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Cabrera-Romero E, Ochoa JP, Barriales-Villa R, Bermúdez-Jiménez FJ, Climent-Payá V, Zorio E, Espinosa MA, Gallego-Delgado M, Navarro-Peñalver M, Arana-Achaga X, Piqueras-Flores J, Espejo-Bares V, Rodríguez-Palomares JF, Lacuey-Lecumberri G, López J, Tiron C, Peña-Peña ML, García-Pinilla JM, Lorca R, Ripoll-Vera T, Díez-López C, Mogollon MV, García-Álvarez A, Martínez-Dolz L, Brion M, Larrañaga-Moreira JM, Jiménez-Jáimez J, García-Álvarez MI, Vilches S, Villacorta E, Sabater-Molina M, Solla-Ruiz I, Royuela A, Domínguez F, Mirelis JG, Garcia-Pavia P. Penetrance of Dilated Cardiomyopathy in Genotype-Positive Relatives. J Am Coll Cardiol 2024; 83:1640-1651. [PMID: 38658103 DOI: 10.1016/j.jacc.2024.02.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Disease penetrance in genotype-positive (G+) relatives of families with dilated cardiomyopathy (DCM) and the characteristics associated with DCM onset in these individuals are unknown. OBJECTIVES This study sought to determine the penetrance of new DCM diagnosis in G+ relatives and to identify factors associated with DCM development. METHODS The authors evaluated 779 G+ patients (age 35.8 ± 17.3 years; 459 [59%] females; 367 [47%] with variants in TTN) without DCM followed at 25 Spanish centers. RESULTS After a median follow-up of 37.1 months (Q1-Q3: 16.3-63.8 months), 85 individuals (10.9%) developed DCM (incidence rate of 2.9 per 100 person-years; 95% CI: 2.3-3.5 per 100 person-years). DCM penetrance and age at DCM onset was different according to underlying gene group (log-rank P = 0.015 and P <0.01, respectively). In a multivariable model excluding CMR parameters, independent predictors of DCM development were: older age (HR per 1-year increase: 1.02; 95% CI: 1.0-1.04), an abnormal electrocardiogram (HR: 2.13; 95% CI: 1.38-3.29); presence of variants in motor sarcomeric genes (HR: 1.92; 95% CI: 1.05-3.50); lower left ventricular ejection fraction (HR per 1% increase: 0.86; 95% CI: 0.82-0.90) and larger left ventricular end-diastolic diameter (HR per 1-mm increase: 1.10; 95% CI: 1.06-1.13). Multivariable analysis in individuals with cardiac magnetic resonance and late gadolinium enhancement assessment (n = 360, 45%) identified late gadolinium enhancement as an additional independent predictor of DCM development (HR: 2.52; 95% CI: 1.43-4.45). CONCLUSIONS Following a first negative screening, approximately 11% of G+ relatives developed DCM during a median follow-up of 3 years. Older age, an abnormal electrocardiogram, lower left ventricular ejection fraction, increased left ventricular end-diastolic diameter, motor sarcomeric genetic variants, and late gadolinium enhancement are associated with a higher risk of developing DCM.
