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Ripoll-Vera T, Pérez Luengo C, Borondo Alcázar JC, García Ruiz AB, Sánchez Del Valle N, Barceló Martín B, Poncela García JL, Gutiérrez Buitrago G, Dasi Martínez C, Canós Villena JC, Moyano Corvillo S, Esgueva Pallarés R, Sancho Sancho JR, Guitart Pinedo G, Hernández Marín E, García García E, Vingut López A, Álvarez Rubio J, Govea Callizo N, Gómez Pérez Y, Melià Mesquida C, Heine D, Rosell Andreo J, Socías Crespí L. Sudden cardiac death in persons aged 50 years or younger: diagnostic yield of a regional molecular autopsy program using massive sequencing. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2021; 74:402-413. [PMID: 32917565 DOI: 10.1016/j.rec.2020.03.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 03/04/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION AND OBJECTIVES Sudden cardiac death (SCD) in young people often has a genetic cause. Consequently, the results of "molecular autopsy" may have important implications for their relatives. Our objective was to evaluate the diagnostic yield of a molecular autopsy program using next-generation sequencing. METHODS We performed a prospective study of a cohort of consecutive patients who died from nonviolent SCD, aged ≤ 50 years, and who underwent molecular autopsy using large panels of next-generation sequencing, with subsequent clinical and genetic family screening. We analyzed demographic, clinical, toxicological, and genetic data. RESULTS We studied 123 consecutive cases of SCD in persons aged ≤ 50 years. The incidence of SCD was 5.8 cases/100 000 individuals/y, mean age was 36.15±12.7 years, and 95 were men (77%). The cause was cardiac in 53%, unexplained SCD in 24%, toxic in 10.6%, and infant SCD in 4%. Among cardiac causes, ischemic heart disease accounted for 38% of deaths, arrhythmogenic cardiomyopathy for 7%, hypertrophic cardiomyopathy for 5%, and idiopathic left ventricular hypertrophy for 11%. Genetic analysis was performed in 62 cases (50.4%). Genetic variants were found in 42 cases (67.7%), with a mean of 3.4±4 genetic variants/patient, and the variant found was considered to be pathogenic or probably pathogenic in 30.6%. In unexplained SCD, 70% showed some genetic variant. Family screening diagnosed 21 carriers or affected individuals, 5 of whom were at risk, indicating an implantable cardiac defibrillator. CONCLUSIONS Protocol-based and exhaustive study of SCD from cardiac causes in persons aged ≤ 50 years is feasible and necessary. In a high percentage of cases, the cause is genetic, indicating the existence of relatives at risk who could benefit from early diagnosis and treatment to avoid complications.
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Affiliation(s)
- Tomás Ripoll-Vera
- Servicio de Cardiología, Hospital Universitario Son Llàtzer, Palma de Mallorca, Islas Baleares, Spain; Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma de Mallorca, Islas Baleares, Spain.
| | - Consuelo Pérez Luengo
- Instituto de Medicina Legal de las Islas Baleares, Palma de Mallorca, Islas Baleares, Spain
| | | | - Ana Belén García Ruiz
- Instituto de Medicina Legal de las Islas Baleares, Palma de Mallorca, Islas Baleares, Spain
| | | | - Bernardino Barceló Martín
- Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma de Mallorca, Islas Baleares, Spain; Servicio de Análisis Clínicos y Toxicología, Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, Spain
| | | | | | - Concepción Dasi Martínez
- Servicio de Histopatología, Instituto Nacional de Toxicología y Ciencias Forenses, Barcelona, Spain
| | | | - Susana Moyano Corvillo
- Servicio de Histopatología, Instituto Nacional de Toxicología y Ciencias Forenses, Barcelona, Spain
| | - Raquel Esgueva Pallarés
- Servicio de Histopatología, Instituto Nacional de Toxicología y Ciencias Forenses, Barcelona, Spain
| | | | | | - Elena Hernández Marín
- Servicio de Química, Instituto Nacional de Toxicología y Ciencias Forenses, Barcelona, Spain
| | - Estela García García
- Servicio de Química, Instituto Nacional de Toxicología y Ciencias Forenses, Barcelona, Spain
| | - Albert Vingut López
- Servicio de Química, Instituto Nacional de Toxicología y Ciencias Forenses, Barcelona, Spain
| | - Jorge Álvarez Rubio
- Servicio de Cardiología, Hospital Universitario Son Llàtzer, Palma de Mallorca, Islas Baleares, Spain; Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma de Mallorca, Islas Baleares, Spain
| | - Nancy Govea Callizo
- Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma de Mallorca, Islas Baleares, Spain; Sección de Genética, Unidad de Diagnóstico Molecular y Genética Clínica, Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, Spain
| | - Yolanda Gómez Pérez
- Servicio de Cardiología, Hospital Universitario Son Llàtzer, Palma de Mallorca, Islas Baleares, Spain; Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma de Mallorca, Islas Baleares, Spain
| | - Catalina Melià Mesquida
- Servicio de Cardiología, Hospital Universitario Son Llàtzer, Palma de Mallorca, Islas Baleares, Spain; Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma de Mallorca, Islas Baleares, Spain
| | - Damián Heine
- Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma de Mallorca, Islas Baleares, Spain; Sección de Genética, Unidad de Diagnóstico Molecular y Genética Clínica, Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, Spain
| | - Jordi Rosell Andreo
- Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma de Mallorca, Islas Baleares, Spain; Sección de Genética, Unidad de Diagnóstico Molecular y Genética Clínica, Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, Spain
| | - Lorenzo Socías Crespí
- Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma de Mallorca, Islas Baleares, Spain; Servicio de Medicina Intensiva, Hospital Universitario Son Llàtzer, Palma de Mallorca, Islas Baleares, Spain
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