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Jeong JH, Oh SK, Kim YG, Choi YY, Lee HS, Shim J, Park YM, Kim JH, Oh YS, Kim NH, Pak HN, On YK, Park HW, Hwang GS, Kim DK, Park YA, Park HS, Cho Y, Oh S, Choi JI, Kim YH. Clinical and Genetic Features of Korean Inherited Arrhythmia Probands. Korean Circ J 2023; 53:693-707. [PMID: 37653714 PMCID: PMC10625850 DOI: 10.4070/kcj.2023.0083] [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: 03/17/2023] [Revised: 05/30/2023] [Accepted: 06/13/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Inherited arrhythmia (IA) is a more common cause of sudden cardiac death in Asian population, but little is known about the genetic background of Asian IA probands. We aimed to investigate the clinical characteristics and analyze the genetic underpinnings of IA in a Korean cohort. METHODS This study was conducted in a multicenter cohort of the Korean IA Registry from 2014 to 2017. Genetic testing was performed using a next-generation sequencing panel including 174 causative genes of cardiovascular disease. RESULTS Among the 265 IA probands, idiopathic ventricular fibrillation (IVF) and Brugada Syndrome (BrS) was the most prevalent diseases (96 and 95 cases respectively), followed by long QT syndrome (LQTS, n=54). Two-hundred-sixteen probands underwent genetic testing, and 69 probands (31.9%) were detected with genetic variant, with yield of pathogenic or likely pathogenic variant as 6.4%. Left ventricular ejection fraction was significantly lower in genotype positive probands (54.7±11.3 vs. 59.3±9.2%, p=0.005). IVF probands showed highest yield of positive genotype (54.0%), followed by LQTS (23.8%), and BrS (19.5%). CONCLUSIONS There were significant differences in clinical characteristics and genetic yields among BrS, LQTS, and IVF. Genetic testing did not provide better yield for BrS and LQTS. On the other hand, in IVF, genetic testing using multiple gene panel might enable the molecular diagnosis of concealed genotype, which may alter future clinical diagnosis and management strategies.
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Affiliation(s)
- Joo Hee Jeong
- Division of Cardiology, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea
| | - Suk-Kyu Oh
- Division of Cardiology, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea
| | - Yun Gi Kim
- Division of Cardiology, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea
| | - Yun Young Choi
- Division of Cardiology, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea
| | - Hyoung Seok Lee
- Division of Cardiology, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea
| | - Jaemin Shim
- Division of Cardiology, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea
| | - Yae Min Park
- Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Jun-Hyung Kim
- Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Yong-Seog Oh
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Nam-Ho Kim
- Department of Internal Medicine, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
| | - Hui-Nam Pak
- Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Keun On
- Department of Internal Medicine, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyung Wook Park
- Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea
| | - Gyo-Seung Hwang
- Department of Cardiology, Ajou University School of Medicine, Suwon, Korea
| | - Dae-Kyeong Kim
- Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Young-Ah Park
- Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hyoung-Seob Park
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University College of Medicine, Daegu, Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Seil Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jong-Il Choi
- Division of Cardiology, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea.
| | - Young-Hoon Kim
- Division of Cardiology, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea
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2
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Zaveri S, Qu YS, Chahine M, Boutjdir M. Ethnic and racial differences in Asian populations with ion channelopathies associated with sudden cardiac death. Front Cardiovasc Med 2023; 10:1253479. [PMID: 37600027 PMCID: PMC10436680 DOI: 10.3389/fcvm.2023.1253479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 07/21/2023] [Indexed: 08/22/2023] Open
Abstract
Cardiovascular diseases are associated with several morbidities and are the most common cause of worldwide disease-related fatalities. Studies show that treatment and outcome-related differences for cardiovascular diseases disproportionately affect minorities in the United States. The emergence of ethnic and racial differences in sudden cardiac death (SCD) and related ion channelopathies complicates cardiovascular disease prevention, diagnosis, management, prognosis, and treatment objectives for patients and physicians alike. This review compiles and synthesizes current research in cardiac ion channelopathies and genetic disorders in Asian populations, an underrepresented population in cardiovascular literature. We first present a brief introduction to SCD, noting relevant observations and statistics from around the world, including Asian populations. We then examined existing differences between Asian and White populations in research, treatment, and outcomes related to cardiac ion channelopathies and SCD, showing progression in thought and research over time for each ion channelopathy. The review also identifies research that explored phenotypic abnormalities, device usage, and risk of death in Asian patients. We touch upon the unique genetic risk factors in Asian populations that lead to cardiac ion channelopathies and SCD while comparing them to White and Western populations, particularly in the United States, where Asians comprise approximately 7% of the total population. We also propose potential solutions such as improving early genetic screening, addressing barriers affecting access to medical care and device utilization, physician training, and patient education on risks.
