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Glinge C, Rossetti S, Oestergaard LB, Stampe NK, Jacobsen MR, Køber L, Engstrøm T, Torp-Pedersen C, Gislason G, Jabbari R, Tfelt-Hansen J. Familial clustering of unexplained heart failure - A Danish nationwide cohort study. Int J Cardiol 2024; 407:132028. [PMID: 38583593 DOI: 10.1016/j.ijcard.2024.132028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 03/23/2024] [Accepted: 04/04/2024] [Indexed: 04/09/2024]
Abstract
AIMS To determine whether a family history of unexplained heart failure (HF) in first-degree relatives (children or sibling) increases the rate of unexplained HF. METHODS AND RESULTS Using Danish nationwide registry data (1978-2017), we identified patients (probands) diagnosed with first unexplained HF (HF without any known comorbidities) in Denmark, and their first-degree relatives. All first-degree relatives were followed from the HF date of the proband and until an event of unexplained HF, exclusion diagnosis, death, emigration, or study end, whichever occurred first. Using the general population as a reference, we calculated adjusted standardized incidence ratios (SIR) of unexplained HF in the three groups of relatives using Poisson regression models. We identified 55,110 first-degree relatives to individuals previously diagnosed with unexplained HF. Having a family history was associated with a significantly increased unexplained HF rate of 2.59 (95%CI 2.29-2.93). The estimate was higher among siblings (SIR 6.67 [95%CI 4.69-9.48]). Noteworthy, the rate of HF increased for all first-degree relatives when the proband was diagnosed with HF in a young age (≤50 years, SIR of 7.23 [95%CI 5.40-9.68]) and having >1 proband (SIR of 5.28 [95%CI 2.75-10.14]). The highest estimate of HF was observed if the proband was ≤40 years at diagnosis (13.17 [95%CI 8.90-19.49]. CONCLUSION A family history of unexplained HF was associated with a two-fold increased rate of unexplained HF among first-degree relatives. The relative rate was increased when the proband was diagnosed at a young age. These data suggest that screening families of unexplained HF with onset below 50 years is indicated.
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Affiliation(s)
- Charlotte Glinge
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
| | - Sara Rossetti
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Louise Bruun Oestergaard
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Department Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Niels Kjær Stampe
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Mia Ravn Jacobsen
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lars Køber
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Thomas Engstrøm
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Cardiology, University of Lund, Lund, Sweden
| | - Christian Torp-Pedersen
- Department Cardiology, Aalborg University Hospital, Aalborg, Denmark; Department of Cardiology, North Zealand University Hospital, Hillerød, Denmark; Department of Public Health, University of Copenhagen, Denmark
| | - Gunnar Gislason
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; The Danish Heart Foundation, Copenhagen, Denmark
| | - Reza Jabbari
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jacob Tfelt-Hansen
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Forensic Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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2
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Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA, Charron P, Corrado D, Dagres N, de Chillou C, Eckardt L, Friede T, Haugaa KH, Hocini M, Lambiase PD, Marijon E, Merino JL, Peichl P, Priori SG, Reichlin T, Schulz-Menger J, Sticherling C, Tzeis S, Verstrael A, Volterrani M. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J 2022; 43:3997-4126. [PMID: 36017572 DOI: 10.1093/eurheartj/ehac262] [Citation(s) in RCA: 804] [Impact Index Per Article: 402.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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3
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Stattin EL, Hagström E, Dahl N, Strömsöe A, Delgado-Vega AM, Klar J, Svennblad B, Börjesson M, Wisten A. Cohort profile: the Swedish study of SUDden cardiac Death in the Young (SUDDY) 2000-2010: a complete nationwide cohort of SCDs. BMJ Open 2022; 12:e055557. [PMID: 35537790 PMCID: PMC9092141 DOI: 10.1136/bmjopen-2021-055557] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
PURPOSE The rationale behind the SUDden cardiac Death in the Young (SUDDY) cohort was to provide a complete nationwide, high-quality platform with integrated multisource data, for clinical and genetic research on sudden cardiac death (SCD) in the young, with the ultimate goal to predict and prevent SCD. PARTICIPANTS The cohort contains all SCD victims <36 years, in Sweden during the period 2000-2010. We assigned five population-based controls per case, together with parents of cases and controls, in total 15 633 individuals. Data of all individuals were extracted from multiple mandatory registries; the National Patient Registry, the Medical Birth Registry, the Prescribed Drug registry, the Cause of Death registry, the Multigeneration Registry, combined with socioeconomic data from Statistics Sweden. From SCD victims, the autopsy report, medical records, ECGs, parental information and biological samples were gathered. FINDINGS TO DATE We identified 903 individuals diagnosed with SCD (67% men, 33% women). The cases comprised 236 infants <1 year of age (26%), 90 individuals aged 1-15 years (10%), 186 individuals aged 15-25 years (21%) and 391 aged 25-35 years (43%). Hospitalisations and outpatient clinic visits due to syncope were significantly more common among cases than controls. DNA obtained from dried blood spots tests (DBS) stored from birth was equally suitable as venous blood samples for high-throughput genetic analysis of SCD cases. FUTURE PLANS We will explore the SUDDY cohort for symptoms and healthcare consumption, socioeconomic variables and family history of SCD. Furthermore, we will perform whole exome sequencing analysis on DNA of cases obtained from DBS or postmortem samples together with parental blood samples in search for gene variants associated with cardiac disease. The genetic analysis together with data compiled in the nationwide cohort is expected to improve current knowledge on the incidence, aetiology, clinical characteristics and family history of SCD.
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Affiliation(s)
- Eva-Lena Stattin
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Emil Hagström
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Niklas Dahl
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Anneli Strömsöe
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
- Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden
| | | | - Joakim Klar
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Bodil Svennblad
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Mats Börjesson
- Department of Molecular and Clinial Medicine, Sahlgrenska Academy, Göteborg university, Göteborg, Sweden
- Center for Health and Performance, Department of Food, Nutrition and Sport Science, Göteborg university, Göteborg, Sweden
| | - Aase Wisten
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Sunderby Research Unit, Umeå university, Umeå, Sweden
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4
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Nolan JP, Sandroni C, Böttiger BW, Cariou A, Cronberg T, Friberg H, Genbrugge C, Haywood K, Lilja G, Moulaert VRM, Nikolaou N, Olasveengen TM, Skrifvars MB, Taccone F, Soar J. Postreanimationsbehandlung. Notf Rett Med 2021. [DOI: 10.1007/s10049-021-00892-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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5
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Nolan JP, Sandroni C, Böttiger BW, Cariou A, Cronberg T, Friberg H, Genbrugge C, Haywood K, Lilja G, Moulaert VRM, Nikolaou N, Olasveengen TM, Skrifvars MB, Taccone F, Soar J. European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: post-resuscitation care. Intensive Care Med 2021; 47:369-421. [PMID: 33765189 PMCID: PMC7993077 DOI: 10.1007/s00134-021-06368-4] [Citation(s) in RCA: 417] [Impact Index Per Article: 139.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/08/2021] [Indexed: 12/13/2022]
Abstract
The European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) have collaborated to produce these post-resuscitation care guidelines for adults, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics covered include the post-cardiac arrest syndrome, diagnosis of cause of cardiac arrest, control of oxygenation and ventilation, coronary reperfusion, haemodynamic monitoring and management, control of seizures, temperature control, general intensive care management, prognostication, long-term outcome, rehabilitation and organ donation.
