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Faridi R, Tona R, Brofferio A, Hoa M, Olszewski R, Schrauwen I, Assir MZ, Bandesha AA, Khan AA, Rehman AU, Brewer C, Ahmed W, Leal SM, Riazuddin S, Boyden SE, Friedman TB. Mutational and phenotypic spectra of KCNE1 deficiency in Jervell and Lange-Nielsen Syndrome and Romano-Ward Syndrome. Hum Mutat 2019; 40:162-176. [PMID: 30461122 PMCID: PMC6328321 DOI: 10.1002/humu.23689] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/01/2018] [Accepted: 11/15/2018] [Indexed: 11/11/2022]
Abstract
KCNE1 encodes a regulatory subunit of the KCNQ1 potassium channel-complex. Both KCNE1 and KCNQ1 are necessary for normal hearing and cardiac ventricular repolarization. Recessive variants in these genes are associated with Jervell and Lange-Nielson syndrome (JLNS1 and JLNS2), a cardio-auditory syndrome characterized by congenital profound sensorineural deafness and a prolonged QT interval that can cause ventricular arrhythmias and sudden cardiac death. Some normal-hearing carriers of heterozygous missense variants of KCNE1 and KCNQ1 have prolonged QT intervals, a dominantly inherited phenotype designated Romano-Ward syndrome (RWS), which is also associated with arrhythmias and elevated risk of sudden death. Coassembly of certain mutant KCNE1 monomers with wild-type KCNQ1 subunits results in RWS by a dominant negative mechanism. This paper reviews variants of KCNE1 and their associated phenotypes, including biallelic truncating null variants of KCNE1 that have not been previously reported. We describe three homozygous nonsense mutations of KCNE1 segregating in families ascertained ostensibly for nonsyndromic deafness: c.50G>A (p.Trp17*), c.51G>A (p.Trp17*), and c.138C>A (p.Tyr46*). Some individuals carrying missense variants of KCNE1 have RWS. However, heterozygotes for loss-of-function variants of KCNE1 may have normal QT intervals while biallelic null alleles are associated with JLNS2, indicating a complex genotype-phenotype spectrum for KCNE1 variants.
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Affiliation(s)
- Rabia Faridi
- Laboratory of Molecular Genetics, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD 20892, USA
- National Centre of Excellence in Molecular Biology, University of the Punjab, Lahore 54550, Pakistan
| | - Risa Tona
- Laboratory of Molecular Genetics, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD 20892, USA
| | - Alessandra Brofferio
- Cardiology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health Clinical Center, Bethesda, MD 20892, USA
| | - Michael Hoa
- Auditory Development and Restoration Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD 20892, USA
| | - Rafal Olszewski
- Auditory Development and Restoration Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD 20892, USA
| | - Isabelle Schrauwen
- Center for Statistical Genetics, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Muhammad Z.K. Assir
- Allama Iqbal Medical Research Centre, Jinnah Hospital Complex, Lahore 54550, Pakistan
| | - Akhtar A. Bandesha
- Cardiology Department, The Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Asma A. Khan
- National Centre of Excellence in Molecular Biology, University of the Punjab, Lahore 54550, Pakistan
| | - Atteeq U. Rehman
- Laboratory of Molecular Genetics, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD 20892, USA
| | - Carmen Brewer
- Audiology Unit, National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health, Bethesda, MD 20892, USA
| | - Wasim Ahmed
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan
| | - Suzanne M. Leal
- Center for Statistical Genetics, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Sheikh Riazuddin
- Allama Iqbal Medical Research Centre, Jinnah Hospital Complex, Lahore 54550, Pakistan
| | - Steven E. Boyden
- Section on Genetics of Communication Disorders, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD 20892, USA
| | - Thomas B. Friedman
- Laboratory of Molecular Genetics, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD 20892, USA
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van Deventer BS, du Toit-Prinsloo L, van Niekerk C. Feasibility of analysis of the SCN5A gene in paraffin embedded samples in sudden infant death cases at the Pretoria Medico-Legal Laboratory, South Africa. Forensic Sci Med Pathol 2018; 14:276-284. [PMID: 29907895 DOI: 10.1007/s12024-018-9995-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2018] [Indexed: 12/19/2022]