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Affiliation(s)
- Sahil Zaveri
- Department of Medicine, Cell Biology, and Pharmacology, State University of New York Downstate Health Sciences University, Brooklyn, NY, United States
- Cardiovascular Research Program, VA New York Harbor Healthcare System, New York, NY, United States
| | - Yongxia Sarah Qu
- Department of Medicine, Cell Biology, and Pharmacology, State University of New York Downstate Health Sciences University, Brooklyn, NY, United States
- Cardiovascular Research Program, VA New York Harbor Healthcare System, New York, NY, United States
- Department of Cardiology, New York Presbyterian Brooklyn Methodist Hospital, New York, NY, United States
| | - Mohamed Chahine
- CERVO Brain Research Center, Institut Universitaire en Santé Mentale de Québec, Québec, QC, Canada
- Department of Medicine, Faculté de Médecine, Université Laval, Quebec, QC, Canada
| | - Mohamed Boutjdir
- Department of Medicine, Cell Biology, and Pharmacology, State University of New York Downstate Health Sciences University, Brooklyn, NY, United States
- Cardiovascular Research Program, VA New York Harbor Healthcare System, New York, NY, United States
- Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, New York, NY, United States
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3
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Ahn KJ, Song MK, Lee SY, Yoon JK, Kim GB, Oh S, Bae EJ. The Outcome of Long QT Syndrome, a Korean Single Center Study. Korean Circ J 2022; 52:771-781. [PMID: 36217598 PMCID: PMC9551231 DOI: 10.4070/kcj.2022.0081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/14/2022] [Accepted: 08/10/2022] [Indexed: 01/08/2023] Open
Abstract
Congenital long QT syndrome is an inherited cardiac channelopathy, causing fatal arrhythmia. In this study, we conducted a retrospective cohort study on 105 congenital LQTS patients and its outcome in a tertiary center. The 10-year event free survival rate was 73.2%, and the outcome was different according to the genotypes. With treatment, all survived except one. The genetic analysis and risk stratification may be essential for better outcome and further nationwide and large scaled studies are required. Background and Objectives Although long QT syndrome (LQTS) is a potentially life-threatening inherited cardiac channelopathy, studies documenting the long-term clinical data of Korean patients with LQTS are scarce. Methods This retrospective cohort study included 105 patients with LQTS (48 women; 45.7%) from a single tertiary center. The clinical outcomes were analyzed for the rate of freedom from breakthrough cardiac events (BCEs), additional treatment needed, and death. Results LQTS was diagnosed at a median age of 11 (range, 0.003–80) years. Genetic testing was performed on 90 patients (yield, 71.1%). The proportions of genetically confirmed patients with LQTS types 1, 2, 3, and others were 34.4%, 12.2%, 12.2%, and 12.2%, respectively. In the symptomatic group (n=70), aborted cardiac arrest was observed in 30% of the patients. Treatments included medications in 60 patients (85.7%), implantable cardioverter-defibrillators in 27 (38.6%; median age, 17 years; range, 2–79 years), and left cardiac sympathetic denervation surgery in 7 (10%; median age, 13 years; range, 2–34). The 10-year BCE-free survival rate was 73.2%. By genotype, significant differences were observed in BCEs despite medication (p<0.001). The 10-year BCE-free survival rate was the highest in patients with LQTS type 1 (81.8%) and the lowest in those with multiple LQTS-associated mutations (LQTM). All patients with LQTS survived, except for one patient who had LQTM. Conclusions Good long-term outcomes can be achieved by using recently developed genetically tailored management strategies for patients with LQTS.