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Affiliation(s)
- Jerry P. Nolan
- University of Warwick, Warwick Medical School, Coventry, CV4 7AL UK
- Royal United Hospital, Bath, BA1 3NG UK
| | - Claudio Sandroni
- Department of Intensive Care, Emergency Medicine and Anaesthesiology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
- Institute of Anaesthesiology and Intensive Care Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Bernd W. Böttiger
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Straße 62, 50937 Cologne, Germany
| | - Alain Cariou
- Cochin University Hospital (APHP) and University of Paris (Medical School), Paris, France
| | - Tobias Cronberg
- Department of Clinical Sciences, Neurology, Lund University, Skane University Hospital, Lund, Sweden
| | - Hans Friberg
- Department of Clinical Sciences, Anaesthesia and Intensive Care Medicine, Lund University, Skane University Hospital, Lund, Sweden
| | - Cornelia Genbrugge
- Acute Medicine Research Pole, Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain, Brussels, Belgium
- Emergency Department, University Hospitals Saint-Luc, Brussels, Belgium
| | - Kirstie Haywood
- Warwick Research in Nursing, Division of Health Sciences, Warwick Medical School, University of Warwick, Room A108, Coventry, CV4 7AL UK
| | - Gisela Lilja
- Department of Clinical Sciences Lund, Neurology, Lund University, Skane University Hospital, Lund, Sweden
| | - Véronique R. M. Moulaert
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Nikolaos Nikolaou
- Cardiology Department, Konstantopouleio General Hospital, Athens, Greece
| | - Theresa Mariero Olasveengen
- Department of Anesthesiology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Markus B. Skrifvars
- Department of Emergency Care and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Fabio Taccone
- Department of Intensive Care, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik, 808, 1070 Brussels, Belgium
| | - Jasmeet Soar
- Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB UK
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6
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Nolan JP, Sandroni C, Böttiger BW, Cariou A, Cronberg T, Friberg H, Genbrugge C, Haywood K, Lilja G, Moulaert VRM, Nikolaou N, Mariero Olasveengen T, Skrifvars MB, Taccone F, Soar J. European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2021: Post-resuscitation care. Resuscitation 2021; 161:220-269. [PMID: 33773827 DOI: 10.1016/j.resuscitation.2021.02.012] [Citation(s) in RCA: 338] [Impact Index Per Article: 112.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) have collaborated to produce these post-resuscitation care guidelines for adults, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics covered include the post-cardiac arrest syndrome, diagnosis of cause of cardiac arrest, control of oxygenation and ventilation, coronary reperfusion, haemodynamic monitoring and management, control of seizures, temperature control, general intensive care management, prognostication, long-term outcome, rehabilitation, and organ donation.
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Affiliation(s)
- Jerry P Nolan
- University of Warwick, Warwick Medical School, Coventry CV4 7AL, UK; Royal United Hospital, Bath, BA1 3NG, UK.
| | - Claudio Sandroni
- Department of Intensive Care, Emergency Medicine and Anaesthesiology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy; Institute of Anaesthesiology and Intensive Care Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Bernd W Böttiger
- University Hospital of Cologne, Kerpener Straße 62, D-50937 Cologne, Germany
| | - Alain Cariou
- Cochin University Hospital (APHP) and University of Paris (Medical School), Paris, France
| | - Tobias Cronberg
- Department of Clinical Sciences, Neurology, Lund University, Skane University Hospital, Lund, Sweden
| | - Hans Friberg
- Department of Clinical Sciences, Anaesthesia and Intensive Care Medicine, Lund University, Skane University Hospital, Lund, Sweden
| | - Cornelia Genbrugge
- Acute Medicine Research Pole, Institute of Experimental and Clinical Research (IREC) Université Catholique de Louvain, Brussels, Belgium; Emergency Department, University Hospitals Saint-Luc, Brussels, Belgium
| | - Kirstie Haywood
- Warwick Research in Nursing, Room A108, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Gisela Lilja
- Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Neurology, Lund, Sweden
| | - Véronique R M Moulaert
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Nikolaos Nikolaou
- Cardiology Department, Konstantopouleio General Hospital, Athens, Greece
| | - Theresa Mariero Olasveengen
- Department of Anesthesiology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway
| | - Markus B Skrifvars
- Department of Emergency Care and Services, University of Helsinki and Helsinki University Hospital, Finland
| | - Fabio Taccone
- Department of Intensive Care, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik, 808, 1070 Brussels, Belgium
| | - Jasmeet Soar
- Southmead Hospital, North Bristol NHS Trust, Bristol BS10 5NB, UK
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7
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Schulze-Bahr E, Dettmeyer RB, Klingel K, Kauferstein S, Wolf C, Baba HA, Bohle RM, Gebauer R, Milting H, Schmidt U, Meder B, Rieß O, Paul T, Bajanowski T, Schunkert H. Postmortale molekulargenetische Untersuchungen (molekulare Autopsie) bei kardiovaskulären und bei ungeklärten Todesfällen. KARDIOLOGE 2021. [DOI: 10.1007/s12181-020-00438-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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8
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Couper K, Putt O, Field R, Poole K, Bradlow W, Clarke A, Perkins GD, Royle P, Yeung J, Taylor-Phillips S. Incidence of sudden cardiac death in the young: a systematic review. BMJ Open 2020; 10:e040815. [PMID: 33033034 PMCID: PMC7542928 DOI: 10.1136/bmjopen-2020-040815] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/28/2020] [Accepted: 09/04/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To summarise studies describing incidence of sudden cardiac death in a general population of young individuals to inform screening policy. DESIGN Systematic review. DATA SOURCES Database searches of MEDLINE, EMBASE and the Cochrane library (all inception to current) on 29 April 2019 (updated 16 November 2019), and forward/backward citation tracking of eligible studies. STUDY ELIGIBILITY CRITERIA All studies that reported incidence of sudden cardiac death in young individuals (12-39 years) in a general population, with no restriction on language or date. Planned subgroups were incidence by age, sex, race and athletic status (including military personnel). DATA EXTRACTION Two reviewers independently assessed study eligibility, extracted study data and assessed risk of bias using the Joanna Briggs Institute critical appraisal checklist for prevalence studies. ANALYSIS Reported incidence of sudden cardiac death in the young per 100 000 person-years. RESULTS 38 studies that reported incidence across five continents. We identified substantial heterogeneity in population, sudden cardiac death definition, and case ascertainment methods, precluding meta-analysis. Median reported follow-up years was 6.97 million (IQR 2.34 million-23.70 million) and number of sudden cardiac death cases was 64 (IQR 40-251). In the general population, the median of reported incidence was 1.7 sudden cardiac death per 100 000 person-years (IQR 1.3-2.6, range 0.75-11.9). Most studies (n=14, 54%) reported an incidence between one and two cases per 100 000 person-years. Incidence was higher in males and older individuals. CONCLUSIONS This systematic review identified variability in the reported incidence of sudden cardiac death in the young across studies. Most studies reported an incidence between one and two cases per 100 000 person-years. PROSPERO REGISTRATION NUMBER CRD42019120563.
