setting of SCD in the young fall under ME/C jurisdiction, this consensus paper has been developed with members of the Society of Cardiovascular Pathology working with cardiovascular pathology-trained, practicing forensic pathologists.
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Affiliation(s)
| | | | - Cristina Basso
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health - University of Padua, Padua, Italy
| | | | | | | | | | - Emily Duncanson
- Jesse E. Edwards Registry of Cardiovascular Disease, St. Paul, MN, USA
| | | | | | | | | | | | | | | | | | - Katarzyna Michaud
- University Center of Legal Medicine Lausanne - Geneva, Lausanne University Hospital and University of Lausanne, Switzerland
| | | | | | - Sarah Parsons
- Victorian Institute of Forensic Medicine, Melbourne, Australia
| | | | - Stefania Rizzo
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health - University of Padua, Padua, Italy
| | | | | | - Mary N Sheppard
- St. George's Medical School, University of London, London, United Kingdom
| | | | | | - Gaetano Thiene
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health - University of Padua, Padua, Italy
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5
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Alcalde M, Nogué-Navarro L, Tiron C, Fernandez-Falgueras A, Iglesias A, Simon A, Buxó M, Pérez-Serra A, Puigmulé M, López L, Picó F, del Olmo B, Corona M, Campuzano O, Moral S, Castella J, Coll M, Brugada R. Rare variants in genes encoding structural myocyte contribute to a thickened ventricular septum in sudden death population without ventricular alterations. Forensic Sci Int Genet 2022; 58:102688. [PMID: 35316720 DOI: 10.1016/j.fsigen.2022.102688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 03/08/2022] [Accepted: 03/12/2022] [Indexed: 01/09/2023]
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6
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Sessa F, Esposito M, Messina G, Di Mizio G, Di Nunno N, Salerno M. Sudden Death in Adults: A Practical Flow Chart for Pathologist Guidance. Healthcare (Basel) 2021; 9:870. [PMID: 34356248 PMCID: PMC8307931 DOI: 10.3390/healthcare9070870] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 12/27/2022] Open
Abstract
The medico-legal term "sudden death (SD)" refers to those deaths that are not preceded by significant symptoms. SD in apparently healthy individuals (newborn through to adults) represents a challenge for medical examiners, law enforcement officers, and society as a whole. This review aims to introduce a useful flowchart that should be applied in all cases of SD. Particularly, this flowchart mixes the data obtained through an up-to-date literature review and a revision of the latest version of guidelines for autopsy investigation of sudden cardiac death (SCD) in order to support medico-legal investigation. In light of this review, following the suggested flowchart step-by-step, the forensic pathologist will be able to apply all the indications of the scientific community to real cases. Moreover, it will be possible to answer all questions relative to SD, such as: death may be attributable to cardiac disease or to other causes, the nature of the cardiac disease (defining whether the mechanism was arrhythmic or mechanical), whether the condition causing SD may be inherited (with subsequent genetic counseling), the assumption of toxic or illicit drugs, traumas, and other unnatural causes.
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Affiliation(s)
- Francesco Sessa
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
| | - Massimiliano Esposito
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.E.); (M.S.)
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
| | - Giulio Di Mizio
- Forensic Medicine, Department of Law, Economy and Sociology, Campus “S. Venuta”, Magna Graecia University, 88100 Catanzaro, Italy;
| | - Nunzio Di Nunno
- Department of History, Society and Studies on Humanity, University of Salento, 73100 Lecce, Italy;
| | - Monica Salerno
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.E.); (M.S.)
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7
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Grassi S, Campuzano O, Coll M, Cazzato F, Sarquella-Brugada G, Rossi R, Arena V, Brugada J, Brugada R, Oliva A. Update on the Diagnostic Pitfalls of Autopsy and Post-Mortem Genetic Testing in Cardiomyopathies. Int J Mol Sci 2021; 22:ijms22084124. [PMID: 33923560 PMCID: PMC8074148 DOI: 10.3390/ijms22084124] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/04/2021] [Accepted: 04/14/2021] [Indexed: 02/08/2023] Open
Abstract
Inherited cardiomyopathies are frequent causes of sudden cardiac death (SCD), especially in young patients. Despite at the autopsy they usually have distinctive microscopic and/or macroscopic diagnostic features, their phenotypes may be mild or ambiguous, possibly leading to misdiagnoses or missed diagnoses. In this review, the main differential diagnoses of hypertrophic cardiomyopathy (e.g., athlete's heart, idiopathic left ventricular hypertrophy), arrhythmogenic cardiomyopathy (e.g., adipositas cordis, myocarditis) and dilated cardiomyopathy (e.g., acquired forms of dilated cardiomyopathy, left ventricular noncompaction) are discussed. Moreover, the diagnostic issues in SCD victims affected by phenotype-negative hypertrophic cardiomyopathy and the relationship between myocardial bridging and hypertrophic cardiomyopathy are analyzed. Finally, the applications/limits of virtopsy and post-mortem genetic testing in this field are discussed, with particular attention to the issues related to the assessment of the significance of the genetic variants.
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Affiliation(s)
- Simone Grassi
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.C.); (R.R.); (A.O.)
- Correspondence:
| | - Oscar Campuzano
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain; (O.C.); (M.C.); (J.B.); (R.B.)
- Cardiovascular Genetics Center, Institut d’Investigació Biomèdica Girona (IDIBGI), University of Girona, 17190 Girona, Spain
- Medical Science Department, School of Medicine, University of Girona, 17003 Girona, Spain;
| | - Mònica Coll
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain; (O.C.); (M.C.); (J.B.); (R.B.)
- Cardiovascular Genetics Center, Institut d’Investigació Biomèdica Girona (IDIBGI), University of Girona, 17190 Girona, Spain
- Medical Science Department, School of Medicine, University of Girona, 17003 Girona, Spain;
| | - Francesca Cazzato
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.C.); (R.R.); (A.O.)
| | - Georgia Sarquella-Brugada
- Medical Science Department, School of Medicine, University of Girona, 17003 Girona, Spain;
- Arrhythmias Unit, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain
| | - Riccardo Rossi
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.C.); (R.R.); (A.O.)
| | - Vincenzo Arena
- Area of Pathology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00147 Rome, Italy;
- Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Josep Brugada
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain; (O.C.); (M.C.); (J.B.); (R.B.)
- Arrhythmias Unit, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain
- Institut Clínic Cardiovascular (ICCV), Hospital Clínic, Universitat de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Ramon Brugada
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain; (O.C.); (M.C.); (J.B.); (R.B.)
- Cardiovascular Genetics Center, Institut d’Investigació Biomèdica Girona (IDIBGI), University of Girona, 17190 Girona, Spain
- Medical Science Department, School of Medicine, University of Girona, 17003 Girona, Spain;
| | - Antonio Oliva
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.C.); (R.R.); (A.O.)
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8
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Hu B, Zeng WP, Li X, Al-Sheikh U, Chen SY, Ding J. A conserved arginine/lysine-based motif promotes ER export of KCNE1 and KCNE2 to regulate KCNQ1 channel activity. Channels (Austin) 2020; 13:483-497. [PMID: 31679457 PMCID: PMC6833972 DOI: 10.1080/19336950.2019.1685626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
KCNE β-subunits play critical roles in modulating cardiac voltage-gated potassium channels. Among them, KCNE1 associates with KCNQ1 channel to confer a slow-activated IKs current, while KCNE2 functions as a dominant negative modulator to suppress the current amplitude of KCNQ1. Any anomaly in these channels will lead to serious myocardial diseases, such as the long QT syndrome (LQTS). Trafficking defects of KCNE1 have been reported to account for the pathogenesis of LQT5. However, the molecular mechanisms underlying KCNE forward trafficking remain elusive. Here, we describe an arginine/lysine-based motif ([R/K](S)[R/K][R/K]) in the proximal C-terminus regulating the endoplasmic reticulum (ER) export of KCNE1 and KCNE2 in HEK293 cells. Notably, this motif is highly conserved in the KCNE family. Our results indicate that the forward trafficking of KCNE2 controlled by the motif (KSKR) is essential for suppressing the cell surface expression and current amplitude of KCNQ1. Unlike KCNE2, the motif (RSKK) in KCNE1 plays important roles in modulating the gating of KCNQ1 in addition to mediating the ER export of KCNE1. Furthermore, truncations of the C-terminus did not reduce the apparent affinity of KCNE2 for KCNQ1, demonstrating that the rigid C-terminus of KCNE2 may not physically interact with KCNQ1. In contrast, the KCNE1 C-terminus is critical for its interaction with KCNQ1. These results contribute to the understanding of the mechanisms of KCNE1 and KCNE2 membrane targeting and how they coassemble with KCNQ1 to regulate the channels activity.
