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Chmielewski P, Kowalik I, Truszkowska G, Michalak E, Ponińska J, Sadowska A, Kalin K, Jaworski K, Minota I, Krzysztoń-Russjan J, Zieliński T, Płoski R, Bilińska ZT. Troponin T Assessment Allows for Identification of Mutation Carriers among Young Relatives of Patients with LMNA-Related Dilated Cardiomyopathy. J Clin Med 2024; 13:3164. [PMID: 38892874 PMCID: PMC11172723 DOI: 10.3390/jcm13113164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Background:LMNA-related dilated cardiomyopathy (LMNA-DCM) caused by mutations in the lamin A/C gene (LMNA) is one of the most common forms of hereditary DCM. Due to the high risk of mutation transmission to offspring and the high incidence of ventricular arrhythmia and sudden death even before the onset of heart failure symptoms, it is very important to identify LMNA-mutation carriers. However, many relatives of LMNA-DCM patients do not report to specialized centers for clinical or genetic screening. Therefore, an easily available tool to identify at-risk subjects is needed. Methods: We compared two cohorts of young, asymptomatic relatives of DCM patients who reported for screening: 29 LMNA mutation carriers and 43 individuals from the control group. Receiver operating characteristic (ROC) curves for potential indicators of mutation carriership status were analyzed. Results: PR interval, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and high-sensitivity cardiac troponin T (hscTnT) serum levels were higher in the LMNA mutation carrier cohort. Neither group differed significantly with regard to creatinine concentration or left ventricular ejection fraction. The best mutation carriership discriminator was hscTnT level with an optimal cut-off value at 5.5 ng/L, for which sensitivity and specificity were 86% and 93%, respectively. The median hscTnT level was 11.0 ng/L in LMNA mutation carriers vs. <3.0 ng/L in the control group, p < 0.001. Conclusions: Wherever access to genetic testing is limited, LMNA mutation carriership status can be assessed reliably using the hscTnT assay. Among young symptomless relatives of LMNA-DCM patients, a hscTnT level >5.5 ng/L strongly suggests mutation carriers.
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Affiliation(s)
- Przemysław Chmielewski
- Unit for Screening Studies in Inherited Cardiovascular Diseases, National Institute of Cardiology, 04-628 Warsaw, Poland; (P.C.); (E.M.)
| | - Ilona Kowalik
- Clinical Research Support Centre, National Institute of Cardiology, 04-628 Warsaw, Poland
| | - Grażyna Truszkowska
- Department of Medical Biology, National Institute of Cardiology, 04-628 Warsaw, Poland
| | - Ewa Michalak
- Unit for Screening Studies in Inherited Cardiovascular Diseases, National Institute of Cardiology, 04-628 Warsaw, Poland; (P.C.); (E.M.)
| | - Joanna Ponińska
- Department of Medical Biology, National Institute of Cardiology, 04-628 Warsaw, Poland
| | - Agnieszka Sadowska
- Unit for Screening Studies in Inherited Cardiovascular Diseases, National Institute of Cardiology, 04-628 Warsaw, Poland; (P.C.); (E.M.)
| | - Katarzyna Kalin
- 1st Department of Arrhythmia, National Institute of Cardiology, 04-628 Warsaw, Poland
| | - Krzysztof Jaworski
- Department of Coronary Artery Disease and Cardiac Rehabilitation, National Institute of Cardiology, 04-628 Warsaw, Poland
| | - Ilona Minota
- Department of Medical Biology, National Institute of Cardiology, 04-628 Warsaw, Poland
| | | | - Tomasz Zieliński
- Department of Heart Failure and Transplantology, National Institute of Cardiology, 04-628 Warsaw, Poland
| | - Rafał Płoski
- Department of Medical Biology, National Institute of Cardiology, 04-628 Warsaw, Poland
| | - Zofia Teresa Bilińska
- Unit for Screening Studies in Inherited Cardiovascular Diseases, National Institute of Cardiology, 04-628 Warsaw, Poland; (P.C.); (E.M.)