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Affiliation(s)
- Keith Couper
- Warwick Medical School, University of Warwick Warwick Medical School, Coventry, UK
- Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Oliver Putt
- Warwick Medical School, University of Warwick Warwick Medical School, Coventry, UK
| | - Richard Field
- Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Kurtis Poole
- Warwick Medical School, University of Warwick Warwick Medical School, Coventry, UK
| | - William Bradlow
- Department of Cardiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Aileen Clarke
- Warwick Medical School, University of Warwick Warwick Medical School, Coventry, UK
| | - Gavin D Perkins
- Warwick Medical School, University of Warwick Warwick Medical School, Coventry, UK
- Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Pamela Royle
- Warwick Medical School, University of Warwick Warwick Medical School, Coventry, UK
| | - Joyce Yeung
- Warwick Medical School, University of Warwick Warwick Medical School, Coventry, UK
- Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Sian Taylor-Phillips
- Warwick Medical School, University of Warwick Warwick Medical School, Coventry, UK
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9
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Huang WC, Huang HT, Chen PY, Wang WC, Ko TM, Shrestha S, Yang CD, Tai CS, Chiew MY, Chou YP, Hu YF, Huang HD. SVAD: A genetic database curates non-ischemic sudden cardiac death-associated variants. PLoS One 2020; 15:e0237731. [PMID: 32813752 PMCID: PMC7437891 DOI: 10.1371/journal.pone.0237731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/31/2020] [Indexed: 11/19/2022] Open
Abstract
Sudden cardiac death (SCD) is an important cause of mortality worldwide. It accounts for approximately half of all deaths from cardiovascular disease. While coronary artery disease and acute myocardial infarction account for the majority of SCD in the elderly population, inherited cardiac diseases (inherited CDs) comprise a substantial proportion of younger SCD victims with a significant genetic component. Currently, the use of next-generation sequencing enables the rapid analysis to investigate relationships between genetic variants and inherited CDs causing SCD. Genetic contribution to risk has been considered an alternate predictor of SCD. In the past years, large numbers of SCD susceptibility variants were reported, but these results are scattered in numerous publications. Here, we present the SCD-associated Variants Annotation Database (SVAD) to facilitate the interpretation of variants and to meet the needs of data integration. SVAD contains data from a broad screening of scientific literature. It was constructed to provide a comprehensive collection of genetic variants along with integrated information regarding their effects. At present, SVAD has accumulated 2,292 entries within 1,239 variants by manually surveying pertinent literature, and approximately one-third of the collected variants are pathogenic/likely-pathogenic following the ACMG guidelines. To the best of our knowledge, SVAD is the most comprehensive database that can provide integrated information on the associated variants in various types of inherited CDs. SVAD represents a valuable source of variant information based on scientific literature and benefits clinicians and researchers, and it is now available on http://svad.mbc.nctu.edu.tw/.
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Affiliation(s)
- Wei-Chih Huang
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan, R.O.C
- Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan, R.O.C
| | - Hsin-Tzu Huang
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan, R.O.C
- Industrial Development Graduate Program of College of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan, R.O.C
| | - Po-Yuan Chen
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan, R.O.C
- Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan, R.O.C
| | - Wei-Chi Wang
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan, R.O.C
- Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan, R.O.C
| | - Tai-Ming Ko
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan, R.O.C
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan, R.O.C
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan, R.O.C
| | - Sirjana Shrestha
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan, R.O.C
- Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan, R.O.C
| | - Chi-Dung Yang
- Warshel Institute for Computational Biology, The Chinese University of Hong Kong, Shenzhen, China
- School of Life and Health Sciences, The Chinese University of Hong Kong, Shenzhen, China
| | - Chun-San Tai
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan, R.O.C
- Institute of Molecular Medicine and Bioengineering, National Chiao Tung University, Hsinchu, Taiwan, R.O.C
| | - Men-Yee Chiew
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan, R.O.C
| | - Yu-Pao Chou
- Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan, R.O.C
| | - Yu-Feng Hu
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C
- Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan, R.O.C
- * E-mail: (HDH); (YFH)
| | - Hsien-Da Huang
- Warshel Institute for Computational Biology, The Chinese University of Hong Kong, Shenzhen, China
- School of Life and Health Sciences, The Chinese University of Hong Kong, Shenzhen, China
- * E-mail: (HDH); (YFH)
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Larsen MK, Christiansen SL, Hertz CL, Frank-Hansen R, Jensen HK, Banner J, Morling N. Targeted molecular genetic testing in young sudden cardiac death victims from Western Denmark. Int J Legal Med 2019; 134:111-121. [DOI: 10.1007/s00414-019-02179-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 10/15/2019] [Indexed: 02/08/2023]
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Abstract
Hypertrophic cardiomyopathy (HCM) is the most common inherited heart disease and defined by unexplained isolated progressive myocardial hypertrophy, systolic and diastolic ventricular dysfunction, arrhythmias, sudden cardiac death and histopathologic changes, such as myocyte disarray and myocardial fibrosis. Mutations in genes encoding for proteins of the contractile apparatus of the cardiomyocyte, such as β-myosin heavy chain and myosin binding protein C, have been identified as cause of the disease. Disease is caused by altered biophysical properties of the cardiomyocyte, disturbed calcium handling, and abnormal cellular metabolism. Mutations in sarcomere genes can also activate other signaling pathways via transcriptional activation and can influence non-cardiac cells, such as fibroblasts. Additional environmental, genetic and epigenetic factors result in heterogeneous disease expression. The clinical course of the disease varies greatly with some patients presenting during childhood while others remain asymptomatic until late in life. Patients can present with either heart failure symptoms or the first symptom can be sudden death due to malignant ventricular arrhythmias. The morphological and pathological heterogeneity results in prognosis uncertainty and makes patient management challenging. Current standard therapeutic measures include the prevention of sudden death by prohibition of competitive sport participation and the implantation of cardioverter-defibrillators if indicated, as well as symptomatic heart failure therapies or cardiac transplantation. There exists no causal therapy for this monogenic autosomal-dominant inherited disorder, so that the focus of current management is on early identification of asymptomatic patients at risk through molecular diagnostic and clinical cascade screening of family members, optimal sudden death risk stratification, and timely initiation of preventative therapies to avoid disease progression to the irreversible adverse myocardial remodeling stage. Genetic diagnosis allowing identification of asymptomatic affected patients prior to clinical disease onset, new imaging technologies, and the establishment of international guidelines have optimized treatment and sudden death risk stratification lowering mortality dramatically within the last decade. However, a thorough understanding of underlying disease pathogenesis, regular clinical follow-up, family counseling, and preventative treatment is required to minimize morbidity and mortality of affected patients. This review summarizes current knowledge about molecular genetics and pathogenesis of HCM secondary to mutations in the sarcomere and provides an overview about current evidence and guidelines in clinical patient management. The overview will focus on clinical staging based on disease mechanism allowing timely initiation of preventative measures. An outlook about so far experimental treatments and potential for future therapies will be provided.
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Affiliation(s)
- Cordula Maria Wolf
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich, Munich, Germany
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12
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Gaertner-Rommel A, Tiesmeier J, Jakob T, Strickmann B, Veit G, Bachmann-Mennenga B, Paluszkiewicz L, Klingel K, Schulz U, Laser KT, Karger B, Pfeiffer H, Milting H. Molecular autopsy and family screening in a young case of sudden cardiac death reveals an unusually severe case of FHL1 related hypertrophic cardiomyopathy. Mol Genet Genomic Med 2019; 7:e841. [PMID: 31293105 PMCID: PMC6687666 DOI: 10.1002/mgg3.841] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/22/2019] [Accepted: 05/29/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Hypertrophic cardiomyopathy (HCM) is a genetic cardiomyopathy with a prevalence of about 1:200. It is characterized by left ventricular hypertrophy, diastolic dysfunction and interstitial fibrosis; HCM might lead to sudden cardiac death (SCD) especially in the young. Due to low autopsy frequencies of sudden unexplained deaths (SUD) the true prevalence of SCD and especially of HCM among SUD remains unclear. Even in cases of proven SCD genetic testing is not a routine procedure precluding appropriate risk stratification and counseling of relatives. METHODS Here we report a case of SCD in a 19-year-old investigated by combined forensic and molecular autopsy. RESULTS During autopsy of the index-patient HCM was detected. As no other possible cause of death could be uncovered by forensic autopsy the event was classified as SCD. Molecular autopsy identified two (probably) pathogenic genetic variants in FHL1 and MYBPC3. The MYBPC3 variant had an incomplete penetrance. The FHL1 variant was a de novo mutation. We detected reduced FHL1 mRNA levels and no FHL1 protein in muscle samples suggesting nonsense-mediated mRNA decay and/or degradation of the truncated protein in the SCD victim revealing a plausible disease mechanism. CONCLUSION The identification of the genetic cause of the SCD contributed to the rational counseling of the relatives and risk assessment within the family. Furthermore our study revealed evidences for the pathomechanism of FHL1 mutations.
