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Binder JS, Weidemann F, Schoser B, Niemann M, Machann W, Beer M, Plank G, Schmidt A, Bisping E, Poparic I, Lafer I, Stojakovic T, Quasthoff S, Vincent JB, Rienmueller R, Speicher MR, Berghold A, Pieske B, Windpassinger C. Spongious Hypertrophic Cardiomyopathy in Patients With Mutations in the Four-and-a-Half LIM Domain 1 Gene. ACTA ACUST UNITED AC 2012; 5:490-502. [DOI: 10.1161/circgenetics.111.962332] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
X-linked myopathy with postural muscle atrophy is a novel X-linked myopathy caused by mutations in the four-and-a-half LIM domain 1 gene (FHL1). Cardiac involvement was suspected in initial publications. We now systematically analyzed the association of the
FHL1
genotype with the cardiac phenotype to establish a potential cardiac involvement in the disease.
Methods and Results—
Seventeen male patients and 23 female mutation carriers were compared with healthy controls. Every patient underwent a comprehensive clinical and cardiovascular workup. ECG abnormalities occurred frequently in affected males and were less frequent in heterozygous females. Both male and female mutation carriers had increased myocardial mass (affected males=115.1±25.3 g/m
2
; heterozygous females=95.1±19.6 g/m
2
; controls=89.0±15.6 g/m
2
and 72.6±12.6 g/m
2
; respectively) with increased wall thickness (typically midventricular and apical segments) mainly in affected males. Longitudinal systolic function was reduced in affected males (radial systolic strain: affected males=24.6±11.8%; male controls=43.2±14.8%;
P
=0.002). Diastolic dysfunction occurred in both affected males and heterozygous females. Cardiac MRI revealed a morphological hallmark of X-linked myopathy with postural muscle atrophy; a characteristic spongious structure and replacement fibrosis indicated by late enhancement could be detected in most affected males. X-linked myopathy with postural muscle atrophy was associated with reduced exercise capacity in affected males but not in heterozygous female mutation carriers.
Conclusions—
X-linked myopathy with postural muscle atrophy patients consistently showed electrical, functional, and characteristic morphological cardiac abnormalities that translate into reduced exercise capacity. Reduced systolic and diastolic function is associated with a novel type of spongious hypertrophic cardiomyopathy. An unexpected finding was that some cardiac abnormalities were also present in heterozygous female mutation carriers.
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Affiliation(s)
- Josepha S. Binder
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
| | - Frank Weidemann
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
| | - Benedikt Schoser
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
| | - Markus Niemann
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
| | - Wolfram Machann
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
| | - Meinrad Beer
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
| | - Gernot Plank
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
| | - Albrecht Schmidt
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
| | - Egbert Bisping
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
| | - Ivana Poparic
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
| | - Ingrid Lafer
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
| | - Tatjana Stojakovic
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
| | - Stefan Quasthoff
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
| | - John B. Vincent
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
| | - Rainer Rienmueller
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
| | - Michael R. Speicher
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
| | - Andrea Berghold
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
| | - Burkert Pieske
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
| | - Christian Windpassinger
- From the Department of Cardiology (J.S.B., A.S., E.B., I.L., B.P.), Institute of Human Genetics (I.P., I.L., M.R.S., C.W.), Department of Neurology (S.Q.), Department of Radiology (R.R.), Institute of Biophysics (G.P.), Clinical Institute of Medical & Chemical Laboratory Diagnostics (T.S.), and Institute for Medical Informatics, Statistics & Documentation, Medical University of Graz, Austria (A.B.); Molecular Neuropsychiatry & Development Lab, Neurogenetics Section, Centre for Addiction
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23
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Kim SW, Park SW, Lim S, Kwon SU, Hoi YJ, Park MK, Lee S, Lee SH, Park JE, Jeon E. Amount of left ventricular hypertrophy determines the plasma N-terminal pro-brain natriuretic peptide level in patients with hypertrophic cardiomyopathy and normal left ventricular ejection fraction. Clin Cardiol 2006; 29:155-60. [PMID: 16649724 PMCID: PMC6654112 DOI: 10.1002/clc.4960290406] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND N-terminal pro-brain natriuretic peptide (NT-proBNP) is increased in patients with hypertrophic cardiomyopathy (HCM); however, the determinants of NT-proBNP level have not been clarified in HCM. HYPOTHESIS This study was performed to determine the relationship between NT-proBNP levels and various echocardiographic variables of patients with HCM and normal left ventricular ejection fraction (LVEF). METHODS We assessed plasma NT-proBNP levels and echocardiographic variables of 36 patients (19 men, 58 +/- 14 years) with HCM and an LVEF of > or = 55%. Echocardiographic variables measured were LV wall thickness, end-diastolic LV internal dimension (LVIDd) and volume (LVEDV), LV mass, and LV mass index (LV mass/body surface area, LVMI). Left ventricular outflow tract pressure gradient, transmitral E and A velocities, deceleration time (DT) of the transmitral E wave, and septal annular E' velocity were measured by Doppler technique. The relationship between echocardiographic variables and plasma NT-proBNP level was analyzed. RESULTS The plasma NT-proBNP level was 775.2 +/- 994.2 pg/ml (range 33.1-4729.0 pg/ml). It showed positive correlations with LV end-diastolic septal thickness (r = 0.39, p = 0.010) and LVMI (r = 0.27, p = 0.050), while it revealed negative correlations with LVIDd (r = -0.44, p = 0.004), LVEDV (r = -0.44, p = 0.004) and DT(r = -0.31,p = 0.034). The NT-proBNP level was higher in the patients with than in those without LV diastolic dysfunction (p = 0.033) and was independently related to LVIDd (p = 0.001), LVMI (p = 0.006) and DT (p = 0.031) by multivariate analysis. CONCLUSION In patients with HCM and normal LVEF, the amount of LV hypertrophy and LV diastolic dysfunction may exert a significant role in determining plasma NT-proBNP level.
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Affiliation(s)
- Seon Woon Kim
- Department of Medicine, Cardiac and Vascular Center, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Seung Woo Park
- Department of Medicine, Cardiac and Vascular Center, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Seong‐Hoon Lim
- Department of Medicine, Cardiac and Vascular Center, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Sung Uk Kwon
- Department of Medicine, Cardiac and Vascular Center, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Yu Jeong Hoi
- Department of Medicine, Cardiac and Vascular Center, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Man Ki Park
- Department of Medicine, Cardiac and Vascular Center, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Sang‐Chol Lee
- Department of Medicine, Cardiac and Vascular Center, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Sang Hoon Lee
- Department of Medicine, Cardiac and Vascular Center, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Jeong Euy Park
- Department of Medicine, Cardiac and Vascular Center, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Eun‐Seok Jeon
- Department of Medicine, Cardiac and Vascular Center, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
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