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Finsterer J, Pölzl G. Novel Phenotype of LMNA Variant c.154C>G Affecting Heart, Liver, and Lipid and Iron Metabolism: A Case Report. Cureus 2023; 15:e38860. [PMID: 37303410 PMCID: PMC10256956 DOI: 10.7759/cureus.38860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 06/13/2023] Open
Abstract
Mutations in the LMNA gene cause heterogeneous phenotypes such as myopathy, progeroid syndromes, hereditary neuropathies, cardiomyopathies, or lipodystrophies. A specific LMNA mutation manifesting as dilated cardiomyopathy (dCMP), and iron metabolism disorder has not been reported. The patient is a 50-year-old female with palpitations and fatigue since childhood, hyperlipidemia for 25 years, gastroesophageal reflux for 20 years, arterial hypertension for eight years, and iron deficiency for one year, requiring intravenous iron supplementation. Family history was positive for dCMP, malignant ventricular arrhythmias (MVAs), and sudden cardiac death (SCD). She was diagnosed with dCMP at the age of 49. Genetic workup revealed the variant c.154C>G (p.Leu52Val) in LMNA, which was also found in two female cousins. Because of ventricular tachycardia in the long-term ECG recordings, an implantable cardioverter-defibrillator (ICD) was implanted in addition to antiarrhythmic, antihypertensive, heart failure, and lipid-lowering treatment. With this therapy, the patient remained in stable condition during the one-year follow-up and was able to successfully carry out her job. In summary, this case shows that the variant c.154C>G (p.Leu52Val) in LMNA manifests not only with dCMP, but also with hyperlipidemia, steatosis, gastroesophageal reflux, arterial hypertension, and iron deficiency. Primary prophylaxis with an ICD and additional symptomatic treatment can stabilise the condition and eventually prevent familial SCD.
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Affiliation(s)
- Josef Finsterer
- Neurology, Neurology and Neurophysiology Center, Vienna, AUT
| | - Gerhard Pölzl
- Internal Medicine, Medical University of Innsbruck, Innsbruck, AUT
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Chmielewski P, Michalak E, Kowalik I, Franaszczyk M, Sobieszczanska-Malek M, Truszkowska G, Stepien-Wojno M, Biernacka EK, Foss-Nieradko B, Lewandowski M, Oreziak A, Bilinska M, Kusmierczyk M, Tesson F, Grzybowski J, Zielinski T, Ploski R, Bilinska ZT. Can Circulating Cardiac Biomarkers Be Helpful in the Assessment of LMNA Mutation Carriers? J Clin Med 2020; 9:jcm9051443. [PMID: 32408651 PMCID: PMC7290314 DOI: 10.3390/jcm9051443] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/27/2020] [Accepted: 05/08/2020] [Indexed: 12/20/2022] Open
Abstract
Mutations in the lamin A/C gene are variably phenotypically expressed; however, it is unclear whether circulating cardiac biomarkers are helpful in the detection and risk assessment of cardiolaminopathies. We sought to assess (1) clinical characteristics including serum biomarkers: high sensitivity troponin T (hsTnT) and N-terminal prohormone brain natriuretic peptide (NT-proBNP) in clinically stable cardiolaminopathy patients, and (2) outcome among pathogenic/likely pathogenic lamin A/C gene (LMNA) mutation carriers. Our single-centre cohort included 53 patients from 21 families. Clinical, laboratory, follow-up data were analysed. Median follow-up was 1522 days. The earliest abnormality, emerging in the second and third decades of life, was elevated hsTnT (in 12% and in 27% of patients, respectively), followed by the presence of atrioventricular block, heart failure, and malignant ventricular arrhythmia (MVA). In patients with missense vs. other mutations, we found no difference in MVA occurrence and, surprisingly, worse transplant-free survival. Increased levels of both hsTnT and NT-proBNP were strongly associated with MVA occurrence (HR > 13, p ≤ 0.02 in both) in univariable analysis. In multivariable analysis, NT-proBNP level > 150 pg/mL was the only independent indicator of MVA. We conclude that assessment of circulating cardiac biomarkers may help in the detection and risk assessment of cardiolaminopathies.