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Affiliation(s)
- Bin Hu
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wen-Ping Zeng
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, China.,School of Life Sciences, University of Science and Technology of China, Hefei, Anhui, China
| | - Xia Li
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Umar Al-Sheikh
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - San-You Chen
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, China.,CAS Key Laboratory of Microscale Magnetic Resonance and Department of Modern Physics, University of Science and Technology of China, Hefei, Anhui, China
| | - Jiuping Ding
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, China
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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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10
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Sarquella-Brugada G, Cesar S, Zambrano MD, Fernandez-Falgueras A, Fiol V, Iglesias A, Torres F, Garcia-Algar O, Arbelo E, Brugada J, Brugada R, Campuzano O. Electrocardiographic Assessment and Genetic Analysis in Neonates: a Current Topic of Discussion. Curr Cardiol Rev 2019; 15:30-37. [PMID: 30210005 PMCID: PMC6367699 DOI: 10.2174/1573403x14666180913114806] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/10/2018] [Accepted: 09/11/2018] [Indexed: 12/30/2022] Open
Abstract
Background: Sudden death of a newborn is a rare entity, which may be caused by genetic cardiac arrhythmias. Among these diseases, Long QT syndrome is the most prevalent arrhythmia in neonates, but other diseases such as Brugada syndrome, Short QT syndrome and Catecholaminergic Polymorphic Ventricular Tachycardia also cause sudden death in infants. All these entities are charac-terized by well-known alterations in the electrocardiogram and the first symptom of the disease may be an unexpected death. Despite the low prevalence of these diseases, the performance of an electro-cardiogram in the first hours or days after birth could help identify these electrical disruptions and adopt preventive measures. In recent years, there has been an important impulse by some experts in the scientific community towards the initiation of a newborn electrocardiogram-screening program, for the detection of these electrocardiographic abnormalities. In addition, the use of genetic analysis in neonates could identify the cause of these heart alterations. Identification of relatives carrying the ge-netic alteration associated with the disease allows adoption of measures to prevent lethal episodes. Conclusion: Recent technological advances enable a comprehensive genetic screening of a large number of genes in a cost-effective way. However, the interpretation of genetic data and its translation into clinical practice are the main challenges for cardiologists and geneticists. However, there is im-portant controversy as to the clinical value, and cost-effectiveness of the use of electrocardiogram as well as of genetic testing to detect these cases. Our review focuses on these current matters of argue.
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Affiliation(s)
- Georgia Sarquella-Brugada
- Arrhythmias Unit, Hospital Sant Joan de Deu, University of Barcelona, Barcelona, Spain.,Medical Science Department, School of Medicine, University of Girona, Girona, Spain
| | - Sergi Cesar
- Arrhythmias Unit, Hospital Sant Joan de Deu, University of Barcelona, Barcelona, Spain
| | | | | | - Victoria Fiol
- Arrhythmias Unit, Hospital Sant Joan de Deu, University of Barcelona, Barcelona, Spain
| | - Anna Iglesias
- Cardiovascular Genetics Center, University of Girona- IDIBGI, Girona, Spain.,Centro Investigación Biomédica Red Enfermedades Cardiovasculares (CIBERCV), Girona, Spain
| | - Francesc Torres
- GRIE, Neonatology Unit, Hospital Clinic-Maternitat, IDIBAPS, BCNatal, Barcelona, Spain
| | - Oscar Garcia-Algar
- GRIE, Neonatology Unit, Hospital Clinic-Maternitat, IDIBAPS, BCNatal, Barcelona, Spain
| | - Elena Arbelo
- Centro Investigación Biomédica Red Enfermedades Cardiovasculares (CIBERCV), Girona, Spain.,Arrhythmias Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Josep Brugada
- Arrhythmias Unit, Hospital Sant Joan de Deu, University of Barcelona, Barcelona, Spain.,Centro Investigación Biomédica Red Enfermedades Cardiovasculares (CIBERCV), Girona, Spain.,Arrhythmias Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Ramon Brugada
- Medical Science Department, School of Medicine, University of Girona, Girona, Spain.,Cardiovascular Genetics Center, University of Girona- IDIBGI, Girona, Spain.,Centro Investigación Biomédica Red Enfermedades Cardiovasculares (CIBERCV), Girona, Spain.,Cardiology Service, Hospital Josep Trueta, University of Girona, Girona. Spain
| | - Oscar Campuzano
- Medical Science Department, School of Medicine, University of Girona, Girona, Spain.,Cardiovascular Genetics Center, University of Girona- IDIBGI, Girona, Spain.,Centro Investigación Biomédica Red Enfermedades Cardiovasculares (CIBERCV), Girona, Spain
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11
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Deciphering the multicomponent synergy mechanism from a systems pharmacology perspective: Application to Gualou Xiebai Decoction for coronary heart disease. J Funct Foods 2018. [DOI: 10.1016/j.jff.2018.02.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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12
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Exome analysis in 34 sudden unexplained death (SUD) victims mainly identified variants in channelopathy-associated genes. Int J Legal Med 2018; 132:1057-1065. [PMID: 29350269 DOI: 10.1007/s00414-018-1775-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 01/09/2018] [Indexed: 12/12/2022]
Abstract
Sudden cardiac death (SCD) is one of the major causes of mortality worldwide, mostly involving coronary artery disease in the elderly. In contrary, sudden death events in young victims often represent the first manifestation of undetected genetic cardiac diseases, which remained without any symptoms during lifetime. Approximately 30% of these sudden death cases have no definite cardiac etiology after a comprehensive medicolegal investigation and are therefore termed as sudden unexplained death (SUD) cases. Advances in high-throughput sequencing approaches have provided an efficient diagnostic tool to identify likely pathogenic variants in cardiovascular disease-associated genes in otherwise autopsy-negative SUD cases. The aim of this study was to genetically investigate a cohort of 34 unexplained death cases by focusing on candidate genes associated with cardiomyopathies and channelopathies. Exome analysis identified potentially disease-causing sequence alterations in 29.4% of the 34 SUD cases. Six (17.6%) individuals had variants with likely functional effects in the channelopathy-associated genes AKAP9, KCNE5, RYR2, and SEMA3A. Interestingly, four of these six SUD individuals were younger than 18 years of age. Since the total SUD cohort of this study included five children and adolescents, post-mortem molecular autopsy screening indicates a high diagnostic yield within this age group. Molecular genetic testing represents a valuable approach to uncover the cause of death in some of the SUD victims; however, 70-80% of the cases still remain elusive, emphasizing the importance of additional research to better understand the pathological mechanisms leading to a sudden death event.