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Affiliation(s)
- Anna Gaertner-Rommel
- Klinikum der Ruhr-Universität Bochum, Klinik für Thorax- und Kardiovaskularchirurgie und Erich und Hanna Klessmann-Institut für Kardiovaskuläre Forschung und Entwicklung, Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Germany
| | - Jens Tiesmeier
- Mühlenkreiskliniken, Krankenhaus Lübbecke-Rahden, Institut für Anästhesiologie, Intensiv- und Notfallmedizin, Medizin Campus OWL, Ruhr-Universität Bochum, Bochum, Germany
| | - Thomas Jakob
- Klinikum Herford, Universitätsklinik für Anästhesiologie, Medizin Campus OWL, Ruhr-Universität Bochum, Herford, Germany
| | | | - Gunter Veit
- Mühlenkreiskliniken, Krankenhaus Lübbecke-Rahden, Institut für Anästhesiologie, Intensiv- und Notfallmedizin, Medizin Campus OWL, Ruhr-Universität Bochum, Bochum, Germany
| | - Bernd Bachmann-Mennenga
- Mühlenkreiskliniken, Johannes Wesling Klinikum, Universitätsinstitut für Anästhesiologie, Intensiv- und Notfallmedizin, Medizin Campus OWL, Ruhr-Universität Bochum, Minden, Germany
| | - Lech Paluszkiewicz
- Klinikum der Ruhr-Universität Bochum, Klinik für Thorax- und Kardiovaskularchirurgie und Erich und Hanna Klessmann-Institut für Kardiovaskuläre Forschung und Entwicklung, Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Germany
| | - Karin Klingel
- Kardiopathologie, Universitätsklinikum Tübingen, Institut für Pathologie und Neuropathologie, Tubingen, Germany
| | - Uwe Schulz
- Klinikum der Ruhr-Universität Bochum, Klinik für Thorax- und Kardiovaskularchirurgie und Erich und Hanna Klessmann-Institut für Kardiovaskuläre Forschung und Entwicklung, Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Germany
| | - Kai T Laser
- Zentrum für angeborene Herzfehler, Herz- und Diabeteszentrum NRW, Klinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | - Bernd Karger
- Universitätsklinikum Münster, Institut für Rechtsmedizin, Münster, Germany
| | - Heidi Pfeiffer
- Universitätsklinikum Münster, Institut für Rechtsmedizin, Münster, Germany
| | - Hendrik Milting
- Klinikum der Ruhr-Universität Bochum, Klinik für Thorax- und Kardiovaskularchirurgie und Erich und Hanna Klessmann-Institut für Kardiovaskuläre Forschung und Entwicklung, Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Germany
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Lynge TH, Winkel BG, Tfelt-Hansen J. Editorial commentary: Sudden cardiac death prediction in the general population and among patients with left ventricular ejection fractions greater than 40%. Trends Cardiovasc Med 2018; 28:522-523. [DOI: 10.1016/j.tcm.2018.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 05/25/2018] [Indexed: 01/19/2023]
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Geri G, Passouant O, Dumas F, Bougouin W, Champigneulle B, Arnaout M, Chelly J, Chiche JD, Varenne O, Guillemet L, Pène F, Waldmann V, Mira JP, Marijon E, Cariou A. Etiological diagnoses of out-of-hospital cardiac arrest survivors admitted to the intensive care unit: Insights from a French registry. Resuscitation 2017; 117:66-72. [DOI: 10.1016/j.resuscitation.2017.06.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 06/01/2017] [Accepted: 06/06/2017] [Indexed: 01/17/2023]
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15
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Postreanimationsbehandlung. Notf Rett Med 2017. [DOI: 10.1007/s10049-017-0331-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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16
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Bougouin W, Cariou A. Aetiologies of cardiac arrest: Seek and ye shall find. Resuscitation 2017; 116:A3-A4. [DOI: 10.1016/j.resuscitation.2017.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 04/25/2017] [Indexed: 10/19/2022]
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Abstract
In the present review, we summarize current approaches to the prevention of sudden cardiac death (SCD) in children and young adults, focusing on age less than 35 years. SCD in the young is rare, but devastating from the societal perspective. While coronary artery disease is the main etiology of SCD in the older age groups, conditions such as cardiomyopathies and electrical channelopathies are more likely to be found in the young. In the majority of younger cases, cardiac arrest can be the first recognized manifestation of the underlying cardiac pathology, although some have experienced cardiovascular symptoms prior to the SCD. Since identification of a cardiac disease is pivotal for implementation of appropriate preventive measures, measures such as electrocardiographic screening in subpopulations such as athletes have been proposed. However, these efforts are impeded by the large number of individuals needed to test in order to find one with cardiac disease, leading to significant rates of false positive findings and high costs. When a high-risk cardiac condition is identified in a young person, measures of lifestyle modification, appropriate medical treatment and ICD implantation in selected individuals based on risk stratification are warranted. Nevertheless, the benefits of lifelong ICD therapy need to be balanced with long-term complications and quality of life.
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Affiliation(s)
- Aapo L Aro
- Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA.,Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
| | - Sumeet S Chugh
- Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
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Abstract
CONTEXT Sudden cardiac death (SCD) in a young athlete is a tragic event and is the leading medical cause of death in this population. The precise incidence of SCD in young athletes has been subject of debate, with studies reporting drastically different rates (1:917,000 athlete-years (AYs) to 1:3000 AYs) depending on the methodological design of the investigation or the targeted population. EVIDENCE ACQUISITION A literature search was performed in PubMed using the terms: incidence, sudden cardiac death, sudden death, sudden cardiac arrest, etiology, pathology, registry, athlete, young, children, and adolescents. Articles were reviewed for relevance and included if they contained information on the incidence of SCD in athletes or young persons up to the age of 35 years. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 5. RESULTS Studies of high quality and rigor consistently yield an incidence of 1:50,000 AYs in college athletes and between 1:50,000 and 1:80,000 AYs for high school athletes, with certain subgroups that appear to be at particularly high risk, including the following: men, basketball players, and African Americans. Initial reports suggest that the most common cause of SCD is hypertrophic cardiomyopathy (HCM). However, more comprehensive investigations in the United States and international populations-athletes, nonathletes, and military-support that the most common finding on autopsy in young individuals with SCD is actually a structurally normal heart (autopsy-negative sudden unexplained death). CONCLUSION SCD is the leading cause of death in athletes during exercise and usually results from intrinsic cardiac conditions that are triggered by the physiologic demands of vigorous exercise. Current rates of SCD appear to be at least 4 to 5 times higher than previously estimated, with men, African Americans, and male basketball players being at greatest risk. Emerging data suggest that the leading finding associated with SCD in athletes is actually a structurally normal heart (autopsy-negative sudden unexplained death).
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Affiliation(s)
- Irfan M. Asif
- Department of Family Medicine, Greenville Health System, University of South Carolina–Greenville School of Medicine, Greenville, South Carolina
| | - Kimberly G. Harmon
- Department of Family Medicine, University of Washington, Seattle, Washington
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Hellenthal N, Gaertner-Rommel A, Klauke B, Paluszkiewicz L, Stuhr M, Kerner T, Farr M, Püschel K, Milting H. Molecular autopsy of sudden unexplained deaths reveals genetic predispositions for cardiac diseases among young forensic cases. Europace 2016; 19:1881-1890. [DOI: 10.1093/europace/euw247] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 07/13/2016] [Indexed: 12/31/2022] Open
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20
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Nolan JP, Soar J, Cariou A, Cronberg T, Moulaert VRM, Deakin CD, Bottiger BW, Friberg H, Sunde K, Sandroni C. European Resuscitation Council and European Society of Intensive Care Medicine Guidelines for Post-resuscitation Care 2015: Section 5 of the European Resuscitation Council Guidelines for Resuscitation 2015. Resuscitation 2016; 95:202-22. [PMID: 26477702 DOI: 10.1016/j.resuscitation.2015.07.018] [Citation(s) in RCA: 734] [Impact Index Per Article: 91.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Jerry P Nolan
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, UK; School of Clinical Sciences, University of Bristol, UK.