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Affiliation(s)
- Eva Cabrera-Romero
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, IDIPHISA, Madrid, Spain; CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, ERN GUARD-Heart, Amsterdam, the Netherlands
| | - Juan Pablo Ochoa
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, ERN GUARD-Heart, Amsterdam, the Netherlands; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Health in Code, Madrid, Spain
| | - Roberto Barriales-Villa
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; Inherited Cardiac Diseases Unit, Department of Cardiology, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain; Instituto de Investigación Biomédica A Coruña (INIBIC), A Coruña, Spain
| | - Francisco José Bermúdez-Jiménez
- Department of Cardiology, Virgen de las Nieves University Hospital, Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain
| | - Vicente Climent-Payá
- Heart Failure and Inherited Cardiac Diseases Unit, Cardiology Department, Hospital General Universitario Dr Balmis, Institute for Health and Biomedical Research of Alicante (ISABIAL), Alicante, Spain
| | - Esther Zorio
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; Department of Cardiology, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Clinical and Translational Research in Cardiology, Instituto de Investigación Sanitaria La Fe (IIS-La Fe), Valencia, Spain
| | - María Angeles Espinosa
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, ERN GUARD-Heart, Amsterdam, the Netherlands; Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - María Gallego-Delgado
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; Inherited Cardiovascular Disease Unit, Department of Cardiology, Complejo Asistencial Universitario de Salamanca, Institute for Biomedical Research of Salamanca (IBSAL), Gerencia Regional de Salud de Castilla y Leon (SACYL), Salamanca, Spain
| | - Marina Navarro-Peñalver
- Unidad CSUR/ERN de Cardiopatías Familiares, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Xabier Arana-Achaga
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Donostia University Hospital, Donostia, Spain; Biodonostia Health Research Institute, Donostia, Spain
| | - Jesús Piqueras-Flores
- Inherited Cardiac Diseases Unit, Cardiology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Department of Medicine, Universidad de Castilla La Mancha, Ciudad Real, Spain; Health Research Institute of Castilla La Mancha (IDISCAM), Ciudad Real, Spain
| | - Victoria Espejo-Bares
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto de investigación 12 de Octubre i+12, Madrid, Spain
| | - José F Rodríguez-Palomares
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, ERN GUARD-Heart, Amsterdam, the Netherlands; Cardiovascular Imaging Department and Inherited Cardiac Diseases Unit, Cardiology Department, Hospital Universitario Vall Hebrón, Barcelona, Spain; Vall Hebron Research Institute (VHIR), Universitat Autónoma de Barcelona (UAB), Barcelona, Spain
| | - Gemma Lacuey-Lecumberri
- Hospital Universitario de Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Javier López
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; Hospital Clínico de Valladolid, Vallodolid, Spain; Instituto de Ciencias del Corazón (ICICOR), Valladolid, Spain
| | - Coloma Tiron
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitari Dr Josep Trueta, Girona, Spain; Medical Science Department, School of Medicine, University of Girona, Girona, Spain
| | - María Luisa Peña-Peña
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, ERN GUARD-Heart, Amsterdam, the Netherlands; Cardiovascular Imaging and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Jose M García-Pinilla
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; Heart Failure and Inherited Cardiac Diseases Unit, Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Departamento de Medicina y Dermatología, Universidad de Málaga, Málaga, Spain
| | - Rebeca Lorca
- Inherited Cardiac Diseases Unit, Área del Corazón, Hospital Universitario Central Asturias (HUCA), Oviedo, Spain; de Fisiología, Departamento de Biología Funcional, Universidad de Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORs), Madrid, Spain
| | - Tomas Ripoll-Vera
- Hospital Universitario Son Llatzer, IdISBa, Palma de Mallorca, Spain
| | - Carles Díez-López
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; Inherited Cardiovascular Diseases Program, Hospital Universitari de Bellvitge, BioHeart Research Group, IDIBELL, Badalona, Spain
| | | | - Ana García-Álvarez
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, ERN GUARD-Heart, Amsterdam, the Netherlands; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Cardiology Department, Hospital Clínic Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Luis Martínez-Dolz
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; Department of Cardiology, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Clinical and Translational Research in Cardiology, Instituto de Investigación Sanitaria La Fe (IIS-La Fe), Valencia, Spain
| | - María Brion
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; Xenética Cardiovascular, Instituto de investigación Sanitaria de Santiago, Inherited Cardiac Diseases Unit, Department of Cardiology Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Jose María Larrañaga-Moreira