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13
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Mishra V, Karumuri BK, Gautier NM, Liu R, Hutson TN, Vanhoof-Villalba SL, Vlachos I, Iasemidis L, Glasscock E. Scn2a deletion improves survival and brain-heart dynamics in the Kcna1-null mouse model of sudden unexpected death in epilepsy (SUDEP). Hum Mol Genet 2017; 26:2091-2103. [PMID: 28334922 DOI: 10.1093/hmg/ddx104] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 03/13/2017] [Indexed: 12/20/2022] Open
Abstract
People with epilepsy have greatly increased probability of premature mortality due to sudden unexpected death in epilepsy (SUDEP). Identifying which patients are most at risk of SUDEP is hindered by a complex genetic etiology, incomplete understanding of the underlying pathophysiology and lack of prognostic biomarkers. Here we evaluated heterozygous Scn2a gene deletion (Scn2a+/-) as a protective genetic modifier in the Kcna1 knockout mouse (Kcna1-/-) model of SUDEP, while searching for biomarkers of SUDEP risk embedded in electroencephalography (EEG) and electrocardiography (ECG) recordings. The human epilepsy gene Kcna1 encodes voltage-gated Kv1.1 potassium channels that act to dampen neuronal excitability whereas Scn2a encodes voltage-gated Nav1.2 sodium channels important for action potential initiation and conduction. SUDEP-prone Kcna1-/- mice with partial genetic ablation of Nav1.2 channels (i.e. Scn2a+/-; Kcna1-/-) exhibited a two-fold increase in survival. Classical analysis of EEG and ECG recordings separately showed significantly decreased seizure durations in Scn2a+/-; Kcna1-/- mice compared with Kcna1-/- mice, without substantial modification of cardiac abnormalities. Novel analysis of the EEG and ECG together revealed a significant reduction in EEG-ECG association in Kcna1-/- mice compared with wild types, which was partially restored in Scn2a+/-; Kcna1-/- mice. The degree of EEG-ECG association was also proportional to the survival rate of mice across genotypes. These results show that Scn2a gene deletion acts as protective genetic modifier of SUDEP and suggest measures of brain-heart association as potential indices of SUDEP susceptibility.
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Affiliation(s)
- Vikas Mishra
- Department of Cellular Biology and Anatomy, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA
| | - Bharat K Karumuri
- Biomedical Engineering, Louisiana Tech University, Ruston, LA 71272, USA
| | - Nicole M Gautier
- Department of Cellular Biology and Anatomy, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA
| | - Rui Liu
- Department of Mathematics and Statistics, Louisiana Tech University, Ruston, LA 71272, USA
| | - Timothy N Hutson
- Biomedical Engineering, Louisiana Tech University, Ruston, LA 71272, USA
| | - Stephanie L Vanhoof-Villalba
- Department of Cellular Biology and Anatomy, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA
| | - Ioannis Vlachos
- Department of Mathematics and Statistics, Louisiana Tech University, Ruston, LA 71272, USA
| | - Leonidas Iasemidis
- Biomedical Engineering, Louisiana Tech University, Ruston, LA 71272, USA
| | - Edward Glasscock
- Department of Cellular Biology and Anatomy, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA
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14
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Ivanova AA, Maksimov VN, Ivanoshchuk DE, Orlov PS, Novoselov VP, Savchenko SV, Voevoda MI. Association of Polymorphism in SCN5A, GJA5, and KCNN3 Gene with Sudden Cardiac Death. Bull Exp Biol Med 2017; 163:73-77. [PMID: 28577096 DOI: 10.1007/s10517-017-3741-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Indexed: 11/29/2022]
Abstract
We studied association of single-nucleotide SCN5A (rs1805124), GJA5 (rs35594137), and KCNN3 (rs13376333) polymorphisms and sudden cardiac death. Humans died suddenly from cardiac causes (N=379) and unrelated sex- and age-matched control subjects were genotyped. No significant intergroup differences were found in the frequency of rs1805124 and rs13376333 genotypes and alleles. In women under 50 years, enhanced risk of sudden cardiac death was associated with rs35594137 GG genotype (OR=3.6; 95%CI=1.2-10.4; p=0.022), while in older women it was associated with rs35594137 AA genotype (OR=3.0; 95%CI=2.3-3.9; p=0.041). In women under 50 years, GA rs35594137 genotype was associated with a protective effect against sudden cardiac death (OR=0.3; 95%CI=0.1-0.8; p=0.036). Thus, GJA5 gene rs35594137 polymorphism is significantly associated with sudden cardiac death in the examined group.
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Affiliation(s)
- A A Ivanova
- Research Institute of Therapy and Preventive Medicine, Novosibirsk, Russia.
| | - V N Maksimov
- Research Institute of Therapy and Preventive Medicine, Novosibirsk, Russia
- Novosibirsk State Medical University, Ministry of Health of the Russian Federation, Novosibirsk, Russia
| | - D E Ivanoshchuk
- Research Institute of Therapy and Preventive Medicine, Novosibirsk, Russia
- Federal Research Centre Institute of Cytology and Genetics, Siberian Division of the Russian Academy of Sciences, Novosibirsk, Russia
- Novosibirsk National Research State University, Novosibirsk, Russia
| | - P S Orlov
- Research Institute of Therapy and Preventive Medicine, Novosibirsk, Russia
- Federal Research Centre Institute of Cytology and Genetics, Siberian Division of the Russian Academy of Sciences, Novosibirsk, Russia
- Novosibirsk National Research State University, Novosibirsk, Russia
| | - V P Novoselov
- Novosibirsk State Medical University, Ministry of Health of the Russian Federation, Novosibirsk, Russia
- Novosibirsk Regional Clinical Bureau of Forensic Medicine, Novosibirsk, Russia
| | - S V Savchenko
- Novosibirsk State Medical University, Ministry of Health of the Russian Federation, Novosibirsk, Russia
- Novosibirsk Regional Clinical Bureau of Forensic Medicine, Novosibirsk, Russia
| | - M I Voevoda
- Research Institute of Therapy and Preventive Medicine, Novosibirsk, Russia
- Federal Research Centre Institute of Cytology and Genetics, Siberian Division of the Russian Academy of Sciences, Novosibirsk, Russia
- Novosibirsk National Research State University, Novosibirsk, Russia
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15
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Mesrati MA, Belhadj M, Aissaoui A, HajSalem N, Oualha D, Boughattas M, Messaoudi I, Hammedi F, Zakhama A, Chadly A. [Sudden cardiovascular death in adults: Study of 361 autopsy cases]. Ann Cardiol Angeiol (Paris) 2017; 66:7-14. [PMID: 27109042 DOI: 10.1016/j.ancard.2016.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 03/15/2016] [Indexed: 06/05/2023]
Abstract
AIMS OF THE STUDY To describe epidemiological aspects of sudden cardiovascular death and to specify the etiopathogenic characteristics. PATIENTS AND METHOD Our study is retrospective and descriptive. It included 361 cases of sudden cardiovascular death, which underwent autopsy in forensic medicine department of Monastir during eight years, from 1st January 2004 to 31st December 2011. RESULTS The incidence of sudden cardiovascular death was 9 per 100,000 person. A marked male predominance was noted. The mean age was 55.75 years. In our series, myocardial infarction represents the leading cause of sudden cardiovascular death, 57.8% of cases. Other etiologies were hypertrophic cardiomyopathy (4.7%), heart failure (1.9%), arrhythmogenic right ventricular dysplasia (2.8%), valvular disease (2%), cardio-myo-pericarditis (1.9%), hydatid cyst of the heart (0.8%), ruptured aneurysm (2.5%), pulmonary embolism (1.9%) and aortic dissection (1.3%). A sudden cardiovascular death at work was found in 25 cases. These cases pose essentially a problem of imputability. CONCLUSION Sudden cardiac death is usually the complication of underlying heart disease, sometimes overlooked. Several risk factors are involved. Sudden cardiac death in healthy heart or death caused by arrhythmia is an important entity seeking the intervention of several actors (forensic doctor, cardiologist, geneticist, media…) for prevention.