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Affiliation(s)
- Kyung Jin Ahn
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
- Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea
| | - Mi Kyoung Song
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Yun Lee
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ja Kyoung Yoon
- Department of Pediatrics, Sejong General Hospital, Bucheon, Korea
| | - Gi Beom Kim
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Seil Oh
- Department of Internal Medicine, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Jung Bae
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
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Kim YG, Oh SK, Choi HY, Choi JI. Inherited arrhythmia syndrome predisposing to sudden cardiac death. Korean J Intern Med 2021; 36:527-538. [PMID: 33092314 PMCID: PMC8137412 DOI: 10.3904/kjim.2020.481] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/27/2020] [Indexed: 12/03/2022] Open
Abstract
Inherited arrhythmia (IA) is one of the main causes of sudden cardiac death (SCD) in young people, and is reported to be a more prevalent cause of SCD in Asia than in Western countries. IAs are a group of genetic disorders caused by mutations in genes encoding cardiac ion channels, leading to electrophysiological characteristics that often occur in the absence of structural abnormalities. Channelopathies, such as long QT syndrome and Brugada syndrome, carry a potential risk of life-threatening ventricular tachyarrhythmias that predispose to SCD, although early prediction and prevention of the risk remain challenging. Recent advances in genetic testing have facilitated risk stratification as well as a precise diagnosis for IA, despite ongoing debates about the implications. Herein, we provide epidemiological data, a pathophysiological overview, and the current clinical approach to IAs related to SCD. In addition, we review the general issues arising from genetic testing for IAs.
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Affiliation(s)
- Yun Gi Kim
- Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Suk-Kyu Oh
- Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ha Young Choi
- Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jong-Il Choi
- Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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5
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Saprungruang A, Khongphatthanayothin A, Mauleekoonphairoj J, Wandee P, Kanjanauthai S, Bhuiyan ZA, Wilde AAM, Poovorawan Y. Genotype and clinical characteristics of congenital long QT syndrome in Thailand. Indian Pacing Electrophysiol J 2018; 18:165-171. [PMID: 30036649 PMCID: PMC6198685 DOI: 10.1016/j.ipej.2018.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/07/2018] [Accepted: 07/19/2018] [Indexed: 11/16/2022] Open
Abstract
Background Congenital long QT syndrome (LQTS) is an inheritable arrhythmic disorder which is linked to at least 17 genes. The clinical characteristics and genetic mutations may be variable among different population groups and they have not yet been studied in Thai population. Methods Clinical characteristics were retrospectively reviewed from children and young adults with congenital long QT syndrome whose blood samples were sent for genotyping during 1998–2017. Sangers sequencing was used to sequentially identify KCNQ1 or KCNH2 genetic variants. Whole exome sequencing (WES) was used to identify variants in all other known LQTS genes. Results Of the 20 subjects (17 families), 45% were male, mean QTc was 550.3 ± 68.8 msec (range 470–731 msec) and total Schwartz's score was 5.6 ± 1.2 points (range 3–8 points). Fifty percent of patients had events at rest, 30% had symptoms after adrenergic mediated events, and 20% were asymptomatic. We discovered pathogenic and likely pathogenic genetic variants in KCNQ1, KCNH2, and SCN5A in 6 (35%), 4 (24%), and 2 (12%) families, respectively. One additional patient had variance of unknown significance (VUS) in KCNH2 and another one in ANK2. No pathogenic genetic variant was found in 3 patients (18%). Most patients received beta-blocker and 9 (45%) had ICD implanted. LQT1 patients were either asymptomatic or had stress-induced arrhythmia. Most of the LQT2 and LQT3 patients developed symptoms at rest or during sleep. Conclusions Our patients with LQTS were mostly symptomatic at presentation. The genetic mutations were predominantly in LQT1, LQT2, and LQT3 genes.