- Inherited Cardiac Diseases Unit, Department of Cardiology, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain; Instituto de Investigación Biomédica A Coruña (INIBIC), A Coruña, Spain
| | - Juan Jiménez-Jáimez
- Department of Cardiology, Virgen de las Nieves University Hospital, Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain
| | - María Isabel García-Álvarez
- Heart Failure and Inherited Cardiac Diseases Unit, Cardiology Department, Hospital General Universitario Dr Balmis, Institute for Health and Biomedical Research of Alicante (ISABIAL), Alicante, Spain
| | - Silvia Vilches
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, ERN GUARD-Heart, Amsterdam, the Netherlands; Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Eduardo Villacorta
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; Inherited Cardiovascular Disease Unit, Department of Cardiology, Complejo Asistencial Universitario de Salamanca, Institute for Biomedical Research of Salamanca (IBSAL), Gerencia Regional de Salud de Castilla y Leon (SACYL), Salamanca, Spain; Universidad de Salamanca, Salamanca, Spain
| | - María Sabater-Molina
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; Unidad CSUR/ERN de Cardiopatías Familiares, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain; Laboratorio de Cardiogenética, Instituto Murciano de Investigación Biosanitaria, Murcia, Spain; Departamento de Ciencias Sociosanitarias, Universidad de Murcia, Murcia, Spain
| | - Itziar Solla-Ruiz
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Donostia University Hospital, Donostia, Spain; Biodonostia Health Research Institute, Donostia, Spain
| | - Ana Royuela
- Biostatistics Unit, Hospital Universitario Puerta de Hierro Majadahonda, IDIPHISA, CIBERESP, Madrid, Spain
| | - Fernando Domínguez
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, IDIPHISA, Madrid, Spain; CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, ERN GUARD-Heart, Amsterdam, the Netherlands; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Jesús G Mirelis
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, IDIPHISA, Madrid, Spain; CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
| | - Pablo Garcia-Pavia
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, IDIPHISA, Madrid, Spain; CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, ERN GUARD-Heart, Amsterdam, the Netherlands; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Universidad Francisco de Vitoria (UFV), Pozuelo de Alarcón, Spain
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Amor-Salamanca A, Santana Rodríguez A, Rasoul H, Rodríguez-Palomares JF, Moldovan O, Hey TM, Delgado MG, Cuenca DL, de Castro Campos D, Basurte-Elorz MT, Macías-Ruiz R, Fuentes Cañamero ME, Galvin J, Bilbao Quesada R, de la Higuera Romero L, Trujillo-Quintero JP, García-Cruz LM, Cárdenas-Reyes I, Jiménez-Jáimez J, García-Hernández S, Valverde-Gómez M, Gómez-Díaz I, Limeres Freire J, García-Pinilla JM, Gimeno-Blanes JR, Savattis K, García-Pavía P, Ochoa JP. Role of TBX20 Truncating Variants in Dilated Cardiomyopathy and Left Ventricular Noncompaction. Circ Genom Precis Med 2024; 17:e004404. [PMID: 38353104 PMCID: PMC11019988 DOI: 10.1161/circgen.123.004404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/07/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Less than 40% of patients with dilated cardiomyopathy (DCM) have a pathogenic/likely pathogenic genetic variant identified. TBX20 has been linked to congenital heart defects; although an association with left ventricular noncompaction (LVNC) and DCM has been proposed, it is still considered a gene with limited evidence for these phenotypes. This study sought to investigate the association between the TBX20 truncating variant (TBX20tv) and DCM/LVNC. METHODS TBX20 was sequenced by next-generation sequencing in 7463 unrelated probands with a diagnosis of DCM or LVNC, 22 773 probands of an internal comparison group (hypertrophic cardiomyopathy, channelopathies, or aortic diseases), and 124 098 external controls (individuals from the gnomAD database). Enrichment of TBX20tv in DCM/LVNC was calculated, cosegregation was determined in selected families, and clinical characteristics and outcomes were analyzed in carriers. RESULTS TBX20tv was enriched in DCM/LVNC (24/7463; 0.32%) compared with internal (1/22 773; 0.004%) and external comparison groups (4/124 098; 0.003%), with odds ratios of 73.23 (95% CI, 9.90-541.45; P<0.0001) and 99.76 (95% CI, 34.60-287.62; P<0.0001), respectively. TBX20tv was cosegregated with DCM/LVNC phenotype in 21 families for a combined logarythm of the odds score of 4.53 (strong linkage). Among 57 individuals with TBX20tv (49.1% men; mean age, 35.9±20.8 years), 41 (71.9%) exhibited DCM/LVNC, of whom 14 (34.1%) had also congenital heart defects. After a median follow-up of 6.9 (95% CI, 25-75:3.6-14.5) years, 9.7% of patients with DCM/LVNC had end-stage heart failure events and 4.8% experienced malignant ventricular arrhythmias. CONCLUSIONS TBX20tv is associated with DCM/LVNC; congenital heart defect is also present in around one-third of cases. TBX20tv-associated DCM/LVNC is characterized by a nonaggressive phenotype, with a low incidence of major cardiovascular events. TBX20 should be considered a definitive gene for DCM and LVNC and routinely included in genetic testing panels for these phenotypes.