| | - Jasmeet Soar
- Anaesthesia and Intensive Care Medicine, Southmead Hospital, Bristol, UK
| | - Alain Cariou
- Cochin University Hospital (APHP) and Paris Descartes University, Paris, France
| | - Tobias Cronberg
- Department of Clinical Sciences, Division of Neurology, Lund University, Lund, Sweden
| | - Véronique R M Moulaert
- Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
| | - Charles D Deakin
- Cardiac Anaesthesia and Cardiac Intensive Care and NIHR Southampton Respiratory Biomedical Research Unit, University Hospital, Southampton, UK
| | - Bernd W Bottiger
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Hans Friberg
- Department of Clinical Sciences, Division of Anesthesia and Intensive Care Medicine, Lund University, Lund, Sweden
| | - Kjetil Sunde
- Department of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Claudio Sandroni
- Department of Anaesthesiology and Intensive Care, Catholic University School of Medicine, Rome, Italy
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Marstrand P, Axelsson A, Thune JJ, Vejlstrup N, Bundgaard H, Theilade J. Cardiac magnetic resonance imaging after ventricular tachyarrhythmias increases diagnostic precision and reduces the need for family screening for inherited cardiac disease. Europace 2016; 18:1860-1865. [PMID: 26838692 DOI: 10.1093/europace/euv446] [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: 10/14/2015] [Accepted: 12/16/2015] [Indexed: 01/20/2023] Open
Abstract
AIMS Guidelines recommend evaluation of family members of sudden cardiac death victims. However, initiation of cascade screening in families with uncertain diagnoses is not cost-effective and may cause unnecessary concern. For these reasons, we set out to assess to what extent cardiac magnetic resonance imaging (CMR) would increase the diagnostic precision and thereby possibly change the indication for family screening in patients with ventricular tachyarrhythmias. METHODS AND RESULTS We retrospectively collected data from 79 patients hospitalized with aborted cardiac arrest (resuscitated from a cardiac arrest), ventricular tachycardia (VT), or syncope who underwent a CMR at the Copenhagen University Hospital, Rigshospitalet, Denmark. Besides CMR, the patients were evaluated with an electrocardiogram, echocardiogram (both 100%), coronary angiogram (CAG)/coronary computed tomography scan (CT-CAG) (81%), exercise stress test (47%), late potentials (54%), electrophysiological study (44%), pharmacological provocation (44%), and/or myocardial biopsy (16%). Family screening was indicated for 53 probands (67%) prior to CMR. After full workup, only 43 cases (54%) warranted evaluation of relatives (19% decrease, P = 0.034). The full evaluation changed whether family screening was indicated in 18 probands (14/18 moved to no indication for family screening). In the 18 where recommendations on family screening changed, CMR findings were the major driver for re-classification in 17 cases. CONCLUSION Cardiac magnetic resonance imaging re-defines the cardiac diagnoses in a significant proportion of cases and reduces the number of patients in whom family screening is warranted. Cardiac magnetic resonance imaging is highly relevant for optimal care and resource allocation when an inherited heart disease is the presumed cause of life-threatening arrhythmias.
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Affiliation(s)
- Peter Marstrand
- Department of Cardiology, Rigshospitalet, University Hospital Copenhagen, Denmark
| | - Anna Axelsson
- Department of Cardiology, Rigshospitalet, University Hospital Copenhagen, Denmark
| | - Jens Jakob Thune
- Department of Cardiology, Rigshospitalet, University Hospital Copenhagen, Denmark
| | - Niels Vejlstrup
- Department of Cardiology, Rigshospitalet, University Hospital Copenhagen, Denmark
| | - Henning Bundgaard
- Department of Cardiology, Rigshospitalet, University Hospital Copenhagen, Denmark
| | - Juliane Theilade
- Department of Cardiology, Herlev Hospital, University Hospital Copenhagen, Denmark
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Katritsis DG, Gersh BJ, Camm AJ. A Clinical Perspective on Sudden Cardiac Death. Arrhythm Electrophysiol Rev 2016; 5:177-182. [PMID: 28116082 PMCID: PMC5248660 DOI: 10.15420/aer.2016:11:2] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 10/28/2016] [Indexed: 11/04/2022] Open
Abstract
This article presents the epidemiology, aetiology and pathophysiology of sudden cardiac death. The modern management of survivors as well as of family members of victims is discussed, as are the relevant recommendations of guidelines prepared by learned societies.
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Affiliation(s)
- Demosthenes G Katritsis
- Athens Euroclinic, Greece, and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Kaiser-Nielsen LV, Tischer SG, Prescott EB, Rasmusen HK. Symptoms, diagnoses, and sporting consequences among athletes referred to a Danish sports cardiology clinic. Scand J Med Sci Sports 2015; 27:115-123. [PMID: 26661094 DOI: 10.1111/sms.12624] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2015] [Indexed: 12/28/2022]
Abstract
As the number of recreational athletes performing exercise and participating in competitions at a high-level increases, exercise-induced cardiac symptoms may become a more common problem, not least because recreational athletes often continue high-level exercise programs into advanced ages. We investigated the prevalence of cardiac symptoms and diagnoses among 201 athletes referred for cardiac evaluation at a Sports Cardiology Clinic in Denmark. To our knowledge, this is the first systematic study of athletes referred for suspected cardiac disease. The athletes were all well-trained recreational to elite athletes who participated in various sports with different training loads and a wide age span (13-66 years). All patients were referred by physicians, primarily their general practitioner (38%), and palpitations were the most common cardiac symptom (40%). Cardiac symptoms had a sensitivity of 86% in detecting cardiac disease and a specificity of 13%. Cardiac disease was diagnosed in 44% of the patients, and atrial fibrillation was the most prevalent diagnosis (7.5%). Cardiac diseases with therapeutic- or sports-related consequences for the patients were diagnosed in 28% of the population, but only 1% received a recommendation to avoid high-level sports indefinitely.
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Affiliation(s)
- L V Kaiser-Nielsen
- Department of Cardiology, Bispebjerg Hospital, Copenhagen University, Copenhagen, Denmark
| | - S G Tischer
- Department of Cardiology, Bispebjerg Hospital, Copenhagen University, Copenhagen, Denmark
| | - E B Prescott
- Department of Cardiology, Bispebjerg Hospital, Copenhagen University, Copenhagen, Denmark
| | - H K Rasmusen
- Department of Cardiology, Bispebjerg Hospital, Copenhagen University, Copenhagen, Denmark
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Monsieurs K, Nolan J, Bossaert L, Greif R, Maconochie I, Nikolaou N, Perkins G, Soar J, Truhlář A, Wyllie J, Zideman D. Kurzdarstellung. Notf Rett Med 2015. [DOI: 10.1007/s10049-015-0097-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Monsieurs KG, Nolan JP, Bossaert LL, Greif R, Maconochie IK, Nikolaou NI, Perkins GD, Soar J, Truhlář A, Wyllie J, Zideman DA, Alfonzo A, Arntz HR, Askitopoulou H, Bellou A, Beygui F, Biarent D, Bingham R, Bierens JJ, Böttiger BW, Bossaert LL, Brattebø G, Brugger H, Bruinenberg J, Cariou A, Carli P, Cassan P, Castrén M, Chalkias AF, Conaghan P, Deakin CD, De Buck ED, Dunning J, De Vries W, Evans TR, Eich C, Gräsner JT, Greif R, Hafner CM, Handley AJ, Haywood KL, Hunyadi-Antičević S, Koster RW, Lippert A, Lockey DJ, Lockey AS, López-Herce J, Lott C, Maconochie IK, Mentzelopoulos SD, Meyran D, Monsieurs KG, Nikolaou NI, Nolan JP, Olasveengen T, Paal P, Pellis T, Perkins GD, Rajka T, Raffay VI, Ristagno G, Rodríguez-Núñez A, Roehr CC, Rüdiger M, Sandroni C, Schunder-Tatzber S, Singletary EM, Skrifvars MB, Smith GB, Smyth MA, Soar J, Thies KC, Trevisanuto D, Truhlář A, Vandekerckhove PG, de Voorde PV, Sunde K, Urlesberger B, Wenzel V, Wyllie J, Xanthos TT, Zideman DA. European Resuscitation Council Guidelines for Resuscitation 2015: Section 1. Executive summary. Resuscitation 2015; 95:1-80. [PMID: 26477410 DOI: 10.1016/j.resuscitation.2015.07.038] [Citation(s) in RCA: 568] [Impact Index Per Article: 63.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Koenraad G Monsieurs
- Emergency Medicine, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium.