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Affiliation(s)
- M A Mesrati
- Service de médecine légale, CHU Fattouma Bourguiba, Monastir, Tunisie; Faculté de médecine, université de Monastir, Monastir, Tunisie
| | - M Belhadj
- Service de médecine légale, CHU Fattouma Bourguiba, Monastir, Tunisie; Faculté de médecine, université de Monastir, Monastir, Tunisie
| | - A Aissaoui
- Service de médecine légale, CHU Fattouma Bourguiba, Monastir, Tunisie; Faculté de médecine, université de Monastir, Monastir, Tunisie.
| | - N HajSalem
- Service de médecine légale, CHU Fattouma Bourguiba, Monastir, Tunisie; Faculté de médecine, université de Monastir, Monastir, Tunisie
| | - D Oualha
- Service de médecine légale, CHU Fattouma Bourguiba, Monastir, Tunisie; Faculté de médecine, université de Monastir, Monastir, Tunisie
| | - M Boughattas
- Service de médecine légale, CHU Fattouma Bourguiba, Monastir, Tunisie; Faculté de médecine, université de Monastir, Monastir, Tunisie
| | - I Messaoudi
- Service de médecine légale, CHU Fattouma Bourguiba, Monastir, Tunisie; Faculté de médecine, université de Monastir, Monastir, Tunisie
| | - F Hammedi
- Service d'anatomie et de cytologie pathologique, CHU Fattouma Bourguiba, Monastir, Tunisie; Faculté de médecine, université de Monastir, Monastir, Tunisie
| | - A Zakhama
- Service d'anatomie et de cytologie pathologique, CHU Fattouma Bourguiba, Monastir, Tunisie; Faculté de médecine, université de Monastir, Monastir, Tunisie
| | - A Chadly
- Service de médecine légale, CHU Fattouma Bourguiba, Monastir, Tunisie; Faculté de médecine, université de Monastir, Monastir, Tunisie
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16
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An insertion/deletion polymorphism within 3'UTR of RYR2 modulates sudden unexplained death risk in Chinese populations. Forensic Sci Int 2016; 270:165-172. [PMID: 27987400 DOI: 10.1016/j.forsciint.2016.12.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 10/26/2016] [Accepted: 12/03/2016] [Indexed: 01/30/2023]
Abstract
Sudden unexplained death (SUD) constitutes a part of the overall sudden death that can not be underestimated. Over the last years, genetic testing on SUD has revealed that inherited channelopathies might play important roles in the pathophysiology of this disease. Ryanodine receptor type-2 (RYR2) is a kind of ion channel extensively distributed in the sarcoplasmic reticulum (SR) of myocardium. Studies on RYR2 have suggested that either dysfunction or abnormal expression of it could lead to arrhythmia, which may cause cardiac arrest. In this study, we conducted a case-control study to evaluate the association of a 4-base pair (4-bp) Indel polymorphism (rs10692285) in the 3'UTR of RYR2 with the risk of SUD and sudden cardiac death induced by coronary heart disease (SCD-AS) in a Chinese population. Logistic regression analysis showed that the insertion allele of rs10692285 had significantly increased the risk of SUD [OR=2.03; 95% confidence interval (CI)=1.08-3.77; P=0.0161; statistical power=0.743]. No relevance was observed between rs10692285 and SCD-AS. Further genotype-phenotype association analysis suggested that the expression level of RYR2 in human myocardium tissues with the insertion allele was higher than that with the deletion allele at both mRNA and protein levels. Dual-Luciferase activity assay system was used to detect the effect of rs10692285 on the transcription activity of RYR2. As expected, the result indicated that the transcription activity of RYR2 with the ins/ins genotype was higher than that with the del/del genotype. Finally, in-silico prediction revealed that different alleles of rs10692285 could alter the local structure of RYR2 mRNA and microRNA (miRNA) binding. In summary, our findings provided evidence that rs10692285 might contribute to SUD susceptibility through affecting the expression of RYR2, which suggest that abnormal ion channel activity is very likely to be the underlying mechanism of SUD, but not for SCD-AS. Thus, rs10692285 may become a potential marker for molecular diagnosis and genetic counseling of SUD.
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17
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Sanchez O, Campuzano O, Fernández-Falgueras A, Sarquella-Brugada G, Cesar S, Mademont I, Mates J, Pérez-Serra A, Coll M, Pico F, Iglesias A, Tirón C, Allegue C, Carro E, Gallego MÁ, Ferrer-Costa C, Hospital A, Bardalet N, Borondo JC, Vingut A, Arbelo E, Brugada J, Castellà J, Medallo J, Brugada R. Natural and Undetermined Sudden Death: Value of Post-Mortem Genetic Investigation. PLoS One 2016; 11:e0167358. [PMID: 27930701 PMCID: PMC5145162 DOI: 10.1371/journal.pone.0167358] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 11/11/2016] [Indexed: 12/15/2022] Open
Abstract
Background Sudden unexplained death may be the first manifestation of an unknown inherited cardiac disease. Current genetic technologies may enable the unraveling of an etiology and the identification of relatives at risk. The aim of our study was to define the etiology of natural deaths, younger than 50 years of age, and to investigate whether genetic defects associated with cardiac diseases could provide a potential etiology for the unexplained cases. Methods and Findings Our cohort included a total of 789 consecutive cases (77.19% males) <50 years old (average 38.6±12.2 years old) who died suddenly from non-violent causes. A comprehensive autopsy was performed according to current forensic guidelines. During autopsy a cause of death was identified in most cases (81.1%), mainly due to cardiac alterations (56.87%). In unexplained cases, genetic analysis of the main genes associated with sudden cardiac death was performed using Next Generation Sequencing technology. Genetic analysis was performed in suspected inherited diseases (cardiomyopathy) and in unexplained death, with identification of potentially pathogenic variants in nearly 50% and 40% of samples, respectively. Conclusions Cardiac disease is the most important cause of sudden death, especially after the age of 40. Close to 10% of cases may remain unexplained after a complete autopsy investigation. Molecular autopsy may provide an explanation for a significant part of these unexplained cases. Identification of genetic variations enables genetic counseling and undertaking of preventive measures in relatives at risk.
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Affiliation(s)
- Olallo Sanchez
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | - Oscar Campuzano
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
- Department of Medical Sciences, School of Medicine, University of Girona, Girona (Spain)
| | - Anna Fernández-Falgueras
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
- Cardiovascular Genetics Unit, Hospital Josep Trueta, Girona (Spain)
| | | | - Sergi Cesar
- Arrhythmia Unit, Hospital Sant Joan de Déu, University of Barcelona, Barcelona (Spain)
| | - Irene Mademont
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | - Jesus Mates
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | | | - Monica Coll
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | - Ferran Pico
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | - Anna Iglesias
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | - Coloma Tirón
- Cardiovascular Genetics Unit, Hospital Josep Trueta, Girona (Spain)
| | - Catarina Allegue
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
| | - Esther Carro
- Arrhythmia Unit, Hospital Sant Joan de Déu, University of Barcelona, Barcelona (Spain)
| | - María Ángeles Gallego
- Forensic Pathology Service, Institut Medicina Legal Ciències Mèdiques Catalunya, Barcelona (Spain)
| | | | - Anna Hospital
- Forensic Pathology Service, Institut Medicina Legal i Ciències Forenses de Catalunya, Girona (Spain)
| | - Narcís Bardalet
- Forensic Pathology Service, Institut Medicina Legal i Ciències Forenses de Catalunya, Girona (Spain)
| | - Juan Carlos Borondo
- Histopathology Unit, Instituto Nacional de Toxicología y Ciencias Forenses, Barcelona (Spain)
| | - Albert Vingut
- Histopathology Unit, Instituto Nacional de Toxicología y Ciencias Forenses, Barcelona (Spain)
| | - Elena Arbelo
- Arrhythmia Unit, Hospital Clinic de Barcelona, University of Barcelona, Barcelona (Spain)
| | - Josep Brugada
- Arrhythmia Unit, Hospital Sant Joan de Déu, University of Barcelona, Barcelona (Spain)
- Arrhythmia Unit, Hospital Clinic de Barcelona, University of Barcelona, Barcelona (Spain)
| | - Josep Castellà
- Forensic Pathology Service, Institut Medicina Legal Ciències Mèdiques Catalunya, Barcelona (Spain)
| | - Jordi Medallo
- Forensic Pathology Service, Institut Medicina Legal Ciències Mèdiques Catalunya, Barcelona (Spain)
| | - Ramon Brugada
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona (Spain)
- Department of Medical Sciences, School of Medicine, University of Girona, Girona (Spain)
- Cardiovascular Genetics Unit, Hospital Josep Trueta, Girona (Spain)
- * E-mail:
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18
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Abstract
Sudden cardiac death (SCD) is defined by the World Health Organization (WHO) as death within 1 h of symptom onset (witnessed) or within 24 h of being observed alive and symptom free (unwitnessed). It affects more than 3 million people annually worldwide and affects approximately 1/1000 people each year in the USA. Familial studies of syndromes with Mendelian inheritance, candidate genes analyses, and genome-wide association studies (GWAS) have helped our understanding of the genetics of SCD. We will review the genetics of arrhythmogenic hereditary syndromes with Mendelian inheritance from familial studies with structural heart disease (hypertrophic cardiomyopathy, dilated cardiomyopathy, and arrhythmogenic cardiomyopathy) as well as primary electrical causes (long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, and short QT syndrome). In addition, we will review the genetics of intermediate phenotypes for SCD such as coronary artery disease and electrocardiographic variables (QT interval, QRS duration, and RR interval). Finally, we will review rare and common variants that are associated with SCD in the general population and were identified from candidate gene analyses and GWAS. Our understanding of the genetics of SCD will improve by the use of next-generation sequencing/whole-exome sequencing as well as whole-genome sequencing which have the potential to discover unsuspected common and rare genetic variants that might be associated with SCD.