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Affiliation(s)
- Almudena Amor-Salamanca
- Cardiology Department, Health in Code SL, A Coruña, Spain (A.A.-S., L.d.l.H.R., I.C.-R., S.G.-H., M.V.-G., I.G.-D., J.P.O.)
| | - Alfredo Santana Rodríguez
- Clinical Genetics Unit, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain (A.S.R., L.M.G.-C.)
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Spain (A.S.R., L.M.G.-C.)
| | - Hazhee Rasoul
- Inherited Cardiovascular Diseases Unit, St. Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom (H.R., K.S.)
| | - José F. Rodríguez-Palomares
- Cardiovascular Imaging Unit and Inherited Cardiac Diseases Unit, Cardiology Department, Vall d′Hebron University Hospital, Barcelona, Spain (J.F.R.-P., J.L.F.)
- Vall d′Hebron Rsrch Unit, Barcelona, Spain (J.F.R.-P.)
- Universitat Autònoma Barcelona, Spain (J.F.R.-P., J.P.T.-Q.)
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain (J.F.R.-P., M.G.D., J.M.G.-P., J.R.G.-B., P.G.-P.)
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, ERN GUARD-Heart, Amsterdam, The Netherlands (J.F.R.-P., J.L.F., J.R.G.-B., P.G.-P.)
| | - Oana Moldovan
- Serviço de Genética Médica, Department de Pediatria, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Portugal (O.M.)
| | - Thomas Morris Hey
- Department of Cardiology, The Clinic of Inherited Cardiovascular Diseases, Odense University Hospital, Denmark (T.M.H.)
| | - María Gallego Delgado
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain (J.F.R.-P., M.G.D., J.M.G.-P., J.R.G.-B., P.G.-P.)
- Cardiology Department, Hospital Universitario de Salamanca, Spain (M.G.D.)
- Biomedical Research Institute of Salamanca, Gerencia Regional de Salud de Castilla y León, Spain (M.G.D.)
| | - David López Cuenca
- Department of Cardiology, Inherited Cardiac Diseases Unit, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain (D.L.C., J.R.G.-B.)
| | - Daniel de Castro Campos
- Department of Cardiology, Heart Failure and Inherited Cardiac Diseases Unit, Hospital Universitario Puerta de Hierro, IDIPHISA, Madrid, Spain (D.d.C.C., P.G.-P., J.P.O.)
| | | | - Rosa Macías-Ruiz
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain (R.M.-R., J.J.-J.)
- Instituto de Investigación Biosanitaria Instituto de Investigación Biosanitaria de Granada (IBS-GRANADA), Spain (R.M.-R., J.J.-J.)
| | | | - Joseph Galvin
- Department of Cardiology, University College Dublin School of Medicine, Mater Misericordiae University Hospital, Ireland (J.G.)
| | | | - Luis de la Higuera Romero
- Cardiology Department, Health in Code SL, A Coruña, Spain (A.A.-S., L.d.l.H.R., I.C.-R., S.G.-H., M.V.-G., I.G.-D., J.P.O.)
| | - Juan Pablo Trujillo-Quintero
- Universitat Autònoma Barcelona, Spain (J.F.R.-P., J.P.T.-Q.)
- Center for Genomic Medicine, Parc Taulí Hospital Universitari, Sabadell, Spain (J.P.T.-Q.)
- Institut d’Investigació i Innovació Parc Taulí, Sabadell, Spain (J.P.T.-Q.)
| | - Loida María García-Cruz
- Clinical Genetics Unit, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain (A.S.R., L.M.G.-C.)
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Spain (A.S.R., L.M.G.-C.)
| | - Ivonne Cárdenas-Reyes
- Cardiology Department, Health in Code SL, A Coruña, Spain (A.A.-S., L.d.l.H.R., I.C.-R., S.G.-H., M.V.-G., I.G.-D., J.P.O.)
| | - Juan Jiménez-Jáimez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain (R.M.-R., J.J.-J.)