| | - Jerry P Nolan
- Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, UK; School of Clinical Sciences, University of Bristol, Bristol, UK
| | | | - Robert Greif
- Department of Anaesthesiology and Pain Medicine, University Hospital Bern, Bern, Switzerland; University of Bern, Bern, Switzerland
| | - Ian K Maconochie
- Paediatric Emergency Medicine Department, Imperial College Healthcare NHS Trust and BRC Imperial NIHR, Imperial College, London, UK
| | | | - Gavin D Perkins
- Warwick Medical School, University of Warwick, Coventry, UK; Heart of England NHS Foundation Trust, Birmingham, UK
| | - Jasmeet Soar
- Anaesthesia and Intensive Care Medicine, Southmead Hospital, Bristol, UK
| | - Anatolij Truhlář
- Emergency Medical Services of the Hradec Králové Region, Hradec Králové, Czech Republic; Department of Anaesthesiology and Intensive Care Medicine, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Jonathan Wyllie
- Department of Neonatology, The James Cook University Hospital, Middlesbrough, UK
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Sudden Death in the Family from Personal History Section. Curr Sports Med Rep 2015; 14:336-7. [PMID: 26166061 DOI: 10.1097/01.csmr.0000466790.90771.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Risk factors and causes of sudden noncardiac death: A nationwide cohort study in Denmark. Heart Rhythm 2015; 12:968-74. [DOI: 10.1016/j.hrthm.2015.01.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Indexed: 11/22/2022]
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Gullach AJ, Risgaard B, Lynge TH, Jabbari R, Glinge C, Haunsø S, Backer V, Winkel BG, Tfelt-Hansen J. Sudden death in young persons with uncontrolled asthma--a nationwide cohort study in Denmark. BMC Pulm Med 2015; 15:35. [PMID: 25887740 PMCID: PMC4404085 DOI: 10.1186/s12890-015-0033-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 04/07/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Asthma is a common chronic disease among young adults, and several studies have reported increased mortality rates in patients with asthma. However, no study has described sudden unexpected death in a nationwide setting in patients with uncontrolled asthma. We defined uncontrolled asthma as a previous hospital admittance because of asthma (of any severity) or when asthma was considered to have influenced the death according to the death certificate. The purpose of this study is to increase the medical focus on young persons with uncontrolled asthma and thereby hopefully aid in preventing sudden unexpected deaths. We therefore aimed to describe clinical characteristics, symptoms, causes of death, and contact with the healthcare system prior to sudden unexpected death in young persons with uncontrolled asthma. METHODS Through the review of death certificates, we found 625 sudden unexpected death cases in individuals aged 1-35 years in Denmark from 2000 to 2006. Of those, 49 persons with uncontrolled asthma were identified. Previous contacts with the healthcare system were identified, and available records from general practitioners were retrieved. RESULTS We identified 49 individuals who suffered from uncontrolled asthma. This corresponds to an incidence rate of 0.32 per 100,000 person-years. The cause of death in 31 cases (63%) was sudden cardiac death, and in 13 cases (27%), it was a fatal asthma attack. Symptoms (chest pain, dyspnea, seizures, general malaise, syncope, and palpitations) prior to death were reported in 41 (84%) of the cases. In 34 (69%) of the cases, antecedent symptoms (symptoms >24 hours before death) were present, and 28 (57%) patients had prodromal symptoms (symptoms <24 hours before death). The most common antecedent symptoms were dyspnea and chest pain, whereas the most common prodromal symptoms were dyspnea, general malaise, and/or fatigue. Twenty-eight patients (57%) sought medical advice from a general practitioner and/or emergency department due to these symptoms. CONCLUSION The cause of death was predominantly sudden cardiac death followed by fatal asthma attack. We found that 41 (84%) of patients suffered from symptoms prior to death and that 28 (57%) sought medical advice from the emergency department and/or general practitioners.
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Affiliation(s)
- Anders Juul Gullach
- Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Copenhagen, Denmark. .,Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, 9312, Juliane Maries Vej 20, Copenhagen, 2100, Denmark.
| | - Bjarke Risgaard
- Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Copenhagen, Denmark. .,Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, 9312, Juliane Maries Vej 20, Copenhagen, 2100, Denmark.
| | - Thomas Hadberg Lynge
- Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Copenhagen, Denmark. .,Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, 9312, Juliane Maries Vej 20, Copenhagen, 2100, Denmark.
| | - Reza Jabbari
- Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Copenhagen, Denmark. .,Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, 9312, Juliane Maries Vej 20, Copenhagen, 2100, Denmark.
| | - Charlotte Glinge
- Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Copenhagen, Denmark. .,Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, 9312, Juliane Maries Vej 20, Copenhagen, 2100, Denmark.
| | - Stig Haunsø
- Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Copenhagen, Denmark. .,Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, 9312, Juliane Maries Vej 20, Copenhagen, 2100, Denmark. .,Department of Medicine and Surgery, University of Copenhagen, Copenhagen, Denmark.
| | - Vibeke Backer
- Department of Respiratory Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
| | - Bo Gregers Winkel
- Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Copenhagen, Denmark. .,Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, 9312, Juliane Maries Vej 20, Copenhagen, 2100, Denmark.
| | - Jacob Tfelt-Hansen
- Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, 9312, Juliane Maries Vej 20, Copenhagen, 2100, Denmark. .,Department of Medicine and Surgery, University of Copenhagen, Copenhagen, Denmark.
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van der Werf C, Hendrix A, Birnie E, Bots ML, Vink A, Bardai A, Blom MT, Bosch J, Bruins W, Das CK, Koster RW, Naujocks T, Schaap B, Tan HL, de Vos R, de Vries P, Woonink F, Doevendans PA, van Weert HC, Wilde AAM, Mosterd A, van Langen IM. Improving usual care after sudden death in the young with focus on inherited cardiac diseases (the CAREFUL study): a community-based intervention study. Europace 2015; 18:592-601. [PMID: 25833117 DOI: 10.1093/europace/euv059] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 02/11/2015] [Indexed: 01/25/2023] Open
Abstract
AIMS Inherited cardiac diseases play an important role in sudden death (SD) in the young. Autopsy and cardiogenetic evaluation of relatives of young SD victims identifies relatives at risk. We studied the usual care after SD in the young aimed at identifying inherited cardiac disease, and assessed the efficacy of two interventions to improve this usual care. METHODS AND RESULTS We conducted a community-based intervention study to increase autopsy rates of young SD victims aged 1-44 years and referral of their relatives to cardiogenetic clinics. In the Amsterdam study region, a 24/7 central telephone number and a website were available to inform general practitioners and coroners. In the Utrecht study region, they were informed by a letter and educational meetings. In two control regions usual care was monitored. Autopsy was performed in 169 of 390 registered SD cases (43.3%). Cardiogenetic evaluation of relatives was indicated in 296 of 390 cases (75.9%), but only 25 of 296 families (8.4%) attended a cardiogenetics clinic. Autopsy rates were 38.7% in the Amsterdam study region, 45.5% in the Utrecht study region, and 49.0% in the control regions. The proportion of families evaluated at cardiogenetics clinics in the Amsterdam study region, the Utrecht study region, and the control regions was 7.3, 9.9, and 8.8%, respectively. CONCLUSIONS The autopsy rate in young SD cases in the Netherlands is low and few families undergo cardiogenetic evaluation to detect inherited cardiac diseases. Two different interventions did not improve this suboptimal situation substantially.