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Affiliation(s)
- Ankavipar Saprungruang
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
| | - Apichai Khongphatthanayothin
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand; Bangkok General Hospital, Bangkok, Thailand
| | - John Mauleekoonphairoj
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pharawee Wandee
- Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Supaluck Kanjanauthai
- Division of Cardiology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Zahurul A Bhuiyan
- Laboratoire de Génétique Moléculaire, Service de Génétique Médicale, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Arthur A M Wilde
- Academic Medical Center, Heart Centre, Department of Clinical and Experimental Cardiology, University of Amsterdam, the Netherlands
| | - Yong Poovorawan
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand; Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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6
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Considerations when using next-generation sequencing for genetic diagnosis of long-QT syndrome in the clinical testing laboratory. Clin Chim Acta 2017; 464:128-135. [DOI: 10.1016/j.cca.2016.11.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 11/08/2016] [Accepted: 11/08/2016] [Indexed: 11/23/2022]
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7
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Cho Y. Management of Patients with Long QT Syndrome. Korean Circ J 2016; 46:747-752. [PMID: 27826330 PMCID: PMC5099327 DOI: 10.4070/kcj.2016.46.6.747] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 03/19/2016] [Accepted: 03/22/2016] [Indexed: 01/02/2023] Open
Abstract
Long QT syndrome (LQTS) is a rare cardiac channelopathy associated with syncope and sudden death due to torsades de pointes and ventricular fibrillation. Syncope and sudden death are frequently associated with physical and emotional stress. Management of patients with LQTS consists of life-style modification, β-blockers, left cardiac sympathetic denervation (LCSD), and implantable cardioverter-defibrillator (ICD) implantation. Prohibition of competitive exercise and avoidance of QT-prolonging drugs are important issues in life-style modification. Although β-blockers are the primary treatment modality for patients with LQTS, these drugs are not completely effective in some patients. Lifelong ICD implantation in young and active patients is associated with significant complications. LCSD is a relatively simple and highly effective surgical procedure. However, LCSD is rarely used.
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Affiliation(s)
- Yongkeun Cho
- Department of Internal Medicine, Kyungpook National Univeristy Hospital, Daegu, Korea
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8
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Jaffer F, Avbersek A, Vavassori R, Fons C, Campistol J, Stagnaro M, De Grandis E, Veneselli E, Rosewich H, Gianotta M, Zucca C, Ragona F, Granata T, Nardocci N, Mikati M, Helseth AR, Boelman C, Minassian BA, Johns S, Garry SI, Scheffer IE, Gourfinkel-An I, Carrilho I, Aylett SE, Parton M, Hanna MG, Houlden H, Neville B, Kurian MA, Novy J, Sander JW, Lambiase PD, Behr ER, Schyns T, Arzimanoglou A, Cross JH, Kaski JP, Sisodiya SM. Faulty cardiac repolarization reserve in alternating hemiplegia of childhood broadens the phenotype. Brain 2015; 138:2859-74. [PMID: 26297560 PMCID: PMC4671482 DOI: 10.1093/brain/awv243] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 06/30/2015] [Indexed: 12/29/2022] Open
Abstract