- Instituto de Investigación Biosanitaria Instituto de Investigación Biosanitaria de Granada (IBS-GRANADA), Spain (R.M.-R., J.J.-J.)
| | - Soledad García-Hernández
- Cardiology Department, Health in Code SL, A Coruña, Spain (A.A.-S., L.d.l.H.R., I.C.-R., S.G.-H., M.V.-G., I.G.-D., J.P.O.)
- Inherited Cardiac Diseases Unit, Hospital Universitario San Cecilio, Granada, Spain (S.G.-H.)
| | - María Valverde-Gómez
- Cardiology Department, Health in Code SL, A Coruña, Spain (A.A.-S., L.d.l.H.R., I.C.-R., S.G.-H., M.V.-G., I.G.-D., J.P.O.)
- Cardiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain (M.V.-G.)
| | - Iria Gómez-Díaz
- Cardiology Department, Health in Code SL, A Coruña, Spain (A.A.-S., L.d.l.H.R., I.C.-R., S.G.-H., M.V.-G., I.G.-D., J.P.O.)
| | - Javier Limeres Freire
- Cardiovascular Imaging Unit and Inherited Cardiac Diseases Unit, Cardiology Department, Vall d′Hebron University Hospital, Barcelona, Spain (J.F.R.-P., J.L.F.)
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, ERN GUARD-Heart, Amsterdam, The Netherlands (J.F.R.-P., J.L.F., J.R.G.-B., P.G.-P.)
| | - José M. García-Pinilla
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain (J.F.R.-P., M.G.D., J.M.G.-P., J.R.G.-B., P.G.-P.)
- Department of Cardiology, Heart Failure and Inherited Cardiac Diseases Unit, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain (J.M.G.-P.)
- Department of Medicine and Dermatology, Universidad de Málaga, Spain (J.M.G.-P.)
| | - Juan R. Gimeno-Blanes
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain (J.F.R.-P., M.G.D., J.M.G.-P., J.R.G.-B., P.G.-P.)
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, ERN GUARD-Heart, Amsterdam, The Netherlands (J.F.R.-P., J.L.F., J.R.G.-B., P.G.-P.)
- Department of Cardiology, Inherited Cardiac Diseases Unit, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain (D.L.C., J.R.G.-B.)
| | - Konstantinos Savattis
- Inherited Cardiovascular Diseases Unit, St. Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom (H.R., K.S.)
- Institute for Cardiovascular Science, University College London, United Kingdom (K.S.)
- Biomedical Research Center, National Institute for Health and Care Research (NIHR) University College London Hospitals, United Kingdom (K.S.)
- William Harvey Research Institute, Queen Mary University of London, United Kingdom (K.S.)
| | - Pablo García-Pavía
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain (J.F.R.-P., M.G.D., J.M.G.-P., J.R.G.-B., P.G.-P.)
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, ERN GUARD-Heart, Amsterdam, The Netherlands (J.F.R.-P., J.L.F., J.R.G.-B., P.G.-P.)
- Department of Cardiology, Heart Failure and Inherited Cardiac Diseases Unit, Hospital Universitario Puerta de Hierro, IDIPHISA, Madrid, Spain (D.d.C.C., P.G.-P., J.P.O.)
- Universidad Francisco de Vitoria, Pozuelo de Alarcón, Spain (P.G.-P.)
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (P.G.-P., J.P.O.)
| | - Juan Pablo Ochoa
- Cardiology Department, Health in Code SL, A Coruña, Spain (A.A.-S., L.d.l.H.R., I.C.-R., S.G.-H., M.V.-G., I.G.-D., J.P.O.)
- Department of Cardiology, Heart Failure and Inherited Cardiac Diseases Unit, Hospital Universitario Puerta de Hierro, IDIPHISA, Madrid, Spain (D.d.C.C., P.G.-P., J.P.O.)
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (P.G.-P., J.P.O.)