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Affiliation(s)
- Christian van der Werf
- Department of Clinical and Experimental Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Anneke Hendrix
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
| | - Erwin Birnie
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Aryan Vink
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Abdennasser Bardai
- Department of Clinical and Experimental Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Marieke T Blom
- Department of Clinical and Experimental Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Jan Bosch
- Regional Ambulance Service Hollands-Midden, Leiden, The Netherlands
| | - Wendy Bruins
- Regional Ambulance Service Utrecht, Utrecht, The Netherlands
| | - C Kees Das
- Department of Forensic Medicine, Amsterdam Public Health Service, Amsterdam, The Netherlands
| | - Rudolph W Koster
- Department of Clinical and Experimental Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Tatjana Naujocks
- Department of Forensic Medicine, Public Health Service of Groningen, Groningen, The Netherlands
| | - Balthasar Schaap
- Department of Forensic Medicine, Public Health Service Hollands Noorden, Schagen, The Netherlands
| | - Hanno L Tan
- Department of Clinical and Experimental Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Ronald de Vos
- Department of Anaesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Philip de Vries
- Department of Forensic Medicine, Public Health Service Hollands Midden, Leiden, The Netherlands
| | - Frits Woonink
- Department of Forensic Medicine, Public Health Service Midden-Nederland, Zeist, The Netherlands
| | - Pieter A Doevendans
- Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Henk C van Weert
- Department of General Practice, Academic Medical Center, Amsterdam, The Netherlands
| | - Arthur A M Wilde
- Department of Clinical and Experimental Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
| | - Arend Mosterd
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands Department of Cardiology, Meander Medical Center, Amersfoort, The Netherlands
| | - Irene M van Langen
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Risk of cardiovascular abnormalities in relatives of SUDEP victims: How should we proceed? Epilepsy Behav 2015; 45:223-4. [PMID: 25819951 DOI: 10.1016/j.yebeh.2015.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 01/16/2015] [Indexed: 11/20/2022]
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Asif IM, Harmon KG. The Role of Screening for Sudden Cardiac Death in Young Competitive Athletes: A Critical Review. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2015. [DOI: 10.1007/s40141-014-0072-z] [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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Hinojar R, Botnar R, Kaski JC, Prasad S, Nagel E, Puntmann VO. Individualized cardiovascular risk assessment by cardiovascular magnetic resonance. Future Cardiol 2015; 10:273-89. [PMID: 24762254 DOI: 10.2217/fca.13.102] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Cardiovascular magnetic resonance (CMR) is gaining clinical importance in preventive medicine. Evidence on diagnostic accuracy and prognostic value, in addition to the development of faster imaging, increased availability of equipment and imaging expertise have led to a wide-spread use of CMR in a growing number of clinical indications. The first part of this review summarizes the role of CMR biomarkers for risk assessment focusing on the patients groups that benefit from the use of CMR. In the second part, the future directions for CMR are discussed and their role in prevention of cardiovascular disease.
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Affiliation(s)
- Rocio Hinojar
- Cardiovascular Imaging Department, Division of Imaging Sciences & Biomedical Engineering, King's College London, London, UK
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Post-mortem genetic analysis in juvenile cases of sudden cardiac death. Forensic Sci Int 2014; 245:30-7. [PMID: 25447171 DOI: 10.1016/j.forsciint.2014.10.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 09/18/2014] [Accepted: 10/04/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND The reason behind a sudden death of a young individual remains unknown in up to 50% of postmortem cases. Pathogenic mutations in genes encoding heart proteins are known to cause sudden cardiac death. OBJECTIVE The aim of our study was to ascertain whether genetic alterations could provide an explanation for sudden cardiac death in a juvenile cohort with no-conclusive cause of death after comprehensive autopsy. METHODS Twenty-nine cases <15 years showing no-conclusive cause of death after a complete autopsy were studied. Genetic analysis of 7 main genes associated with sudden cardiac death was performed using Sanger technology in low quality DNA cases, while in good quality cases the analysis of 55 genes associated with sudden cardiac death was performed using Next Generation Sequencing technology. RESULTS Thirty-five genetic variants were identified in 12 cases (41.37%). Ten genetic/variants in genes encoding cardiac ion channels were identified in 8 cases (27.58%). We also identified 9 cases (31.03%) carrying 25 genetic variants in genes encoding structural cardiac proteins. Nine cases carried more than one genetic variation, 5 of them combining structural and non-structural genes. CONCLUSIONS Our study supports the inclusion of molecular autopsy in forensic routine protocols when no conclusive cause of death is identified. Around 40% of sudden cardiac death young cases carry a genetic variant that could provide an explanation for the cause of death. Because relatives could be at risk of sudden cardiac death, our data reinforce their need of clinical assessment and, if indicated, of genetic analysis.
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van der Werf C, Stiekema L, Tan HL, Hofman N, Alders M, van der Wal AC, van Langen IM, Wilde AA. Low rate of cardiac events in first-degree relatives of diagnosis-negative young sudden unexplained death syndrome victims during follow-up. Heart Rhythm 2014; 11:1728-32. [DOI: 10.1016/j.hrthm.2014.05.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Indexed: 01/23/2023]
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The Danish Civil Registration System as a tool in epidemiology. Eur J Epidemiol 2014; 29:541-9. [PMID: 24965263 DOI: 10.1007/s10654-014-9930-3] [Citation(s) in RCA: 2361] [Impact Index Per Article: 236.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 06/10/2014] [Indexed: 02/07/2023]
Abstract
The methodological advances in epidemiology have facilitated the use of the Danish Civil Registration System (CRS) in ways not previously described systematically. We reviewed the CRS and its use as a research tool in epidemiology. We obtained information from the Danish Law on Civil Registration and the Central Office of Civil Registration, and used existing literature to provide illustrative examples of its use. The CRS is an administrative register established on April 2, 1968. It contains individual-level information on all persons residing in Denmark (and Greenland as of May 1, 1972). By January 2014, the CRS had cumulatively registered 9.5 million individuals and more than 400 million person-years of follow-up. A unique ten-digit Civil Personal Register number assigned to all persons in the CRS allows for technically easy, cost-effective, and unambiguous individual-level record linkage of Danish registers. Daily updated information on migration and vital status allows for nationwide cohort studies with virtually complete long-term follow-up on emigration and death. The CRS facilitates sampling of general population comparison cohorts, controls in case-control studies, family cohorts, and target groups in population surveys. The data in the CRS are virtually complete, have high accuracy, and can be retrieved for research purposes while protecting the anonymity of Danish residents. In conclusion, the CRS is a key tool for epidemiological research in Denmark.
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Risgaard B, Winkel BG, Jabbari R, Behr ER, Ingemann-Hansen O, Thomsen JL, Ottesen GL, Gislason GH, Bundgaard H, Haunsø S, Holst AG, Tfelt-Hansen J. Burden of Sudden Cardiac Death in Persons Aged 1 to 49 Years. Circ Arrhythm Electrophysiol 2014; 7:205-11. [DOI: 10.1161/circep.113.001421] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Knowledge of the burden and causes of sudden cardiac death (SCD) is sparse in persons aged <50 years; better understanding is needed to lower the risk of SCD. The aim of this study was to report SCD incidence rates and autopsy findings in persons aged 1 to 49 years.