Alternating hemiplegia of childhood is a rare disorder caused by de novo mutations in the ATP1A3 gene, expressed in neurons and cardiomyocytes. As affected individuals may survive into adulthood, we use the term 'alternating hemiplegia'. The disorder is characterized by early-onset, recurrent, often alternating, hemiplegic episodes; seizures and non-paroxysmal neurological features also occur. Dysautonomia may occur during hemiplegia or in isolation. Premature mortality can occur in this patient group and is not fully explained. Preventable cardiorespiratory arrest from underlying cardiac dysrhythmia may be a cause. We analysed ECG recordings of 52 patients with alternating hemiplegia from nine countries: all had whole-exome, whole-genome, or direct Sanger sequencing of ATP1A3. Data on autonomic dysfunction, cardiac symptoms, medication, and family history of cardiac disease or sudden death were collected. All had 12-lead electrocardiogram recordings available for cardiac axis, cardiac interval, repolarization pattern, and J-point analysis. Where available, historical and prolonged single-lead electrocardiogram recordings during electrocardiogram-videotelemetry were analysed. Half the cohort (26/52) had resting 12-lead electrocardiogram abnormalities: 25/26 had repolarization (T wave) abnormalities. These abnormalities were significantly more common in people with alternating hemiplegia than in an age-matched disease control group of 52 people with epilepsy. The average corrected QT interval was significantly shorter in people with alternating hemiplegia than in the disease control group. J wave or J-point changes were seen in six people with alternating hemiplegia. Over half the affected cohort (28/52) had intraventricular conduction delay, or incomplete right bundle branch block, a much higher proportion than in the normal population or disease control cohort (P = 0.0164). Abnormalities in alternating hemiplegia were more common in those ≥16 years old, compared with those <16 (P = 0.0095), even with a specific mutation (p.D801N; P = 0.045). Dynamic, beat-to-beat or electrocardiogram-to-electrocardiogram, changes were noted, suggesting the prevalence of abnormalities was underestimated. Electrocardiogram changes occurred independently of seizures or plegic episodes. Electrocardiogram abnormalities are common in alternating hemiplegia, have characteristics reflecting those of inherited cardiac channelopathies and most likely amount to impaired repolarization reserve. The dynamic electrocardiogram and neurological features point to periodic systemic decompensation in ATP1A3-expressing organs. Cardiac dysfunction may account for some of the unexplained premature mortality of alternating hemiplegia. Systematic cardiac investigation is warranted in alternating hemiplegia of childhood, as cardiac arrhythmic morbidity and mortality are potentially preventable.
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Affiliation(s)
- Fatima Jaffer
- 1 MRC Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK 2 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Andreja Avbersek
- 3 NIHR UCLH Biomedical Research Centre Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK 4 Epilepsy Society, Chalfont-St-Peter, Bucks, SL9 0RJ, UK
| | - Rosaria Vavassori
- 5 A.I.S.EA Onlus, Via Sernovella, 37 - Verderio Superiore, 23878 Lecco, Italy
| | - Carmen Fons
- 6 Paediatric Neurology Department, Hospital Sant Joan de Déu, P° de Sant Joan de Déu, 2 08950 Esplugues de Llobregat, Barcelona University, Barcelona, Spain
| | - Jaume Campistol
- 6 Paediatric Neurology Department, Hospital Sant Joan de Déu, P° de Sant Joan de Déu, 2 08950 Esplugues de Llobregat, Barcelona University, Barcelona, Spain
| | - Michela Stagnaro
- 7 Child Neuropsychiatry Unit, Istituto Giannina Gaslini, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children's Sciences, Istituto Giannina Gaslini, Largo Gaslini 5, 26148, University of Genoa, Genoa, Italy
| | - Elisa De Grandis
- 7 Child Neuropsychiatry Unit, Istituto Giannina Gaslini, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children's Sciences, Istituto Giannina Gaslini, Largo Gaslini 5, 26148, University of Genoa, Genoa, Italy
| | - Edvige Veneselli
- 7 Child Neuropsychiatry Unit, Istituto Giannina Gaslini, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children's Sciences, Istituto Giannina Gaslini, Largo Gaslini 5, 26148, University of Genoa, Genoa, Italy
| | - Hendrik Rosewich
- 8 University Medical Center Göttingen, Georg August University, Department of Pediatrics and Adolescent Medicine, Division of Pediatric Neurology, Georg August University, Robert Koch Strasse 40, 37099 Göttingen, Germany
| | - Melania Gianotta
- 9 Child Neurology Unit IRCCS Istituto delle Scienze Neurologiche di Bologna, Ospedale Bellaria, Via Altura 3, 40139 Bologna, Italy