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Corrado D, Anastasakis A, Basso C, Bauce B, Blomström-Lundqvist C, Bucciarelli-Ducci C, Cipriani A, De Asmundis C, Gandjbakhch E, Jiménez-Jáimez J, Kharlap M, McKenna WJ, Monserrat L, Moon J, Pantazis A, Pelliccia A, Perazzolo Marra M, Pillichou K, Schulz-Menger J, Jurcut R, Seferovic P, Sharma S, Tfelt-Hansen J, Thiene G, Wichter T, Wilde A, Zorzi A. Proposed diagnostic criteria for arrhythmogenic cardiomyopathy: European Task Force consensus report. Int J Cardiol 2024; 395:131447. [PMID: 37844667 DOI: 10.1016/j.ijcard.2023.131447] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 10/18/2023]
Abstract
Arrhythmogenic cardiomyopathy (ACM) is a heart muscle disease characterized by prominent "non-ischemic" myocardial scarring predisposing to ventricular electrical instability. Diagnostic criteria for the original phenotype, arrhythmogenic right ventricular cardiomyopathy (ARVC), were first proposed in 1994 and revised in 2010 by an international Task Force (TF). A 2019 International Expert report appraised these previous criteria, finding good accuracy for diagnosis of ARVC but a lack of sensitivity for identification of the expanding phenotypic disease spectrum, which includes left-sided variants, i.e., biventricular (ABVC) and arrhythmogenic left ventricular cardiomyopathy (ALVC). The ARVC phenotype together with these left-sided variants are now more appropriately named ACM. The lack of diagnostic criteria for the left ventricular (LV) phenotype has resulted in clinical under-recognition of ACM patients over the 4 decades since the disease discovery. In 2020, the "Padua criteria" were proposed for both right- and left-sided ACM phenotypes. The presently proposed criteria represent a refinement of the 2020 Padua criteria and have been developed by an expert European TF to improve the diagnosis of ACM with upgraded and internationally recognized criteria. The growing recognition of the diagnostic role of CMR has led to the incorporation of myocardial tissue characterization findings for detection of myocardial scar using the late‑gadolinium enhancement (LGE) technique to more fully characterize right, biventricular and left disease variants, whether genetic or acquired (phenocopies), and to exclude other "non-scarring" myocardial disease. The "ring-like' pattern of myocardial LGE/scar is now a recognized diagnostic hallmark of ALVC. Additional diagnostic criteria regarding LV depolarization and repolarization ECG abnormalities and ventricular arrhythmias of LV origin are also provided. These proposed upgrading of diagnostic criteria represents a working framework to improve management of ACM patients.
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Affiliation(s)
- Domenico Corrado
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua Medical School, Italy.
| | - Aris Anastasakis
- Unit of Inherited and Rare Cardiovascular Diseases, Onassis Cardiac Surgery Center, Athens, Greece
| | - Cristina Basso
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua Medical School, Italy
| | - Barbara Bauce
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua Medical School, Italy
| | - Carina Blomström-Lundqvist
- Department of Cardiology, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | | | - Alberto Cipriani
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua Medical School, Italy
| | - Carlo De Asmundis
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis, Brussel - Vrije Universiteit Brussel, Belgium
| | - Estelle Gandjbakhch
- Sorbonne Universitè, APHP, Centre de Référence des Maladies Cardiaques héréditaires Groupe Hospitalier Pitié Salpêtrière-Charles Foix, Paris, France
| | | | - Maria Kharlap
- Department of cardiac arrhythmias, National Centre for Therapy and Preventive Medicine, Moscow, Petroverigsky, Russia
| | - William J McKenna
- Institute of Cardiovascular Science, University College London, United Kingdom
| | - Lorenzo Monserrat
- Cardiovascular Genetics, Medical Department, Dilemma Solutions SL, A Coruña, Spain
| | - James Moon
- CMR Service, Barts Heart Centre, University College London, United Kingdom
| | - Antonis Pantazis
- Inherited Cardiovascular Conditions services, The Royal Brompton and Harefield Hospitals, London, United Kingdom
| | | | - Martina Perazzolo Marra
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua Medical School, Italy