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Affiliation(s)
- Przemyslaw Chmielewski
- Unit for Screening Studies in Inherited Cardiovascular Diseases, National Institute of Cardiology, 04-628 Warsaw, Poland; (P.C.); (E.M.); (M.S.-W.); (B.F.-N.)
| | - Ewa Michalak
- Unit for Screening Studies in Inherited Cardiovascular Diseases, National Institute of Cardiology, 04-628 Warsaw, Poland; (P.C.); (E.M.); (M.S.-W.); (B.F.-N.)
| | - Ilona Kowalik
- Department of Coronary Artery Disease and Cardiac Rehabilitation, National Institute of Cardiology, 04-628 Warsaw, Poland;
| | - Maria Franaszczyk
- Molecular Biology Laboratory, Department of Medical Biology, National Institute of Cardiology, 04-628 Warsaw, Poland; (M.F.); (G.T.)
| | | | - Grazyna Truszkowska
- Molecular Biology Laboratory, Department of Medical Biology, National Institute of Cardiology, 04-628 Warsaw, Poland; (M.F.); (G.T.)
| | - Malgorzata Stepien-Wojno
- Unit for Screening Studies in Inherited Cardiovascular Diseases, National Institute of Cardiology, 04-628 Warsaw, Poland; (P.C.); (E.M.); (M.S.-W.); (B.F.-N.)
| | | | - Bogna Foss-Nieradko
- Unit for Screening Studies in Inherited Cardiovascular Diseases, National Institute of Cardiology, 04-628 Warsaw, Poland; (P.C.); (E.M.); (M.S.-W.); (B.F.-N.)
| | - Michal Lewandowski
- 2nd Department of Arrhythmia, National Institute of Cardiology, 04-628 Warsaw, Poland;
| | - Artur Oreziak
- 1st Department of Arrhythmia, National Institute of Cardiology, 04-628 Warsaw, Poland; (A.O.); (M.B.)
| | - Maria Bilinska
- 1st Department of Arrhythmia, National Institute of Cardiology, 04-628 Warsaw, Poland; (A.O.); (M.B.)
| | - Mariusz Kusmierczyk
- Department of Cardiac Surgery and Transplantology, National Institute of Cardiology, 04-628 Warsaw, Poland;
| | - Frédérique Tesson
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Jacek Grzybowski
- Department of Cardiomyopathy, National Institute of Cardiology, 04-628 Warsaw, Poland;
| | - Tomasz Zielinski
- Department of Heart Failure and Transplantology, National Institute of Cardiology, 04-628 Warsaw, Poland; (M.S.-M.); (T.Z.)
| | - Rafal Ploski
- Department of Medical Genetics, Medical University of Warsaw, 02-106 Warsaw, Poland;
| | - Zofia T. Bilinska
- Unit for Screening Studies in Inherited Cardiovascular Diseases, National Institute of Cardiology, 04-628 Warsaw, Poland; (P.C.); (E.M.); (M.S.-W.); (B.F.-N.)
- Correspondence: ; Tel.: +48-223434711
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Abstract
Dilated cardiomyopathy (DCM) represents one of the primary cardiomyopathies and may lead to heart failure and sudden death. Until recently, ventricular arrhythmias were considered to be a direct consequence of the systolic dysfunction of the left ventricle (LV) and guidelines for implantable cardioverter defibrillator implantation were established on this basis. However, the identification of heritable dilated cardiomyopathy phenotypes that presented with mildly impaired or moderate LV dysfunction, with or without chamber dilatation, and ventricular arrhythmias exceeding the degree of the underlying morphological abnormalities lead to the identification of the arrhythmogenic phenotypes and genotypes of DCM. This subset of DCM patients presents phenotypic and in many cases genotypic overlaps with left dominant arrhythmogenic cardiomyopathy (LDAC). LMNA, SCN5A, FLNC, TTN, and RBM20 are the main genes responsible for arrhythmogenic DCM. Moreover, desmosomal genes such as DSP and other non-desmosomal such as DES and PLN have been associated with both LDAC and arrhythmogenic DCM. The aim of this review is to highlight the importance of genetic profiling among DCM patients with disproportionate arrhythmic burden and the significance of the electrocardiogram, cardiac magnetic resonance, Holter monitoring, detailed family history, and other assays in order to identify red flags for arrhythmogenic DCM and proceed to an early preventive approach for sudden cardiac death. A special consideration was given to the phenotypic and genotypic overlap with LDAC. The role of myocarditis as a common disease expression of LDAC and arrhythmogenic DCM is also analyzed supporting the premise of their phenotypic overlap.