| | - Claudio Zucca
- 10 Clinical Neurophysiology Unit, IRCCS "E. Medea", Via Don L. Monza 20, 23842 Bosisio Parini (LC), Italy
| | - Francesca Ragona
- 11 Department of Pediatric Neuroscience, IRCCS Foundation Neurological Institute C. Besta, Via Celoria 11, 20133 Milano, Italy
| | - Tiziana Granata
- 11 Department of Pediatric Neuroscience, IRCCS Foundation Neurological Institute C. Besta, Via Celoria 11, 20133 Milano, Italy
| | - Nardo Nardocci
- 11 Department of Pediatric Neuroscience, IRCCS Foundation Neurological Institute C. Besta, Via Celoria 11, 20133 Milano, Italy
| | - Mohamed Mikati
- 12 Division of Paediatric Neurology, Duke University, T0913J Children Health Centre, Duke University Medical Centre, Durham, USA
| | - Ashley R Helseth
- 12 Division of Paediatric Neurology, Duke University, T0913J Children Health Centre, Duke University Medical Centre, Durham, USA
| | - Cyrus Boelman
- 13 Division of Neurology, Department of Paediatrics, The Hospital for Sick Children and University of Toronto, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8
| | - Berge A Minassian
- 13 Division of Neurology, Department of Paediatrics, The Hospital for Sick Children and University of Toronto, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8
| | - Sophia Johns
- 14 Inherited Cardiovascular Diseases Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, and Institute of Cardiovascular Science, University College London, London, WC1N 3JH, UK
| | - Sarah I Garry
- 15 Florey Institute of Neurosciences and Mental Health, and Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - Ingrid E Scheffer
- 15 Florey Institute of Neurosciences and Mental Health, and Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - Isabelle Gourfinkel-An
- 16 Centre de reference epilepsies rares et Sclérose tubéreuse de Bourneville (site Parisien adolescents-adultes), Hôpital Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital 75651 Paris cedex 13, France
| | - Ines Carrilho
- 17 Neuropediatric Department Centro Hospitalar do Porto, Rua da Boavista, 8274050-111, Porto, Portugal
| | - Sarah E Aylett
- 18 Clinical Neurosciences, Developmental Neuroscience Programme, UCL Institute of Child Health, & Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK
| | - Matthew Parton
- 1 MRC Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK
| | - Michael G Hanna
- 1 MRC Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK
| | - Henry Houlden
- 2 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Brian Neville
- 18 Clinical Neurosciences, Developmental Neuroscience Programme, UCL Institute of Child Health, & Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK
| | - Manju A Kurian
- 19 Molecular Neurosciences, Developmental Neurosciences Programme, UCL Institute of Child Health and Department of Neurology, Great Ormond Street Hospital, London, London, WC1N 3JH, UK
| | - Jan Novy
- 3 NIHR UCLH Biomedical Research Centre Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK 4 Epilepsy Society, Chalfont-St-Peter, Bucks, SL9 0RJ, UK
| | - Josemir W Sander
- 3 NIHR UCLH Biomedical Research Centre Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK 4 Epilepsy Society, Chalfont-St-Peter, Bucks, SL9 0RJ, UK
| | - Pier D Lambiase
- 20 Department of Cardiac Electrophysiology, The Heart Hospital, Institute of Cardiovascular Science, University College London, 16-18 Westmoreland St, London W1G 8PH, UK
| | - Elijah R Behr
- 21 Cardiac and Cell Sciences Institute, St George's University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Tsveta Schyns
- 22 European Network for Research on Alternating Hemiplegia, ENRAH, Brussels, Belgium
| | - Alexis Arzimanoglou
- 23 Epilepsy, Sleep and Paediatric Neurophysiology Department (ESEFNP), University Hospitals of Lyon (HCL), and DYCOG team, Lyon Neuroscience Research Centre (CRNL), INSERM U1028; CNRS UMR 5292, Lyon, France
| | - J Helen Cross
- 18 Clinical Neurosciences, Developmental Neuroscience Programme, UCL Institute of Child Health, & Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK 24 Young Epilepsy, St. Piers Lane, Lingfield, Surrey RH7 6PW, UK
| | - Juan P Kaski