Abstract
To determine variations in the SCN5A gene linked to inherited cardiac arrhythmogenic disorders in sudden, unexplained infant death (SUID) cases examined at the Pretoria Medico-Legal Laboratory, South Africa. A retrospective study was conducted on SUID cases and controls, analyzing DNA extracted from archived formalin-fixed, paraffin-embedded (FFPE) myocardial tissue samples as well as blood samples. A total of 48 FFPE tissue samples (cases), 10 control FFPE tissue samples and nine control blood samples were included. DNA extracted from all samples was used to test for variations in the SCN5A gene by using high resolution melt (HRM) real-time PCR and sequencing. Genetic analysis showed 31 different single nucleotide variants in the entire study population (n = 67). Five previously reported variants of known pathogenic significance, and 14 variants of benign clinical significance, were identified. The study found 12 different variants in the cases that were not published in any database or literature and were considered novel. Of these novel variants, two were predicted as "probably damaging" with a high level of certainty (found in four case samples), one (identified in another case sample) was predicted to be "possibly damaging" with a 50% chance of being disease-causing, and nine were predicted to be benign. This study shows the significant added value of using genetic testing in determining the cause of death in South African SUID cases. Considering the high heritability of these arrhythmic disorders, post mortem genetic testing could play an important role in the understanding of the pathogenesis thereof and could also aid in the diagnosis and treatment of family members at risk, ultimately preventing similar future cases.
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Affiliation(s)
| | - Lorraine du Toit-Prinsloo
- Department of Forensic Medicine, University of Pretoria, Pretoria, South Africa.,Department of Forensic Medicine, Sydney, Forensic & Analytical Science Services (FASS), NSW Health Pathology, Sydney, New South Wales, Australia
| | - Chantal van Niekerk
- Department of Chemical Pathology, University of Pretoria, R3-43 Pathology Building, Prinshof Campus, Pretoria, 0002, Republic of South Africa. .,Department of Chemical Pathology, National Health Laboratory Services (NHLS), Tshwane Academic Division, Pretoria, South Africa.
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Gando I, Morganstein J, Jana K, McDonald TV, Tang Y, Coetzee WA. Infant sudden death: Mutations responsible for impaired Nav1.5 channel trafficking and function. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2017; 40:703-712. [PMID: 28370132 DOI: 10.1111/pace.13087] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 03/20/2017] [Accepted: 03/27/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Two genetic variants in SCN5A, encoding the Nav1.5 Na+ channel α-subunit, were found in a 5-month-old girl who died suddenly in her sleep. The first variant is a missense mutation, resulting in an amino acid change (Q1832E), which has been described (but not characterized) in a patient with Brugada syndrome. The second is a nonsense mutation that produces a premature stop codon and a C-terminal truncation (R1944Δ). METHODS AND RESULTS To investigate their functional relevance with patch clamp experiments in transfected HEK-293 cells. The Q1832E mutation drastically reduced Nav1.5 current density. The R1944Δ C-terminal truncation had negligible effects on Nav1.5 current density. Neither of the mutations affected the voltage dependence of steady activation and inactivation or influenced the late Na+ current or the recovery from inactivation. Biochemical and immunofluorescent approaches demonstrated that the Q1832E mutation caused severe trafficking defects. Polymerase chain reaction cloning and sequencing the victim's genomic DNA allowed us to determine that the two variants were in trans. We investigated the functional consequences by coexpressing Nav1.5(Q1832E) and Nav1.5(R1944Δ), which led to a significantly reduced current amplitude relative to wild-type. CONCLUSIONS These sudden infant death syndrome (SIDS)-related variants caused a severely dysfunctional Nav1.5 channel, which was mainly due to trafficking defects caused by the Q1832E mutation. The decreased current density is likely to be a major contributing factor to arrhythmogenesis in Brugada syndrome and the sudden death of this SIDS victim.