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19
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Buscemi L, Alessandrini F, Perna G, Tagliabracci A. Next-generation sequencing of 68 genes in sudden unexplained death of young individuals in forensics. FORENSIC SCIENCE INTERNATIONAL GENETICS SUPPLEMENT SERIES 2015. [DOI: 10.1016/j.fsigss.2015.09.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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O'Connor LC, Torrance HJ, McKeown DA. ELISA Detection of Phenazepam, Etizolam, Pyrazolam, Flubromazepam, Diclazepam and Delorazepam in Blood Using Immunalysis®Benzodiazepine Kit. J Anal Toxicol 2015; 40:159-61. [DOI: 10.1093/jat/bkv122] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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21
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Farrugia A, Keyser C, Hollard C, Raul J, Muller J, Ludes B. Targeted next generation sequencing application in cardiac channelopathies: Analysis of a cohort of autopsy-negative sudden unexplained deaths. Forensic Sci Int 2015; 254:5-11. [DOI: 10.1016/j.forsciint.2015.06.023] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 05/22/2015] [Accepted: 06/24/2015] [Indexed: 12/19/2022]
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22
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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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23
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Neary MT, Neary JM, Lund GK, Holt TN, Garry FB, Mohun TJ, Breckenridge RA. Myosin heavy chain 15 is associated with bovine pulmonary arterial pressure. Pulm Circ 2015; 4:496-503. [PMID: 25621163 DOI: 10.1086/677364] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 04/16/2014] [Indexed: 11/03/2022] Open
Abstract
Bovine pulmonary hypertension, brisket disease, causes significant morbidity and mortality at elevations above 2,000 m. Mean pulmonary arterial pressure (mPAP) is moderately heritable, with inheritance estimated to lie within a few major genes. Invasive mPAP measurement is currently the only tool available to identify cattle at risk of hypoxia-induced pulmonary hypertension. A genetic test could allow selection of cattle suitable for high altitude without the need for invasive testing. In this study we evaluated three candidate genes (myosin heavy chain 15 [MYH15], NADH dehydrogenase flavoprotein 2, and FK binding protein 1A) for association with mPAP in 166 yearling Angus bulls grazing at 2,182 m. The T allele (rs29016420) of MYH15 was linked to lower mPAP in a dominant manner (CC 47.2 ± 1.6 mmHg [mean ± standard error of the mean]; CT/TT 42.8 ± 0.7 mmHg; P = 0.02). The proportions of cattle with MYH15 CC, CT, and TT genotypes were 55%, 41%, and 4%, respectively. Given the high frequency of the deleterious allele, it is likely that the relative contribution of MYH15 polymorphisms to pulmonary hypertension is small, supporting previous predictions that the disease is polygenic. We evaluated allelic frequency of MYH15 in the Himalayan yak (Bos grunniens), a closely related species adapted to high altitude, and found 100% prevalence of T allele homozygosity. In summary, we identified a polymorphism in MYH15 significantly associated with mPAP. This finding may aid selection of cattle suitable for high altitude and contribute to understanding human hypoxia-induced pulmonary hypertension.
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Affiliation(s)
- Marianne T Neary
- Medical Research Council, National Institute for Medical Research, Mill Hill, London, United Kingdom ; These two authors contributed equally to the work
| | - Joseph M Neary
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA ; These two authors contributed equally to the work
| | - Gretchen K Lund
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Timothy N Holt
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Franklyn B Garry
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Timothy J Mohun
- Medical Research Council, National Institute for Medical Research, Mill Hill, London, United Kingdom
| | - Ross A Breckenridge
- Medical Research Council, National Institute for Medical Research, Mill Hill, London, United Kingdom ; Division of Medicine, University College London, London, United Kingdom
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Hertz CL, Christiansen SL, Ferrero-Miliani L, Fordyce SL, Dahl M, Holst AG, Ottesen GL, Frank-Hansen R, Bundgaard H, Morling N. Next-generation sequencing of 34 genes in sudden unexplained death victims in forensics and in patients with channelopathic cardiac diseases. Int J Legal Med 2014; 129:793-800. [PMID: 25467552 DOI: 10.1007/s00414-014-1105-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 10/30/2014] [Indexed: 01/11/2023]
Abstract
Sudden cardiac death (SCD) is responsible for a large proportion of sudden deaths in young individuals. In forensic medicine, many cases remain unexplained after routine postmortem autopsy and conventional investigations. These cases are called sudden unexplained deaths (SUD). Genetic testing has been suggested useful in forensic medicine, although in general with a significantly lower success rate compared to the clinical setting. The purpose of the study was to estimate the frequency of pathogenic variants in the genes most frequently associated with SCD in SUD cases and compare the frequency to that in patients with inherited cardiac channelopathies. Fifteen forensic SUD cases and 29 patients with channelopathies were investigated. DNA from 34 of the genes most frequently associated with SCD were captured using NimbleGen SeqCap EZ library build and were sequenced with next-generation sequencing (NGS) on an Illumina MiSeq. Likely pathogenic variants were identified in three out of 15 (20%) forensic SUD cases compared to 12 out of 29 (41%) patients with channelopathies. The difference was not statistically significant (p = 0.1). Additionally, two larger deletions of entire exons were identified in two of the patients (7%). The frequency of likely pathogenic variants was >2-fold higher in the clinical setting as compared to SUD cases. However, the demonstration of likely pathogenic variants in three out of 15 forensic SUD cases indicates that NGS investigations will contribute to the clinical investigations. Hence, this has the potential to increase the diagnostic rate significantly in the forensic as well as in the clinical setting.
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Affiliation(s)
- C L Hertz
- Section of Forensic Genetics, Department of Forensic Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 11 Frederik V's Vej, 2100, Copenhagen, Denmark,
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25
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Forensische Molekularpathologie. Rechtsmedizin (Berl) 2014. [DOI: 10.1007/s00194-014-0975-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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26
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Hertz CL, Ferrero-Miliani L, Frank-Hansen R, Morling N, Bundgaard H. A comparison of genetic findings in sudden cardiac death victims and cardiac patients: the importance of phenotypic classification. Europace 2014; 17:350-7. [PMID: 25345827 DOI: 10.1093/europace/euu210] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Sudden cardiac death (SCD) is responsible for a large proportion of non-traumatic, sudden and unexpected deaths in young individuals. Sudden cardiac death is a known manifestation of several inherited cardiac diseases. In post-mortem examinations, about two-thirds of the SCD cases show structural abnormalities at autopsy. The remaining cases stay unexplained after thorough investigations and are referred to as sudden unexplained deaths. A routine forensic investigation of the SCD victims in combination with genetic testing makes it possible to establish a likely diagnosis in some of the deaths previously characterized as unexplained. Additionally, a genetic diagnose in a SCD victim with a structural disease may not only add to the differential diagnosis, but also be of importance for pre-symptomatic family screening. In the case of SCD, the optimal establishment of the cause of death and management of the family call for standardized post-mortem procedures, genetic screening, and family screening. Studies of genetic testing in patients with primary arrhythmia disorders or cardiomyopathies and of victims of SCD presumed to be due to primary arrhythmia disorders or cardiomyopathies, were systematically identified and reviewed. The frequencies of disease-causing mutation were on average between 16 and 48% in the cardiac patient studies, compared with ∼10% in the post-mortem studies. The frequency of pathogenic mutations in heart genes in cardiac patients is up to four-fold higher than that in SCD victims in a forensic setting. Still, genetic investigation of SCD victims is important for the diagnosis and the possible investigation of relatives at risk.