- 14 Inherited Cardiovascular Diseases Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, and Institute of Cardiovascular Science, University College London, London, WC1N 3JH, UK
| | - Sanjay M Sisodiya
- 3 NIHR UCLH Biomedical Research Centre Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK 4 Epilepsy Society, Chalfont-St-Peter, Bucks, SL9 0RJ, UK
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9
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Saprungruang A, Vithessonthi K, La-Orkhun V, Lertsapcharoen P, Khongphatthanayothin A. Clinical presentation and course of long QT syndrome in Thai children. J Arrhythm 2015; 31:296-301. [PMID: 26550086 DOI: 10.1016/j.joa.2015.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Revised: 03/23/2015] [Accepted: 04/01/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Congenital long QT syndrome (LQTS) is a genetically transmitted cardiac channelopathy that can lead to lethal arrhythmia and sudden cardiac death in healthy young people. The clinical characteristics of LQTS are variable and depend on the subtype of long QT syndrome, which differ among populations. This single hospital-based case review study examined the clinical presentation of long QT syndrome and the outcomes of its treatment in 20 Thai children at King Chulalongkorn Memorial Hospital in Bangkok, Thailand. METHODS Inpatient and outpatient records of children (aged 0-14 years) diagnosed with long QT syndrome from January 1, 1998, to September 30, 2013, were retrospectively reviewed. Presentation at diagnosis, treatments, and clinical courses were collected and analyzed. In the 20 subjects, total Schwartz scores totaled 5.2±0.9 points, and mean age at diagnosis was 7.6±4.4 years (range, 1 day-13.8 years). The patients were assigned to one of 3 groups based on trigger events: 50% of patients had events at rest (sleep or at rest), 35% experienced adrenergic-mediated events (e.g., stress, exercise, startle), and 15% were asymptomatic. Excluding the 3 patients who died at first presentation, 100% of patients received a beta blocker, and 47.1% were treated with an automatic implantable cardioverter-defibrillator (AICD). RESULTS At follow-up (median=959 days; range, 1-4170 days), 4 patients (20%) were known to have died, 3 of whom died shortly after the diagnosis. Among patients who survived the initial event, 52.9% (9 of 17) experienced cardiac events (appropriate AICD shock, death, and/or syncope) during the follow-up period. The mean duration from diagnosis to cardiac event was 1420±759 days (range, 497-2499 days). CONCLUSIONS All 20 patients with LQTS were mostly symptomatic at presentation. Owing to the geographical region and ethnicity of the Thai population, we conclude that the ratio of patients who develop cardiac symptoms at rest or during sleep might be higher than in other Asian countries.
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Affiliation(s)
- Ankavipar Saprungruang
- Division of Cardiology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Kanyalak Vithessonthi
- Division of Cardiology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Vidhavas La-Orkhun
- Division of Cardiology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Pornthep Lertsapcharoen
- Division of Cardiology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Apichai Khongphatthanayothin
- Division of Cardiology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand ; Bangkok Heart Hospital, Bangkok, Thailand
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10
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Takahashi K, Shimizu W, Miyake A, Nabeshima T, Nakayashiro M, Ganaha H. High Prevalence of the SCN5A E1784K Mutation in School Children With Long QT Syndrome Living on the Okinawa Islands. Circ J 2014; 78:1974-9. [DOI: 10.1253/circj.cj-13-1516] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Akira Miyake
- Department of Pediatric Cardiology, Okinawa Children’s Medical Center
| | - Taisuke Nabeshima
- Department of Pediatric Cardiology, Okinawa Children’s Medical Center
| | - Mami Nakayashiro
- Department of Pediatric Cardiology, Okinawa Children’s Medical Center
| | - Hitoshi Ganaha
- Department of Pediatric Cardiology, Okinawa Children’s Medical Center
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