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Affiliation(s)
- Ivan Gando
- Pediatrics, NYU School of Medicine, New York, NY
| | | | - Kundan Jana
- Pediatrics, NYU School of Medicine, New York, NY
| | - Thomas V McDonald
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Yingying Tang
- Molecular Genetics Laboratory, Office of Chief Medical Examiner, New York, NY
| | - William A Coetzee
- Pediatrics, NYU School of Medicine, New York, NY.,Physiology & Neuroscience, NYU School of Medicine, New York, NY.,Biochemistry and Molecular Pharmacology, NYU School of Medicine, New York, NY
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Methner DNR, Scherer SE, Welch K, Walkiewicz M, Eng CM, Belmont JW, Powell MC, Korchina V, Doddapaneni HV, Muzny DM, Gibbs RA, Wolf DA, Sanchez LA, Kahn R. Postmortem genetic screening for the identification, verification, and reporting of genetic variants contributing to the sudden death of the young. Genome Res 2016; 26:1170-7. [PMID: 27435932 PMCID: PMC5052040 DOI: 10.1101/gr.195800.115] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 07/15/2016] [Indexed: 12/30/2022]
Abstract
Each year in the United States, thousands of cases of sudden and unexpected deaths of infants, children, and young adults are assigned an undetermined cause of death after postmortem investigation and autopsy. Heritable genetic variants have been suggested as the cause of up to a third of sudden death (SD) cases. Elucidation of the genetic variants involved in SD cases is important to not only help establish cause and manner of death of these individuals, but to also aid in determining whether familial genetic testing should be considered. Previously, these types of postmortem screenings have not been a feasible option for most county medical examiners' and coroners' offices. We sequenced full exons of 64 genes associated with SD in the largest known cohort (351) of infant and young SD decedents using massively parallel sequencing at <$600 per sample. Genetic variants were assessed through literature review and clinical evaluation by a multidisciplinary consortium of experts. Thirteen individuals (3.7%), eight infants (2.8% of those <1 yr of age) and five children/young adults (7.0% of those >1 yr of age), were found to have a reportable genetic variant contributing to SD. These percentages represent an estimate lower than those previously reported. Overall yields and results likely vary between studies due to differences in evaluation techniques and reporting. Additionally, we recommend ongoing assessment of data, including nonreported novel variants, as technology and literature continually advance. This study demonstrates a strategy to implement molecular autopsies in medicolegal investigations of young SD decedents.
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Affiliation(s)
| | - Steven E Scherer
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Katherine Welch
- Harris County Institute of Forensic Sciences, Houston, Texas 77054, USA
| | - Magdalena Walkiewicz
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Christine M Eng
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, USA
| | - John W Belmont
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, USA; Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Mark C Powell
- Harris County Institute of Forensic Sciences, Houston, Texas 77054, USA
| | - Viktoriya Korchina
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, USA
| | | | - Donna M Muzny
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Richard A Gibbs
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Dwayne A Wolf
- Harris County Institute of Forensic Sciences, Houston, Texas 77054, USA
| | - Luis A Sanchez
- Harris County Institute of Forensic Sciences, Houston, Texas 77054, USA
| | - Roger Kahn
- Harris County Institute of Forensic Sciences, Houston, Texas 77054, USA
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Abbott GW. KCNE1 and KCNE3: The yin and yang of voltage-gated K(+) channel regulation. Gene 2015; 576:1-13. [PMID: 26410412 DOI: 10.1016/j.gene.2015.09.059] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 09/03/2015] [Accepted: 09/22/2015] [Indexed: 12/20/2022]
Abstract
The human KCNE gene family comprises five genes encoding single transmembrane-spanning ion channel regulatory subunits. The primary function of KCNE subunits appears to be regulation of voltage-gated potassium (Kv) channels, and the best-understood KCNE complexes are with the KCNQ1 Kv α subunit. Here, we review the often opposite effects of KCNE1 and KCNE3 on Kv channel biology, with an emphasis on regulation of KCNQ1. Slow-activating IKs channel complexes formed by KCNQ1 and KCNE1 are essential for human ventricular myocyte repolarization, while constitutively active KCNQ1-KCNE3 channels are important in the intestine. Inherited sequence variants in human KCNE1 and KCNE3 cause cardiac arrhythmias but by different mechanisms, and each is important for hearing in unique ways. Because of their contrasting effects on KCNQ1 function, KCNE1 and KCNE3 have proved invaluable tools in the mechanistic understanding of how channel gating can be manipulated, and each may also provide a window into novel insights and new therapeutic opportunities in K(+) channel pharmacology. Finally, findings from studies of Kcne1(-/-) and Kcne3(-/-) mouse lines serve to illustrate the complexity of KCNE biology and KCNE-linked disease states.
