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Yoshinaga M, Kucho Y, Sarantuya J, Ninomiya Y, Horigome H, Ushinohama H, Shimizu W, Horie M. Genetic Characteristics of Children and Adolescents With Long-QT Syndrome Diagnosed by School-Based Electrocardiographic Screening Programs. Circ Arrhythm Electrophysiol 2014; 7:107-12. [DOI: 10.1161/circep.113.000426] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
A school-based electrocardiographic screening program has been developed in Japan. However, few data are available on the genetic characteristics of pediatric patients with long-QT syndrome who were diagnosed by this program.
Methods and Results—
A total of 117 unrelated probands aged ≤18 years were the subjects who were referred to our centers for genetic testing. Of these, 69 subjects diagnosed by the program formed the screened group. A total of 48 subjects were included in the clinical group and were diagnosed with long-QT syndrome–related symptoms, familial study, or by chance. Mutations were classified as radical, of high probability of pathogenicity, or of uncertain significance. Two subjects in the clinical group died. Genotypes were identified in 50 (72%) and 23 (48%) of subjects in the screened and clinical groups, respectively. Of the
KCNQ1
or
KCNH2
mutations, 31 of 33 (94%) in the screened group and 14 of 15 (93%) in the clinical group were radical and of high probability of pathogenicity. Prevalence of symptoms before (9/69 versus 31/48;
P
<0.0001) and after (12/69 versus 17/48;
P
=0.03) diagnosis was significantly lower in the screened group when compared with that in the clinical group although the QTc values, family history of long-QT syndrome, sudden death, and follow-up periods were not different between the groups.
Conclusions—
These data suggest that the screening program may be effective for early diagnosis of long-QT syndrome that may allow intervention before symptoms. In addition, screened patients should have follow-up equivalent to clinically identified patients.
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Affiliation(s)
- Masao Yoshinaga
- From the Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan (M.Y., Y.K., Y.N.); Department of Molecular Biology and Genetics, School of Bio-medicine, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia (J.S.); Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (H.H.); Department of Cardiology, Fukuoka Children’s Hospital and Medical Center for Infectious Diseases, Fukuoka, Japan (H.U.); Department of
| | - Yu Kucho
- From the Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan (M.Y., Y.K., Y.N.); Department of Molecular Biology and Genetics, School of Bio-medicine, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia (J.S.); Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (H.H.); Department of Cardiology, Fukuoka Children’s Hospital and Medical Center for Infectious Diseases, Fukuoka, Japan (H.U.); Department of
| | - Jav Sarantuya
- From the Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan (M.Y., Y.K., Y.N.); Department of Molecular Biology and Genetics, School of Bio-medicine, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia (J.S.); Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (H.H.); Department of Cardiology, Fukuoka Children’s Hospital and Medical Center for Infectious Diseases, Fukuoka, Japan (H.U.); Department of
| | - Yumiko Ninomiya
- From the Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan (M.Y., Y.K., Y.N.); Department of Molecular Biology and Genetics, School of Bio-medicine, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia (J.S.); Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (H.H.); Department of Cardiology, Fukuoka Children’s Hospital and Medical Center for Infectious Diseases, Fukuoka, Japan (H.U.); Department of
| | - Hitoshi Horigome
- From the Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan (M.Y., Y.K., Y.N.); Department of Molecular Biology and Genetics, School of Bio-medicine, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia (J.S.); Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (H.H.); Department of Cardiology, Fukuoka Children’s Hospital and Medical Center for Infectious Diseases, Fukuoka, Japan (H.U.); Department of
| | - Hiroya Ushinohama
- From the Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan (M.Y., Y.K., Y.N.); Department of Molecular Biology and Genetics, School of Bio-medicine, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia (J.S.); Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (H.H.); Department of Cardiology, Fukuoka Children’s Hospital and Medical Center for Infectious Diseases, Fukuoka, Japan (H.U.); Department of
| | - Wataru Shimizu
- From the Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan (M.Y., Y.K., Y.N.); Department of Molecular Biology and Genetics, School of Bio-medicine, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia (J.S.); Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (H.H.); Department of Cardiology, Fukuoka Children’s Hospital and Medical Center for Infectious Diseases, Fukuoka, Japan (H.U.); Department of
| | - Minoru Horie
- From the Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan (M.Y., Y.K., Y.N.); Department of Molecular Biology and Genetics, School of Bio-medicine, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia (J.S.); Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (H.H.); Department of Cardiology, Fukuoka Children’s Hospital and Medical Center for Infectious Diseases, Fukuoka, Japan (H.U.); Department of
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