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Affiliation(s)
- Christin L Hertz
- Section of Forensic Genetics, Department of Forensic Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 11 Frederik V's Vej, 2100 Copenhagen, Denmark
| | - Laura Ferrero-Miliani
- Section of Forensic Genetics, Department of Forensic Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 11 Frederik V's Vej, 2100 Copenhagen, Denmark
| | - Rune Frank-Hansen
- Section of Forensic Genetics, Department of Forensic Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 11 Frederik V's Vej, 2100 Copenhagen, Denmark
| | - Niels Morling
- Section of Forensic Genetics, Department of Forensic Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 11 Frederik V's Vej, 2100 Copenhagen, Denmark
| | - Henning Bundgaard
- Rigshospitalets Unit for Inherited Heart Diseases, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Denmark
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Brion M, Blanco-Verea A, Sobrino B, Santori M, Gil R, Ramos-Luis E, Martinez M, Amigo J, Carracedo A. Next generation sequencing challenges in the analysis of cardiac sudden death due to arrhythmogenic disorders. Electrophoresis 2014; 35:3111-6. [PMID: 24981977 DOI: 10.1002/elps.201400148] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 06/02/2014] [Accepted: 06/21/2014] [Indexed: 01/11/2023]
Abstract
Inherited arrhythmogenic disorders is a relatively common cause of cardiac sudden death in young people. Diagnosis has been difficult so far due to the genetic heterogeneity of the disease. Next generation sequencing (NGS) is offering a new scenario for diagnosis. The purpose of our study was to validate NGS for the analysis of twenty-eight genes known to be associated with inherited arrhythmogenic disorders and therefore with sudden cardiac death. SureSelect hybridization was used to enrich DNA from 53 samples, prior to be sequenced with the SOLID™ System of Life Technologies. Depth of coverage, consistency of coverage across samples, and location of variants identified were assessed. All the samples showed a depth of coverage over 200×, except one of them discarded because of its coverage below 30×. Average percentage of target bp covered at least 20× was 96.45%. In the remaining samples, following a prioritization process 46 possible variants in 31 samples were found, of which 45 were confirmed by Sanger sequencing. After filtering variants according to their minor allele frequency in the Exome Sequencing Project 27 putative pathogenic variants in 20 samples remained. With the use of in silico tools, 13 variants in 11 samples were classified as likely pathogenic. In conclusion, NGS allowed us to accurately detect arrhythmogenic disease causing mutations in a fast and cost-efficient manner that is suitable for daily clinical and forensic practice of genetic testing of this type of disorders.
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Affiliation(s)
- Maria Brion
- Grupo de Xenética de enfermidades cardiovasculares e oftalmolóxicas, IDIS, RIC Santiago de Compostela, Spain; Fundación Pública Galega de Medicina Xenómica, SERGAS, Santiago de Compostela, Spain
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28
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Sudden cardiac death from parvovirus B19 myocarditis in a young man with Brugada syndrome. J Forensic Leg Med 2014; 25:8-13. [DOI: 10.1016/j.jflm.2014.04.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 02/27/2014] [Accepted: 04/16/2014] [Indexed: 12/19/2022]
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29
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Sener MT, Karakus E, Halici Z, Akpinar E, Topcu A, Kok AN. Can early myocardial infarction-related deaths be diagnosed using postmortem urotensin receptor expression levels? Forensic Sci Med Pathol 2014; 10:395-400. [PMID: 24935436 DOI: 10.1007/s12024-014-9575-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE Myocardial infarction (MI) is one of the most prevalent causes of sudden adult death. It is difficult to diagnose early MI postmortem because there are no typical or characteristic changes in morphology. In this study, changes in the level of the mRNA for the urotensin receptor (UR) were investigated postmortem to determine the suitability of UR as a biomarker for diagnosis of early MI after death. METHODS An MI rat model was developed by injecting rats with isoproterenol (ISO) (lethal dose 850 mg/kg) or normal saline (control group). The hearts of rats in the control and ISO-induced MI groups were harvested at 0, 1, 3, 6, 12, 24, 48, and 72 h (h) postmortem. The hearts were then immediately submerged in 1 mL of RNA stabilization solution and stored at 4 °C for <1 week before RNA extraction. Relative UR expression analysis was performed using the StepOne Plus Real Time PCR System with cDNA synthesized from rat heart. RESULTS Postmortem UR mRNA expression was higher in the ISO-induced MI group than in the control group, at both 4 and 20 °C, at all of the time points examined except 72 h postmortem (p < 0.0001). The largest increases were observed at ambient temperature and 6 h postmortem. CONCLUSIONS Based on our findings, increased postmortem UR expression could serve as a biomarker to aid diagnosis of early MI.
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Affiliation(s)
- Mustafa Talip Sener
- Department of Forensic Medicine, Ataturk University School of Medicine, 25240, Erzurum, Turkey,
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30
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Mercuri A, Turchi S, Borghini A, Chiesa MR, Lazzerini G, Musacchio L, Zirilli O, Andreassi MG. Nitrogen biobank for cardiovascular research. Curr Cardiol Rev 2013; 9:253-9. [PMID: 23909635 PMCID: PMC3780350 DOI: 10.2174/1573403x113099990035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2012] [Revised: 12/17/2012] [Accepted: 12/17/2012] [Indexed: 01/05/2023] Open
Abstract
Biobanks play a crucial role in "-Omics" research providing well-annotated samples to study major diseases, their pathways and mechanisms. Accordingly, there are major efforts worldwide to professionalize biobanks in order to provide high quality preservation and storage of biological samples with potentially greater scientific impact. Biobanks are an important resource to elucidate relevant disease mechanisms as well as to improve the diagnosis, prognosis, and treatment of both pediatric and adult cardiovascular disease. High-quality biological sample collections housed in specialized bio-repositories are needed to discover new genetic factors and molecular mechanisms of congenital heart disease and inherited cardiomyopathies in order to prevent the potential risk of having a fatal cardiac condition as well as to facilitate rational drug design around molecular diseases (personalized medicine). Biological samples are also required to improve the understanding the environmental mechanisms of heart disease (environmental cardiology). The goal of this paper is to focus on preanalytical issues (informed consent, sample type, time of collection, temperature and processing procedure) related to collection of biological samples for research purposes. In addition, the paper provides an overview of the efforts made recently by our Institute in designing and implementing a high-security liquid nitrogen storage system (-196°C). We described the implementations of reliable preservation technologies and appropriate quality control (the right temperature, the right environment, fully traceable with all possible back-up systems) in order to ensure maximum security for personnel as well as the quality and suitability of the stored samples.