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Affiliation(s)
- Thomas Zegkos
- 1st Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece.
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Bhattacharjee P, Dasgupta D, Sengupta K. DCM associated LMNA mutations cause distortions in lamina structure and assembly. Biochim Biophys Acta Gen Subj 2017; 1861:2598-2608. [PMID: 28844980 DOI: 10.1016/j.bbagen.2017.08.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 08/01/2017] [Accepted: 08/11/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND A and B-type lamins are integral scaffolding components of the nuclear lamina which impart rigidity and shape to all metazoan nuclei. Over 450 mutations in A-type lamins are associated with 16 human diseases including dilated cardiomyopathy (DCM). Here, we show that DCM mutants perturb the self-association of lamin A (LA) and it's binding with lamin B1 (LB1). METHODS We used confocal and superresolution microscopy (NSIM) to study the effect of LA mutants on the nuclear lamina. We further used circular dichroism, fluorescence spectroscopy and isothermal titration calorimetry (ITC) to probe the structural modulations, self-association and heteropolymeric association of mutant LA. RESULTS Transfection of mutants in cultured cell lines result in the formation of nuclear aggregates of varied size and distribution. Endogenous LB1 is sequestered into these aggregates. This is consistent with the ten-fold increase in association constant of the mutant proteins compared to the wild type. These mutants exhibit differential heterotypic interaction with LB1, along with significant secondary and tertiary structural alterations of the interacting proteins. Thermodynamic studies demonstrate that the mutants bind to LB1 with different stoichiometry, affinity and energetics. CONCLUSIONS In this report we show that increased self-association propensity of mutant LA modulates the LA-LB1 interaction and precludes the formation of an otherwise uniform laminar network. GENERAL SIGNIFICANCE Our results might highlight the role of homotypic and heterotypic interactions of LA in the pathogenesis of DCM and hence laminopathies in the broader sense.
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Affiliation(s)
- Pritha Bhattacharjee
- Biophysics and Structural Genomics Division, Saha Institute of Nuclear Physics, 1/AF Bidhannagar, Kolkata 700064, India
| | - Dipak Dasgupta
- Biophysics and Structural Genomics Division, Saha Institute of Nuclear Physics, 1/AF Bidhannagar, Kolkata 700064, India.
| | - Kaushik Sengupta
- Biophysics and Structural Genomics Division, Saha Institute of Nuclear Physics, 1/AF Bidhannagar, Kolkata 700064, India.
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Zaragoza MV, Nguyen CHH, Widyastuti HP, McCarthy LA, Grosberg A. Dupuytren's and Ledderhose Diseases in a Family with LMNA-Related Cardiomyopathy and a Novel Variant in the ASTE1 Gene. Cells 2017; 6:E40. [PMID: 29104234 PMCID: PMC5753070 DOI: 10.3390/cells6040040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 10/07/2017] [Accepted: 10/27/2017] [Indexed: 12/23/2022] Open
Abstract
Dupuytren's disease (palmar fibromatosis) involves nodules in fascia of the hand that leads to flexion contractures. Ledderhose disease (plantar fibromatosis) is similar with nodules of the foot. While clinical aspects are well-described, genetic mechanisms are unknown. We report a family with cardiac disease due to a heterozygous LMNA mutation (c.736C>T, p.Gln246Stop) with palmar/plantar fibromatosis and investigate the hypothesis that a second rare DNA variant increases the risk for fibrotic disease in LMNA mutation carriers. The proband and six family members were evaluated for the cardiac and hand/feet phenotypes and tested for the LMNA mutation. Fibroblast RNA studies revealed monoallelic expression of the normal LMNA allele and reduced lamin A/C mRNAs consistent with LMNA haploinsufficiency. A novel, heterozygous missense variant (c.230T>C, p.Val77Ala) in the Asteroid Homolog 1 (ASTE1) gene was identified as a potential risk factor in fibrotic disease using exome sequencing and family studies of five family members: four LMNA mutation carriers with fibromatosis and one individual without the LMNA mutation and no fibromatosis. With a possible role in epidermal growth factor receptor signaling, ASTE1 may contribute to the increased risk for palmar/plantar fibromatosis in patients with Lamin A/C haploinsufficiency.