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Affiliation(s)
- Geoffrey W Abbott
- Bioelectricity Laboratory, Dept. of Pharmacology and Dept. of Physiology and Biophysics, School of Medicine, University of California, Irvine, CA, USA; 360 Medical Surge II, Dept. of Pharmacology, School of Medicine, University of California, Irvine, CA 92697, USA.
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OBEYESEKERE MANOJN, SY RAYMONDW, KLEIN GEORGEJ, GULA LORNEJ, MODI SIMON, CONACHER SUSAN, LEONG-SIT PETER, SKANES ALLANC, YEE RAYMOND, KRAHN ANDREWD. End-Recovery QTc: A Useful Metric for Assessing Genetic Variants of Unknown Significance in Long-QT syndrome. J Cardiovasc Electrophysiol 2012; 23:637-42. [DOI: 10.1111/j.1540-8167.2011.02265.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhang T, Moss A, Cong P, Pan M, Chang B, Zheng L, Fang Q, Zareba W, Robinson J, Lin C, Li Z, Wei J, Zeng Q, Qi M. LQTS gene LOVD database. Hum Mutat 2010; 31:E1801-10. [PMID: 20809527 PMCID: PMC3037562 DOI: 10.1002/humu.21341] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The Long QT Syndrome (LQTS) is a group of genetically heterogeneous disorders that predisposes young individuals to ventricular arrhythmias and sudden death. LQTS is mainly caused by mutations in genes encoding subunits of cardiac ion channels (KCNQ1, KCNH2,SCN5A, KCNE1, and KCNE2). Many other genes involved in LQTS have been described recently(KCNJ2, AKAP9, ANK2, CACNA1C, SCNA4B, SNTA1, and CAV3). We created an online database(http://www.genomed.org/LOVD/introduction.html) that provides information on variants in LQTS-associated genes. As of February 2010, the database contains 1738 unique variants in 12 genes. A total of 950 variants are considered pathogenic, 265 are possible pathogenic, 131 are unknown/unclassified, and 292 have no known pathogenicity. In addition to these mutations collected from published literature, we also submitted information on gene variants, including one possible novel pathogenic mutation in the KCNH2 splice site found in ten Chinese families with documented arrhythmias. The remote user is able to search the data and is encouraged to submit new mutations into the database. The LQTS database will become a powerful tool for both researchers and clinicians.
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Affiliation(s)
- Tao Zhang
- James D. Watson Institute of Genome Sciences, College of Life Sciences, Zhejiang UniversityHangzhou, Zhejiang, China
- Center for Genetic and Genomic Medicine, Zhejiang University School of Medicine First Affiliated HospitalHangzhou, Zhejiang, China
| | - Arthur Moss
- Department of Medicine(Cardiology), University of RochesterRochester, New York, USA
| | - Peikuan Cong
- Center for Genetic and Genomic Medicine, Zhejiang University School of Medicine First Affiliated HospitalHangzhou, Zhejiang, China
| | - Min Pan
- Center for Genetic and Genomic Medicine, Zhejiang University School of Medicine First Affiliated HospitalHangzhou, Zhejiang, China
| | - Bingxi Chang
- Peking Union Medical College HospitalBeijing, China
| | - Liangrong Zheng
- Department of Cardiology, Zhejiang University School of Medicine First Affiliated HospitalHangzhou, Zhejiang, China
| | - Quan Fang
- Peking Union Medical College HospitalBeijing, China
| | - Wojciech Zareba
- Department of Medicine(Cardiology), University of RochesterRochester, New York, USA
| | - Jennifer Robinson
- Department of Medicine(Cardiology), University of RochesterRochester, New York, USA
| | - Changsong Lin
- Center for Genetic and Genomic Medicine, Zhejiang University School of Medicine First Affiliated HospitalHangzhou, Zhejiang, China
| | - Zhongxiang Li
- Zhejiang Academy of Medical SciencesHangzhou, Zhejiang, China
| | - Junfang Wei
- Division of Sport Medicine, College of Education, Zhejiang UniversityHangzhou, Zhejiang, China
| | | | - Ming Qi
- James D. Watson Institute of Genome Sciences, College of Life Sciences, Zhejiang UniversityHangzhou, Zhejiang, China
- Center for Genetic and Genomic Medicine, Zhejiang University School of Medicine First Affiliated HospitalHangzhou, Zhejiang, China
- Department of Pathology and Laboratory Medicine, University of RochesterRochester, New York, USA
- **Correspondence to Ming Qi, PhD, FACMG, Center for Genetic and Genomic Medicine, Zhejiang University School of Medicine First Affiliated Hospital, 79 Qingchun Road, Hangzhou, Zhejiang, China, 310003, Telephone: +86-571-88208274, Fax: +86-571-88208274, E-mail:
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Shinlapawittayatorn K, Du XX, Liu H, Ficker E, Kaufman ES, Deschênes I. A common SCN5A polymorphism modulates the biophysical defects of SCN5A mutations. Heart Rhythm 2010; 8:455-62. [PMID: 21109022 DOI: 10.1016/j.hrthm.2010.11.034] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Accepted: 11/12/2010] [Indexed: 01/21/2023]
Abstract
BACKGROUND Defects in the cardiac sodium channel gene, SCN5A, can cause a broad spectrum of inherited arrhythmia syndromes. After genotyping of a proband who presented with syncope, the SCN5A mutant P2006A and the common polymorphism H558R were identified. OBJECTIVE The main objective of this study was to determine whether the SCN5A-H558R polymorphism could modify the defective gating kinetics observed in the P2006A mutation and therefore explain why this gain-of-function mutation has been identified in control populations. METHODS Mutations were engineered using site-directed mutagenesis and heterologously expressed transiently in HEK293 cells. Whole-cell sodium currents were measured at room temperature using the whole-cell patch-clamp technique. RESULTS In HEK293 cells, P2006A displayed biophysical defects typically associated with long QT syndrome by increasing persistent sodium current, producing a depolarizing shift in voltage dependence of inactivation, and hastening recovery from inactivation. Interestingly, when coexpressed either on the same or different genes, P2006A and H558R displayed currents that behaved like wild type (WT). We also investigated whether H558R can modulate the gating defects of other SCN5A mutations. The H558R polymorphism also restored the gating defects of the SCN5A mutation V1951L to the WT level. CONCLUSIONS Our results suggest that H558R might play an important role in stabilization of channel fast inactivation and may provide a plausible explanation as to why the P2006A gain-of-function mutation has been identified in control populations. Our results also suggest that the SCN5A polymorphism H558R might be a disease-modifying gene.
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Affiliation(s)
- Krekwit Shinlapawittayatorn
- Heart and Vascular Research Center, Department of Medicine, MetroHealth Campus, Case Western Reserve University, Cleveland, Ohio 44109-1998, USA
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Hershberger RE, Parks SB, Kushner JD, Li D, Ludwigsen S, Jakobs P, Nauman D, Burgess D, Partain J, Litt M. Coding sequence mutations identified in MYH7, TNNT2, SCN5A, CSRP3, LBD3, and TCAP from 313 patients with familial or idiopathic dilated cardiomyopathy. Clin Transl Sci 2010; 1:21-6. [PMID: 19412328 DOI: 10.1111/j.1752-8062.2008.00017.x] [Citation(s) in RCA: 148] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND More than 20 genes have been reported to cause idiopathic and familial dilated cardiomyopathy (IDC/FDC), but the frequency of genetic causation remains poorly understood. METHODS AND RESULTS Blood samples were collected and DNA prepared from 313 patients, 183 with FDC and 130 with IDC. Genomic DNA underwent bidirectional sequencing of six genes, and mutation carriers were followed up by evaluation of additional family members. We identified in 36 probands, 31 unique protein-altering variants (11.5% overall) that were not identified in 253 control subjects (506 chromosomes). These included 13 probands (4.2%) with 12 beta-myosin heavy chain (MYH7) mutations, nine probands (2.9%) with six different cardiac troponin T (TNNT2) mutations, eight probands (2.6%) carrying seven different cardiac sodium channel (SCN5A) mutations, three probands (1.0%) with three titin-cap or telethonin (TCAP) mutations, three probands (1.0%) with two LIM domain binding 3 (LDB3) mutations, and one proband (0.3%) with a muscle LIM protein (CSRP3) mutation. Four nucleotide changes did not segregate with phentoype and/or did not alter a conserved amino acid and were therefore considered unlikely to be disease-causing. Mutations in 11 probands were assessed as likely disease-causing, and in 21 probands were considered possibly disease-causing. These 32 probands included 14 of the 130 with IDC (10.8%) and 18 of 183 with FDC (9.8%) CONCLUSIONS Mutations of these six genes each account for a small fraction of the genetic cause of FDC/IDC. The frequency of possible or likely disease-causing mutations in these genes is similar for IDC and FDC.