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Affiliation(s)
| | - Stefano Turchi
- U.O. Biobank, CNR, Institute of Clinical Physiology, Pisa, Italy
| | - Andrea Borghini
- U.O. Biobank, CNR, Institute of Clinical Physiology, Pisa, Italy
| | | | - Guido Lazzerini
- U.O. Biobank, CNR, Institute of Clinical Physiology, Pisa, Italy
| | | | - Ottavio Zirilli
- U.O. Biobank, CNR, Institute of Clinical Physiology, Pisa, Italy
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Suárez-Peñaranda JM, Cordeiro C, Rodríguez-Calvo M, Vieira DN, Muñoz-Barús JI. Cardiac Inhibitory Reflex as a Cause/Mechanism of Death. J Forensic Sci 2013; 58:1644-7. [DOI: 10.1111/1556-4029.12212] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 08/18/2012] [Accepted: 08/18/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Jose M. Suárez-Peñaranda
- Department of Pathology and Forensic Science; University of Santiago de Compostela; Santiago de Compostela Spain
| | - Cristina Cordeiro
- National Institute of Legal Medicine and Forensic Sciences of Portugal; Centre Branch; Coimbra Portugal
- Centre of Forensic Sciences (CENCIFOR); University of Coimbra; Coimbra Portugal
| | - Marisol Rodríguez-Calvo
- Department of Pathology and Forensic Science; University of Santiago de Compostela; Santiago de Compostela Spain
| | - Duarte N. Vieira
- National Institute of Legal Medicine and Forensic Sciences of Portugal; Centre Branch; Coimbra Portugal
- Centre of Forensic Sciences (CENCIFOR); University of Coimbra; Coimbra Portugal
| | - Jose Ignacio Muñoz-Barús
- Department of Pathology and Forensic Science; University of Santiago de Compostela; Santiago de Compostela Spain
- Institute of Forensic Science; University of Santiago de Compostela; Rúa San Francisco s/n; 15782 Santiago de Compostela Spain
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Liu C, Zhao Q, Su T, Tang S, Lv G, Liu H, Quan L, Cheng J. Postmortem molecular analysis of KCNQ1, KCNH2, KCNE1 and KCNE2 genes in sudden unexplained nocturnal death syndrome in the Chinese Han population. Forensic Sci Int 2013; 231:82-7. [PMID: 23890619 DOI: 10.1016/j.forsciint.2013.04.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 03/15/2013] [Accepted: 04/17/2013] [Indexed: 10/26/2022]
Abstract
The etiology of sudden unexplained nocturnal death syndrome (SUNDS) remains unclear. Previous studies have implicated that SUNDS is probably allelic to cardiac sodium channel diseases such as Brugada syndrome. The variation in cardiac potassium channels is the main genetic cause of inherited long QT syndrome (LQTS), which may manifest as syncope and sudden cardiac death without structural disease. We hypothesized that cardiac potassium channel disease may be responsible for certain Chinese SUNDS cases. Genotyping of 4 main LQTS-susceptibility genes (KCNQ1, KCNH2, KCNE1, and KCNE2) was performed here for the first time in SUNDS victims from the Chinese Han population to address the pathogenic cause of some SUNDS using polymerase chain reaction and direct DNA sequencing. 120 sporadic SUNDS cases were enrolled. Genomic DNA was extracted from blood samples. A total of 2 novel non-synonymous mutations and 3 previously reported arrhythmia susceptibility polymorphisms were identified in KCNQ1, KCNH2, KCNE1, and KCNE2. We concluded that the variants in KCNQ1, KCNH2, KCNE1 and KCNE2 genes may be correlated with the occurrence of part of SUNDS cases in southern China.
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Affiliation(s)
- Chao Liu
- Guangzhou Institute of Criminal Sciences and Technology, Guangzhou 510030, China
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33
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Kauferstein S, Kiehne N, Jenewein T, Biel S, Kopp M, König R, Erkapic D, Rothschild M, Neumann T. Genetic analysis of sudden unexplained death: a multidisciplinary approach. Forensic Sci Int 2013; 229:122-7. [PMID: 23683917 DOI: 10.1016/j.forsciint.2013.03.050] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 03/11/2013] [Accepted: 03/23/2013] [Indexed: 02/03/2023]
Abstract
Each year infants, children and young adults die suddenly and unexpectedly. In many cases the cause of death can be elucidated by medico-legal autopsy, however, a significant number of these cases remain unexplained despite a detailed postmortem investigation and are labeled as sudden unexplained death (SUD). Post-mortem genetic testing, so called molecular autopsy, revealed that primary arrhythmogenic disorders including long QT syndrome and catecholaminergic polymorphic ventricular tachycardia (CPVT) may account for a certain number of these cases. Because of the inheritance of these diseases, close relatives of the deceased may also at potential risk of carrying fatal cardiac disorders. Therefore, advanced diagnostic analyses, genetic counseling and interdisciplinary collaboration should be integral parts of clinical and forensic practice. In the present study, we performed mutation analyses of the major genes causing cardiac channelopathies in 15 SUD cases. In four cases we found putative pathogenic mutations in cardiac ion channel genes. Clinical and genetic examination of family members of SUD victims was also performed and affected family members were identified. This study demonstrates that molecular genetic screening needs to become an inherent part of the postmortem examination. This will enhance the ability of screening family members of SUD victims who may be at risk. The present data also illustrate that detection and follow up of familial cases of sudden death is challenging and requires a close multidisciplinary collaboration between different medical disciplines, with great responsibility for the forensic pathologist.
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Affiliation(s)
- Silke Kauferstein
- Institute of Legal Medicine, University of Frankfurt, Kennedyallee 104, D-60596 Frankfurt am Main, Germany.
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34
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Suárez-Mier MP, Aguilera B, Mosquera RM, Sánchez-de-León MS. Pathology of sudden death during recreational sports in Spain. Forensic Sci Int 2013; 226:188-96. [DOI: 10.1016/j.forsciint.2013.01.016] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Revised: 09/12/2012] [Accepted: 01/15/2013] [Indexed: 10/27/2022]
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35
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Uddin MN, Samanidou VF, Papadoyannis IN. Bio-Sample Preparation and Gas Chromatographic Determination of Benzodiazepines--A Review. J Chromatogr Sci 2013; 51:587-98. [DOI: 10.1093/chromsci/bms263] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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36
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Wilders R. Cardiac ion channelopathies and the sudden infant death syndrome. ISRN CARDIOLOGY 2012; 2012:846171. [PMID: 23304551 PMCID: PMC3529486 DOI: 10.5402/2012/846171] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 10/23/2012] [Indexed: 12/13/2022]
Abstract
The sudden infant death syndrome (SIDS) causes the sudden death of an apparently healthy infant, which remains unexplained despite a thorough investigation, including the performance of a complete autopsy. The triple risk model for the pathogenesis of SIDS points to the coincidence of a vulnerable infant, a critical developmental period, and an exogenous stressor. Primary electrical diseases of the heart, which may cause lethal arrhythmias as a result of dysfunctioning cardiac ion channels (“cardiac ion channelopathies”) and are not detectable during a standard postmortem examination, may create the vulnerable infant and thus contribute to SIDS. Evidence comes from clinical correlations between the long QT syndrome and SIDS as well as genetic analyses in cohorts of SIDS victims (“molecular autopsy”), which have revealed a large number of mutations in ion channel-related genes linked to inheritable arrhythmogenic syndromes, in particular the long QT syndrome, the short QT syndrome, the Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia. Combining data from population-based cohort studies, it can be concluded that at least one out of five SIDS victims carries a mutation in a cardiac ion channel-related gene and that the majority of these mutations are of a known malignant phenotype.
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Affiliation(s)
- Ronald Wilders
- Department of Anatomy, Embryology and Physiology, Heart Failure Research Center, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands
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Larsen M, Nissen P, Berge K, Leren T, Kristensen I, Jensen H, Banner J. Molecular autopsy in young sudden cardiac death victims with suspected cardiomyopathy. Forensic Sci Int 2012; 219:33-8. [DOI: 10.1016/j.forsciint.2011.11.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 10/31/2011] [Accepted: 11/17/2011] [Indexed: 10/14/2022]
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Detection of genetic variation in KCNQ1 gene by high-resolution melting analysis in a prospective-based series of postmortem negative sudden death: comparison of results obtained in fresh frozen and formalin-fixed paraffin-embedded tissues. Int J Legal Med 2012; 126:649-57. [DOI: 10.1007/s00414-012-0688-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 02/23/2012] [Indexed: 10/28/2022]
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Murakami C, Nakamura S, Irie W, Sasaki C, Furukawa M, Kurihara K. Analysis of the sarcomere protein gene mutation on cardiomyopathy—Mutations in the troponin complex genes. FORENSIC SCIENCE INTERNATIONAL GENETICS SUPPLEMENT SERIES 2011. [DOI: 10.1016/j.fsigss.2011.09.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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40
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Differences in investigations of sudden unexpected deaths in young people in a nationwide setting. Int J Legal Med 2011; 126:223-9. [DOI: 10.1007/s00414-011-0602-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Accepted: 07/01/2011] [Indexed: 10/18/2022]
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41
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Edelmann J, Schumann S, Nastainczyk M, Husser-Bollmann D, Lessig R. Long QT syndrome mutation detection by SNaPshot technique. Int J Legal Med 2011; 126:969-73. [PMID: 21769575 DOI: 10.1007/s00414-011-0598-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Accepted: 06/24/2011] [Indexed: 11/29/2022]
Abstract
Long QT syndrome (LQTS) is a cardiac disorder with an abnormality of cardiac rhythm associated with sudden death especially in younger, apparently healthy individuals. If there is no clear cause of death detectable during comprehensive coroner's inquest (autopsy-negative cases), you have to consider LQTS and other heritable arrhythmia syndromes. A molecular genetic screening regarding mutations in associated genes can help to ensure the cause of death and to protect affected family members. Genetic testing of LQTS, currently performed mainly by sequencing, is still very expensive and time consuming. With this study we present a rapid and reasonable method for the simultaneously screening of some of the most common mutations associated with LQTS, focused on the KCNQ1 and KCNH2 genes. With the method of SNaPshot minisequencing, a total of 58 mutations were analyzed in four multiplex assays which were successfully established and optimized. The comparison with samples previously analyzed by direct sequencing showed concordance. Furthermore, autopsy-negative cases were tested but no mutations could be observed in any of the specimen. The presented method is well suitable for LQTS mutation screening. An enhancement to further mutations and population-based investigations regarding mutation frequencies should be the aim of prospective studies.