Methods and Results—
All deaths in persons aged 1 to 49 years were included in 2007 to 2009. Death certificates were reviewed by 2 physicians. History of previous admissions to hospital was assessed, and discharge summaries were read. Sudden unexpected death cases were identified and autopsy reports were collected. In the 3-year study period, there were 7849 deaths of which we identified 893 (11%) SCD cases. The annual incidence rate per 100 000 persons increased from 2.3 (95% confidence interval, 2.0–2.7) to 21.7 (95% confidence interval, 20.2–23.4) in persons aged 1 to 35 and 36 to 49 years, respectively. Coronary artery disease was the most common cause of death and was found in 158 (36%) autopsied cases, followed by 135 (31%) cases of sudden unexplained death.
Conclusions—
In a nationwide cohort of persons aged <50 years, the annual incidence rate of SCD was ≈10× higher in persons aged 36 to 49 years than in persons aged 1 to 35 years. Notably, coronary artery disease was the most common cause of SCD, followed by unexplained deaths. These findings may help in developing strategies to prevent SCD in the future.
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Affiliation(s)
- Bjarke Risgaard
- From the Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC) (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), Laboratory of Molecular Cardiology (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), and Unit for Inherited Cardiac Diseases, Department of Cardiology (H.B.), The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Cardiovascular Sciences Research Centre, St George’s University of London, London, United Kingdom (E.R.B.); Department of Forensic
| | - Bo Gregers Winkel
- From the Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC) (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), Laboratory of Molecular Cardiology (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), and Unit for Inherited Cardiac Diseases, Department of Cardiology (H.B.), The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Cardiovascular Sciences Research Centre, St George’s University of London, London, United Kingdom (E.R.B.); Department of Forensic
| | - Reza Jabbari
- From the Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC) (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), Laboratory of Molecular Cardiology (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), and Unit for Inherited Cardiac Diseases, Department of Cardiology (H.B.), The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Cardiovascular Sciences Research Centre, St George’s University of London, London, United Kingdom (E.R.B.); Department of Forensic
| | - Elijah R. Behr
- From the Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC) (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), Laboratory of Molecular Cardiology (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), and Unit for Inherited Cardiac Diseases, Department of Cardiology (H.B.), The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Cardiovascular Sciences Research Centre, St George’s University of London, London, United Kingdom (E.R.B.); Department of Forensic
| | - Ole Ingemann-Hansen
- From the Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC) (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), Laboratory of Molecular Cardiology (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), and Unit for Inherited Cardiac Diseases, Department of Cardiology (H.B.), The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Cardiovascular Sciences Research Centre, St George’s University of London, London, United Kingdom (E.R.B.); Department of Forensic
| | - Jørgen Lange Thomsen
- From the Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC) (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), Laboratory of Molecular Cardiology (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), and Unit for Inherited Cardiac Diseases, Department of Cardiology (H.B.), The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Cardiovascular Sciences Research Centre, St George’s University of London, London, United Kingdom (E.R.B.); Department of Forensic
| | - Gyda Lolk Ottesen
- From the Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC) (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), Laboratory of Molecular Cardiology (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), and Unit for Inherited Cardiac Diseases, Department of Cardiology (H.B.), The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Cardiovascular Sciences Research Centre, St George’s University of London, London, United Kingdom (E.R.B.); Department of Forensic
| | - Gunnar H. Gislason
- From the Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC) (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), Laboratory of Molecular Cardiology (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), and Unit for Inherited Cardiac Diseases, Department of Cardiology (H.B.), The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Cardiovascular Sciences Research Centre, St George’s University of London, London, United Kingdom (E.R.B.); Department of Forensic
| | - Henning Bundgaard
- From the Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC) (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), Laboratory of Molecular Cardiology (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), and Unit for Inherited Cardiac Diseases, Department of Cardiology (H.B.), The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Cardiovascular Sciences Research Centre, St George’s University of London, London, United Kingdom (E.R.B.); Department of Forensic
| | - Stig Haunsø
- From the Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC) (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), Laboratory of Molecular Cardiology (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), and Unit for Inherited Cardiac Diseases, Department of Cardiology (H.B.), The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Cardiovascular Sciences Research Centre, St George’s University of London, London, United Kingdom (E.R.B.); Department of Forensic
| | - Anders Gaarsdal Holst
- From the Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC) (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), Laboratory of Molecular Cardiology (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), and Unit for Inherited Cardiac Diseases, Department of Cardiology (H.B.), The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Cardiovascular Sciences Research Centre, St George’s University of London, London, United Kingdom (E.R.B.); Department of Forensic
| | - Jacob Tfelt-Hansen
- From the Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC) (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), Laboratory of Molecular Cardiology (B.R., B.G.W., R.J., S.H., A.G.H., J.T.-H.), and Unit for Inherited Cardiac Diseases, Department of Cardiology (H.B.), The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Cardiovascular Sciences Research Centre, St George’s University of London, London, United Kingdom (E.R.B.); Department of Forensic
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Kumar S, Peters S, Thompson T, Morgan N, Maccicoca I, Trainer A, Zentner D, Kalman JM, Winship I, Vohra JK. Familial cardiological and targeted genetic evaluation: Low yield in sudden unexplained death and high yield in unexplained cardiac arrest syndromes. Heart Rhythm 2013; 10:1653-60. [DOI: 10.1016/j.hrthm.2013.08.022] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Indexed: 11/26/2022]
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van der Werf C, Onderwater AT, van Langen IM, Smets EMA. Experiences, considerations and emotions relating to cardiogenetic evaluation in relatives of young sudden cardiac death victims. Eur J Hum Genet 2013; 22:192-6. [PMID: 23736216 DOI: 10.1038/ejhg.2013.126] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 04/07/2013] [Accepted: 05/10/2013] [Indexed: 11/09/2022] Open
Abstract
Relatives of young sudden cardiac death (SCD) victims are at increased risk of carrying a potentially fatal inherited cardiac disease. Hence, it is recommended to perform an autopsy on the victim and to refer his or her relatives to a cardiogenetics clinic for a full evaluation to identify those at risk and allow preventive measures to be taken. However, at present, the number of families attending a cardiogenetics clinic after the SCD of a young relative is low in the Netherlands. We performed a qualitative study and report on the experiences and attitudes of first-degree relatives who attended a cardiogenetics clinic for evaluation. In total, we interviewed nine first-degree relatives and one spouse of seven SCD victims about their experiences, considerations and emotions before attendance and at the first stage of the cardiogenetic evaluation before DNA results were available. Interviews were transcribed verbatim and analysed. Medical professionals did not have an important role in informing or referring relatives to a cardiogenetics clinic. Importantly, all participants indicated that they would have appreciated a more directive approach from medical professionals, because their mourning process hampered their own search for information and decision-making. A need to understand the cause of death and wanting to prevent another SCD event occurring in the family were the most important reasons for attending a clinic. There are possibilities to improve the information process and better support their decision-making. The multidisciplinary cardiogenetic evaluation was appreciated, but could be improved by minor changes in the way it is implemented.
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Affiliation(s)
- Christian van der Werf
- Department of Cardiology, Heart Failure Research Centre, Academic Medical Centre, Amsterdam, The Netherlands
| | - Astrid T Onderwater
- Department of Medical Psychology, Academic Medical Centre/University of Amsterdam, Amsterdam, The Netherlands
| | - Irene M van Langen
- Department of Genetics, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Ellen M A Smets
- Department of Medical Psychology, Academic Medical Centre/University of Amsterdam, Amsterdam, The Netherlands
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Theilade J, Kanters J, Henriksen FL, Gilså-Hansen M, Svendsen JH, Eschen O, Toft E, Reimers JI, Tybjærg-Hansen A, Christiansen M, Jensen HK, Bundgaard H. Cascade Screening in Families with Inherited Cardiac Diseases Driven by Cardiologists: Feasibility and Nationwide Outcome in Long QT Syndrome. Cardiology 2013; 126:131-7. [DOI: 10.1159/000350825] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 03/17/2013] [Indexed: 01/17/2023]
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