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Affiliation(s)
- Ray E Hershberger
- Division of Cardiovascular Medicine, Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA.
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10
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Abstract
The human fetal heart develops arrhythmias and conduction disturbances in response to ischemia, inflammation, electrolyte disturbances, altered load states, structural defects, inherited genetic conditions, and many other causes. Yet sinus rhythm is present without altered rate or rhythm in some of the most serious electrophysiological diseases, which makes detection of diseases of the fetal conduction system challenging in the absence of magnetocardiographic or electrocardiographic recording techniques. Life-threatening changes in QRS or QT intervals can be completely unrecognized if heart rate is the only feature to be altered. For many fetal arrhythmias, echocardiography alone can assess important clinical parameters for diagnosis. Appropriate treatment of the fetus requires awareness of arrhythmia characteristics, mechanisms, and potential associations. Criteria to define fetal bradycardia specific to gestational age are now available and may allow detection of ion channelopathies, which are associated with fetal and neonatal bradycardia. Ectopic beats, once thought to be entirely benign, are now recognized to have important pathologic associations. Fetal tachyarrhythmias can now be defined precisely for mechanism-specific therapy and for subsequent monitoring of response. This article reviews the current and future diagnostic techniques and pharmacologic treatments for fetal arrhythmia.
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11
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Sand PG, Luettich A, Kleinjung T, Hajak G, Langguth B. An Examination of KCNE1 Mutations and Common Variants in Chronic Tinnitus. Genes (Basel) 2010; 1:23-37. [PMID: 24710009 PMCID: PMC3960860 DOI: 10.3390/genes1010023] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Revised: 04/23/2010] [Accepted: 04/27/2010] [Indexed: 11/16/2022] Open
Abstract
Chronic tinnitus is a highly prevalent and often incapacitating condition frequently associated with sensorineural hearing loss. While its etiology remains incompletely understood there is a growing awareness of genetic factors that predispose to, or aggravate chronic tinnitus. Candidate genes for the disorder include KCNE1, a potassium channel subunit gene that has been implicated in maturation defects of central vestibular neurons, in Menière's disease, and in noise-induced hearing loss. 201 Caucasian outpatients with a diagnosis of chronic tinnitus were systematically screened for mutations in the KCNE1 open reading frame and in the adjacent sequence by direct sequencing. Allele frequencies were determined for 46 known variants, plus two novel KCNE1 mutations. These comprised one missense substitution (V47I) in the highly conserved region encoding the KCNE1 transmembrane domain, and one rare variant in the gene's 3'UTR. When genotypes were grouped assuming dominance of the minor alleles, no significant genotype or compound genotype effects were observed on tinnitus severity. The newly identified V47I substitution argues in favor of an enlarged spectrum of mutations in hearing disorders. However, with regard to allele frequencies in healthy control populations from earlier studies, more common KCNE1 variants are unlikely to play a major role in chronic tinnitus. Further investigations are invited to address variation in additional channel subunits as possible risk factors in tinnitus.
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Affiliation(s)
- Philipp G Sand
- Department of Psychiatry, University of Regensburg, Universitaetsstr. 84, 93042 Regensburg, Germany.
| | - Alexander Luettich
- Experimental and Clinical Neurosciences Graduate Program, University of Regensburg, Germany.