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Affiliation(s)
- Michael V Zaragoza
- UCI Cardiogenomics Program, Department of Pediatrics, Division of Genetics & Genomics, School of Medicine, University of California, Irvine, Irvine, CA 92697, USA.
- Department of Biological Sciences, School of Medicine, University of California, Irvine, Irvine, CA 92697, USA.
| | - Cecilia H H Nguyen
- UCI Cardiogenomics Program, Department of Pediatrics, Division of Genetics & Genomics, School of Medicine, University of California, Irvine, Irvine, CA 92697, USA.
| | - Halida P Widyastuti
- UCI Cardiogenomics Program, Department of Pediatrics, Division of Genetics & Genomics, School of Medicine, University of California, Irvine, Irvine, CA 92697, USA.
- Department of Biological Sciences, School of Medicine, University of California, Irvine, Irvine, CA 92697, USA.
| | - Linda A McCarthy
- Department of Biomedical Engineering and The Edwards Lifesciences Center for Advanced Cardiovascular Technology, University of California, Irvine, Irvine, CA 92697, USA.
| | - Anna Grosberg
- Department of Biomedical Engineering and The Edwards Lifesciences Center for Advanced Cardiovascular Technology, University of California, Irvine, Irvine, CA 92697, USA.
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Kayvanpour E, Sedaghat-Hamedani F, Amr A, Lai A, Haas J, Holzer DB, Frese KS, Keller A, Jensen K, Katus HA, Meder B. Genotype-phenotype associations in dilated cardiomyopathy: meta-analysis on more than 8000 individuals. Clin Res Cardiol 2016; 106:127-139. [DOI: 10.1007/s00392-016-1033-6] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 08/23/2016] [Indexed: 02/06/2023]
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Marcos-Alonso S, Bautista-Hernandez V, Portela Torrón F. Successful cardiac transplantation in a patient with congenital generalized lipodystrophy. Pediatr Transplant 2016; 20:321-4. [PMID: 26821845 DOI: 10.1111/petr.12656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 11/30/2022]
Abstract
We report a case of a 12-yr-old boy referred to our unit with congenital generalized lipodystrophy and dilated cardiomyopathy related to a lamin gene mutation. He progressively developed end-stage heart failure and was referred for heart transplant evaluation. The patient's lipid profile, glucose level, and renal function were normal, and vascular retinopathy was ruled out. He underwent orthotopic bicaval HT and had an uneventful recovery. He was discharged home two wk after surgery with good graft function. During follow-up, he developed hyperglycemia and dyslipidemia, which were controlled by increasing leptin dose and starting oral antidiabetic drugs. The patient is currently doing well two yr after transplantation.