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Affiliation(s)
- Jeanett Edelmann
- Institute of Forensic Medicine, University of Leipzig, Leipzig, Germany.
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42
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Prevalence of HCM and long QT syndrome mutations in young sudden cardiac death-related cases. Int J Legal Med 2011; 125:565-72. [PMID: 21499742 DOI: 10.1007/s00414-011-0572-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2010] [Accepted: 04/01/2011] [Indexed: 01/08/2023]
Abstract
Cardiomyopathies and channelopathies are major causes of sudden cardiac death. The genetic study of these diseases is difficult because of their heterogenic nature not only in their genetic traits but also in their phenotypic expression. The purpose of the present study is the analysis of a wide spectrum of previously known genetic mutations in key genes related to hypertrophic cardiomyopathy (HCM), long QT syndrome (LQTS), and Brugada syndrome (BrS) development. The samples studied include cases of sudden cardiac death (SCD) in young adults and their relatives in order to identify the real impact of genetic screening of SCD in forensic cases. Genetic screening of described variation in 16 genes implicated in the development of HCM and three more genes implicated in LQTS and BrS was performed by using MassARRAY technology. In addition, direct sequencing of the two most prevalent genes implicated in the development of SQTL type 1 and 2 was also carried out. Genetic screening allowed us to unmask four possibly pathogenic mutation carriers in the 49 SCD cases considered; carriers of mutation represent 9% (2/23) of the probands with structural anomalies found after autopsy and 7% (1/14) of the probands with structurally normal hearts after in depth autopsy protocol. One mutation was found among 12 of the recovered SCD cases considered. In people with direct family history of sudden cardiac death, but not themselves, 11 additional mutation carriers were found. Three different mutations were found in six of the 19 LQTS patients, representing three families and two different mutations were found among six patients with previous syncope. Genetic analysis in sudden cardiac death cases could help to elucidate the cause of death, but it also can help in the prevention of future deaths in families at risk. The study presented here shows the importance and relevance of genetic screening in patients with signs of cardiac hypertrophy and in family cases with more than one relative affected.
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Ferrero-Miliani L, Holst AG, Pehrson S, Morling N, Bundgaard H. Strategy for clinical evaluation and screening of sudden cardiac death relatives. Fundam Clin Pharmacol 2011; 24:619-35. [PMID: 20698891 DOI: 10.1111/j.1472-8206.2010.00864.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Sudden cardiac death (SCD) may be the first and final manifestation of several heart diseases. In the young, SCD is often caused by a hereditary cardiac disease. As the most frequently seen inherited cardiac diseases have an autosomal-dominant pattern of inheritance, half of the first-degree relatives are at risk of having or developing the same disease. Therefore, screening of these high-risk relatives is a rational approach to reduce the incidence of SCD. To offer family screening and counseling, the cause of death should be carefully established. Autopsy is only performed in a limited number of cases. We advocate for systematic autopsies in SCD, because positive findings are crucial for choosing the optimal screening program for the relatives. A negative autopsy makes identification of at-risk population difficult. However, this finding also provides clues to the cardiologist, because a limited number of inherited cardiac diseases associated with SCD are without any structural changes. In other cases, the autopsy may reveal noncardiac causes of death, which is also important for reassuring the relatives. However, in cases with no autopsy or negative findings, thorough clinical examinations and selective genetic screening of relatives may identify a likely diagnosis in more than 50% of affected families. There is a need for consensus regarding routine evaluation of SCD cases and the ethical and legal framework related to postmortem testing. We propose an algorithm that narrows the diagnostic possibilities in apparently healthy relatives of young SCD victims. Molecular autopsy may play an important role.
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Affiliation(s)
- Laura Ferrero-Miliani
- Section of Forensic Genetics, Department of Forensic Medicine, Faculty of Health Sciences, University of Copenhagen, Frederik V's Vej 11, DK-2100 Copenhagen, Denmark.
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Murakami C, Nakamura S, Kobayashi M, Maeda K, Irie W, Wada B, Hayashi M, Sasaki C, Nakamaru N, Furukawa M, Kurihara K. Analysis of the sarcomere protein gene mutation on cardiomyopathy – Mutations in the cardiac troponin I gene. Leg Med (Tokyo) 2010; 12:280-3. [DOI: 10.1016/j.legalmed.2010.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 07/16/2010] [Accepted: 07/26/2010] [Indexed: 11/30/2022]
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Fragkouli K, Vougiouklakis T. Sudden cardiac death: An 11-year postmortem analysis in the region of Epirus, Greece. Pathol Res Pract 2010; 206:690-4. [DOI: 10.1016/j.prp.2010.05.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Revised: 03/24/2010] [Accepted: 05/18/2010] [Indexed: 10/19/2022]
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Abstract
Sudden cardiac death (SCD) is a major health problem and constitutes one of the most important unsolved challenges in the practice of forensic pathology due to the failure to determine the cause of death. Particularly, an important number of previously healthy young people who have died suddenly and unexpectedly are consequence of genetic heart disorders, either structural cardiomyopathies or arrhythmogenic abnormalities. The technological approach to analyze this type of genetically heterogeneous disorders is far from easy but nowadays the variety of chemistries and methodologies improves choice. This review offers to the reader a state of the art of the available technologies for the study of genetics of sudden cardiac death, including mutation screening approaches, genome wide association studies, and the recently developed next-generation sequencing.
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Franchitto N, Bounes V, Telmon N, Rougé D. Mitral valve prolapse and out-of-hospital sudden death: a case report and literature review. MEDICINE, SCIENCE, AND THE LAW 2010; 50:164-167. [PMID: 21133272 DOI: 10.1258/msl.2010.100033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The emergency medical services were called to the workplace of a 25-year-old woman who appeared to be dead. The alarm was raised by employees who had found her unconscious at her desk. There was no semi-automatic defibrillator on the premises and no member of staff had received specific training in management of cardiac arrest. External cardiac massage was immediately started as advised by telephone by the emergency physician and ventricular fibrillation was diagnosed on arrival of the medical team. Despite continuous resuscitation, the victim did not revive. The death certificate was signed with a medicolegal objection to burial, leading to an inquiry. Several causes were suggested by the emergency physician who had been called to the patient, and who was unable to account for the death. Autopsy established the diagnosis of mitral valve prolapse. The authors stress that autopsy is imperative and detail the implications of such a procedure.
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Affiliation(s)
- Nicolas Franchitto
- Department of Legal Medicine, Toulouse-Rangueil University Hospital, 1 Avenue Jean Poulhès, 31059 Toulouse, France.
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No association of IL-10 promoter SNP -592 and -1082 and SIDS. Forensic Sci Int 2010; 204:179-81. [PMID: 20591588 DOI: 10.1016/j.forsciint.2010.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 05/10/2010] [Accepted: 06/01/2010] [Indexed: 11/21/2022]
Abstract
Sudden infant death syndrome (SIDS) constitutes a considerable percentage of infant death of unknown etiology. The genetically controlled pathway of cytokine mediated response to inflammation is presumed to play a role in SIDS. The A allele of SNP -592 of the promoter region of the anti-inflammatory cytokine IL-10 has been suggested to be associated with SIDS. Herein we investigated whether we could confirm this finding by SNP genotyping a series of 123 cases of SIDS and 406 control cases. We did not find a correlation between the A allele or an A allele containing genotype of IL-10 promoter SNP -592 and SIDS which is in contrast to previous studies. Also, in concordance with previous work, no association of the A allele or A allele containing genotypes of IL-10 promoter SNP -1082 and SIDS was found.
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