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany.
| | - Goeran Hajak
- Department of Psychiatry, University of Regensburg, Universitaetsstr. 84, 93042 Regensburg, Germany.
| | - Berthold Langguth
- Department of Psychiatry, University of Regensburg, Universitaetsstr. 84, 93042 Regensburg, Germany.
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Horigome H, Nagashima M, Sumitomo N, Yoshinaga M, Ushinohama H, Iwamoto M, Shiono J, Ichihashi K, Hasegawa S, Yoshikawa T, Matsunaga T, Goto H, Waki K, Arima M, Takasugi H, Tanaka Y, Tauchi N, Ikoma M, Inamura N, Takahashi H, Shimizu W, Horie M. Clinical Characteristics and Genetic Background of Congenital Long-QT Syndrome Diagnosed in Fetal, Neonatal, and Infantile Life. Circ Arrhythm Electrophysiol 2010; 3:10-7. [DOI: 10.1161/circep.109.882159] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Hitoshi Horigome
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Masami Nagashima
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Naokata Sumitomo
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Masao Yoshinaga
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Hiroya Ushinohama
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Mari Iwamoto
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Junko Shiono
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Koh Ichihashi
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Satoshi Hasegawa
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Tadahiro Yoshikawa
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Tamotsu Matsunaga
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Hiroko Goto
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Kenji Waki
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Masaki Arima
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Hisashi Takasugi
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Yasuhiko Tanaka
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Nobuo Tauchi
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Masanobu Ikoma
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Noboru Inamura
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Hideto Takahashi
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Wataru Shimizu
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
| | - Minoru Horie
- From the Department of Child Health (H.H.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; the Department of Cardiology (M.N.), Aichi Children’s Health and Medical Center, Ohbu, Japan; the Department of Pediatrics and Child Health (N.S.), Nihon University School of Medicine, Tokyo, Japan; the Department of Pediatrics (M.Y.), National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan; the Department of Cardiology (H.U.), Fukuoka Children’s
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Hedley PL, Jørgensen P, Schlamowitz S, Wangari R, Moolman-Smook J, Brink PA, Kanters JK, Corfield VA, Christiansen M. The genetic basis of long QT and short QT syndromes: A mutation update. Hum Mutat 2009; 30:1486-511. [DOI: 10.1002/humu.21106] [Citation(s) in RCA: 318] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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14
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Schwartz PJ, Stramba-Badiale M, Crotti L, Pedrazzini M, Besana A, Bosi G, Gabbarini F, Goulene K, Insolia R, Mannarino S, Mosca F, Nespoli L, Rimini A, Rosati E, Salice P, Spazzolini C. Prevalence of the congenital long-QT syndrome. Circulation 2009; 120:1761-7. [PMID: 19841298 DOI: 10.1161/circulationaha.109.863209] [Citation(s) in RCA: 673] [Impact Index Per Article: 44.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The prevalence of genetic arrhythmogenic diseases is unknown. For the long-QT syndrome (LQTS), figures ranging from 1:20 000 to 1:5000 were published, but none was based on actual data. Our objective was to define the prevalence of LQTS. METHODS AND RESULTS In 18 maternity hospitals, an ECG was performed in 44 596 infants 15 to 25 days old (43 080 whites). In infants with a corrected QT interval (QTc) >450 ms, the ECG was repeated within 1 to 2 weeks. Genetic analysis, by screening 7 LQTS genes, was performed in 28 of 31 (90%) and in 14 of 28 infants (50%) with, respectively, a QTc >470 ms or between 461 and 470 ms. A QTc of 451 to 460, 461 to 470, and >470 ms was observed in 177 (0.41%), 28 (0.06%), and 31 infants (0.07%). Among genotyped infants, disease-causing mutations were found in 12 of 28 (43%) with a QTc >470 ms and in 4 of 14 (29%) with a QTc of 461 to 470 ms. One genotype-negative infant (QTc 482 ms) was diagnosed as affected by LQTS on clinical grounds. Among family members of genotype-positive infants, 51% were found to carry disease-causing mutations. In total, 17 of 43 080 white infants were affected by LQTS, demonstrating a prevalence of at least 1:2534 apparently healthy live births (95% confidence interval, 1:1583 to 1:4350). CONCLUSIONS This study provides the first data-based estimate of the prevalence of LQTS among whites. On the basis of the nongenotyped infants with QTc between 451 and 470 ms, we advance the hypothesis that this prevalence might be close to 1:2000. ECG-guided molecular screening can identify most infants affected by LQTS and unmask affected relatives, thus allowing effective preventive measures.