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Affiliation(s)
- Sonia Marcos-Alonso
- Congenital Heart Diseases and Pediatric Cardiology Unit, Pediatric Department, Hospital Materno Infantil, Complejo Hospitalario Universitario A Coruña, A Coruna, Spain
| | - Víctor Bautista-Hernandez
- Congenital Heart Diseases and Pediatric Cardiology Unit, Cardiac Surgery Department, Complejo Hospitalario Universitario A Coruña, A Coruna, Spain
| | - Francisco Portela Torrón
- Congenital Heart Diseases and Pediatric Cardiology Unit, Cardiac Surgery Department, Complejo Hospitalario Universitario A Coruña, A Coruna, Spain
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Franaszczyk M, Bilinska ZT, Sobieszczańska-Małek M, Michalak E, Sleszycka J, Sioma A, Małek ŁA, Kaczmarska D, Walczak E, Włodarski P, Hutnik Ł, Milanowska B, Dzielinska Z, Religa G, Grzybowski J, Zieliński T, Ploski R. The BAG3 gene variants in Polish patients with dilated cardiomyopathy: four novel mutations and a genotype-phenotype correlation. J Transl Med 2014; 12:192. [PMID: 25008357 PMCID: PMC4105391 DOI: 10.1186/1479-5876-12-192] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 06/25/2014] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND BAG3 gene mutations have been recently implicated as a novel cause of dilated cardiomyopathy (DCM). Our aim was to evaluate the prevalence of BAG3 mutations in Polish patients with DCM and to search for genotype-phenotype correlations. METHODS We studied 90 unrelated probands by direct sequencing of BAG3 exons and splice sites. Large deletions/insertions were screened for by quantitative real time polymerase chain reaction (qPCR). RESULTS We found 5 different mutations in 6 probands and a total of 21 mutations among their relatives: the known p.Glu455Lys mutation (2 families), 4 novel mutations: p.Gln353ArgfsX10 (c.1055delC), p.Gly379AlafsX45 (c.1135delG), p.Tyr451X (c.1353C>A) and a large deletion of 17,990 bp removing BAG3 exons 3-4. Analysis of mutation positive relatives of the probands from this study pooled with those previously reported showed higher DCM prevalence among those with missense vs. truncating mutations (OR = 8.33, P = 0.0058) as well as a difference in age at disease onset between the former and the latter in Kaplan-Meier survival analysis (P = 0.006). Clinical data from our study suggested that in BAG3 mutation carriers acute onset DCM with hemodynamic compromise may be triggered by infection. CONCLUSIONS BAG3 point mutations and large deletions are relatively frequent cause of DCM. Delayed DCM onset associated with truncating vs. non-truncating mutations may be important for genetic counseling.
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Affiliation(s)
- Maria Franaszczyk
- Laboratory of Molecular Biology, Institute of Cardiology, Warsaw, Alpejska 42 04-628, Poland
| | - Zofia T Bilinska
- Unit for Screening Studies in Inherited Cardiovascular Diseases, Institute of Cardiology, Warsaw, Alpejska 42 04-628, Poland
| | | | - Ewa Michalak
- Unit for Screening Studies in Inherited Cardiovascular Diseases, Institute of Cardiology, Warsaw, Alpejska 42 04-628, Poland
| | - Justyna Sleszycka
- Department of Cardiomyopathies, Institute of Cardiology, Warsaw, Alpejska 42 04-628, Poland
| | - Agnieszka Sioma
- Unit for Screening Studies in Inherited Cardiovascular Diseases, Institute of Cardiology, Warsaw, Alpejska 42 04-628, Poland
| | - Łukasz A Małek
- Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Alpejska 42 04-628, Poland
| | - Dorota Kaczmarska
- Unit for Screening Studies in Inherited Cardiovascular Diseases, Institute of Cardiology, Warsaw, Alpejska 42 04-628, Poland
| | - Ewa Walczak
- Department of Pathology, Institute of Rheumatology, Warsaw, Spartańska 1 02-637, Poland
| | - Paweł Włodarski
- The Department of Histology and Embryology, Centre of Biostructure, Medical University of Warsaw, Warsaw, Chałubińskiego 5 02-004, Poland
| | - Łukasz Hutnik
- The Department of Histology and Embryology, Centre of Biostructure, Medical University of Warsaw, Warsaw, Chałubińskiego 5 02-004, Poland
| | - Blanka Milanowska
- Unit for Screening Studies in Inherited Cardiovascular Diseases, Institute of Cardiology, Warsaw, Alpejska 42 04-628, Poland
| | - Zofia Dzielinska
- Department of Structural Heart Diseases, Institute of Cardiology, Warsaw, Alpejska 42 04-628, Poland
| | - Grzegorz Religa
- Department of Cardiac Surgery, Institute of Cardiology, Warsaw, Alpejska 42 04-628, Poland
| | - Jacek Grzybowski
- Department of Cardiomyopathies, Institute of Cardiology, Warsaw, Alpejska 42 04-628, Poland
| | - Tomasz Zieliński
- Department of Heart Failure and Transplantology, Institute of Cardiology, Warsaw, Alpejska 42 04-628, Poland
| | - Rafal Ploski
- Department of Medical Genetics, Centre of Biostructure, Medical University of Warsaw, Warsaw, Pawinskiego 3C 02-106, Poland
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