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Affiliation(s)
- Peter J Schwartz
- Department of Lung, Blood, and Heart, University of Pavia, Pavia, Italy.
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15
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Abstract
Mutations in the cardiac sodium channel gene SCN5A are responsible for a spectrum of hereditary arrhythmias, including type-3 long QT syndrome (LQT3), Brugada syndrome (BrS), conduction disturbance and sinus node dysfunction. These syndromes were originally regarded as independent entities with distinct clinical manifestations and biophysical properties, but recent evidence shows considerable clinical overlap, implying a new disease entity known as an overlap syndrome of cardiac sodium channelopathy. Class IC sodium-channel blockers often induced the BrS phenotype in some patients with LQT3, confirming the clinical overlap of LQT3 and BrS. It also raises a concern about the safety of the class IC drug and questions about the determinants of overlap. Here, an overview is given of current knowledge on the clinical features, prevalence, and molecular and biophysical mechanisms underlying overlap syndrome to gain more insight into this complex issue and generate better therapeutic strategies for patient management.
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Affiliation(s)
- Naomasa Makita
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
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Cardiac sodium channel overlap syndromes: different faces of SCN5A mutations. Trends Cardiovasc Med 2008; 18:78-87. [PMID: 18436145 DOI: 10.1016/j.tcm.2008.01.002] [Citation(s) in RCA: 163] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2007] [Revised: 12/29/2007] [Accepted: 01/07/2008] [Indexed: 12/19/2022]
Abstract
Cardiac sodium channel dysfunction caused by mutations in the SCN5A gene is associated with a number of relatively uncommon arrhythmia syndromes, including long-QT syndrome type 3 (LQT3), Brugada syndrome, conduction disease, sinus node dysfunction, and atrial standstill, which potentially lead to fatal arrhythmias in relatively young individuals. Although these various arrhythmia syndromes were originally considered separate entities, recent evidence indicates more overlap in clinical presentation and biophysical defects of associated mutant channels than previously appreciated. Various SCN5A mutations are now known to present with mixed phenotypes, a presentation that has become known as "overlap syndrome of cardiac sodium channelopathy." In many cases, multiple biophysical defects of single SCN5A mutations are suspected to underlie the overlapping clinical manifestations. Here, we provide an overview of current knowledge on SCN5A mutations associated with sodium channel overlap syndromes and discuss a possible role for modifiers in determining disease expressivity in the individual patient.
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Abstract
The final common pathway to death in all of us is an arrhythmia, yet we still know far too little about the contribution of conduction abnormalities and arrhythmias to the compromised states of the human fetus. At no other time in the human life cycle is the human being at more risk of unexplained and unexpected death than during the prenatal period. The risk of sudden death from 20-40 weeks gestation is 6-12 deaths/1000 fetuses/year. This is equal to, and in some ethnic groups HIGHER than, the risk of death in the adult population with known coronary artery disease over the same time frame (6-12 deaths/1000 patients/year). Because only a small percentage of the United States population is pregnant each year, because fetal demise is not often acknowledged through public displays such as funerals, and finally because fetal death is culturally accepted to a much greater extent than it should be, this critically important area of women's healthcare has not had the technological advances that have been seen in adult cardiac intensive care and other areas of medicine. Fetal cardiac deaths may be preventable and the diseases that lead to these deaths are often treatable, especially if the sophistication of our modern ICU's could somehow be translated to the prenatal monitoring arena. This review article will outline recent advances in evaluating fetal electrophysiology, helping the perinatologist to better understand the nuances of fetal arrhythmias.
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Affiliation(s)
- Janette F Strasburger
- Children's Hospital of Wisconsin - Fox Valley, 200 Theda Clark Medical Plaza, Suite 480, Neenah, WI 54956-2884, USA.
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