| | - Kalliopi Pillichou
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua Medical School, Italy
| | - Jeanette Schulz-Menger
- Charité, Universitätsmedizin Berlin, Campus Buch - ECRC and Helios Clinics, DZHK Partnersite Berlin, Germany
| | - Ruxandra Jurcut
- Expert Center for Rare Genetic Cardiovascular Diseases, Institute for Cardiovascular Diseases "Prof.dr.C.C.Iliescu", UMF "Carol Davila", Bucharest, Romania
| | - Petar Seferovic
- University of Belgrade, Faculty of Medicine and Heart Failure Center, Belgrade University Medical Center, Belgrade
| | - Sanjay Sharma
- Cardiology Clinical Academic Group, St. George's, University of London, United Kingdom
| | - Jacob Tfelt-Hansen
- Section of Genetics, Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Denmark; Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Gaetano Thiene
- University of Padua Medical School, ARCA Associazione Ricerche Cardiopatie Aritmiche ETS, Padova, Italy
| | - Thomas Wichter
- Dept. of Internal Medicine / Cardiology, Heart Center Osnabrück - Bad Rothenfelde, Niels-Stensen-Kliniken, Marienhospital Osnabrück, Osnabrück, Germany
| | - Arthur Wilde
- Amsterdam UMC location University of Amsterdam, Department of Cardiology, Amsterdam, the Netherlands
| | - Alessandro Zorzi
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua Medical School, Italy
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Sola-García E, Molina-Lerma M, Jiménez-Jáimez J, Macías-Ruiz R, Sánchez-Millán PJ, Tercedor L, Álvarez M. Autothreshold algorithm feasibility and safety in left bundle branch pacing. Europace 2023; 26:euad359. [PMID: 38042980 PMCID: PMC10766140 DOI: 10.1093/europace/euad359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 11/25/2023] [Indexed: 12/04/2023] Open
Abstract
AIMS Autothreshold algorithms enable remote monitoring of patients with conventional pacing, but there is limited information on their performance in left bundle branch pacing (LBBP). Our objective was to analyse the behaviour of the autothreshold algorithm in LBBP and compare it with conventional pacing and manual thresholds during initial device programming (acute phase), after 1-7 days (subacute), and 1-3 months later (chronic). METHODS AND RESULTS A prospective, non-randomized, single-centre comparative study was conducted. Consecutive patients with indication for cardiac pacing were enrolled. Implants were performed in the left bundle branch area or the right ventricle endocardium at the discretion of the operator. Left bundle branch pacing was determined according to published criteria. Autothreshold algorithm was activated in both groups whenever allowed by the device. Seventy-five patients were included, with 50 undergoing LBBP and 25 receiving conventional pacing. Activation of the autothreshold algorithm was more feasible in later phases, showing a favourable trend towards bipolar pacing. Failures in algorithm activation were primarily due to insufficient safety margins (82.8% in LBBP and 90% in conventional pacing). The remainder was attributed to atrial tachyarrhythmias (10.3% and 10%, respectively) and electrical noise (the remaining 6.9% in the LBBP group). In the LBBP group, there were not statistically significant differences between manual and automatic thresholds, and both remained stable during follow-up (mean increase of 0.50 V). CONCLUSION The autothreshold algorithm is feasible in LBBP, with a favourable trend towards bipolar pacing. Automatic thresholds are similar to manual in patients with LBBP, and they remain stable during follow-up.
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Affiliation(s)
- Elena Sola-García
- Cardiology Department, Virgen de las Nieves University Hospital, Avenida de las Fuerzas Armadas n° 2, Granada 18014, Spain
- Instituto de investigación biosanitaria de Granada (FIBAO), Edificio Licinio de la Fuente, Calle Dr. Azpitarte nº 4, Planta 5ª, Granada 18012, Spain
| | - Manuel Molina-Lerma
- Instituto de investigación biosanitaria de Granada (FIBAO), Edificio Licinio de la Fuente, Calle Dr. Azpitarte nº 4, Planta 5ª, Granada 18012, Spain
- Arrhythmia Unit, Cardiology Department, Virgen de las Nieves University Hospital, Avenida de las Fuerzas Armadas n° 2, Granada 18014, Spain
| | - Juan Jiménez-Jáimez
- Instituto de investigación biosanitaria de Granada (FIBAO), Edificio Licinio de la Fuente, Calle Dr. Azpitarte nº 4, Planta 5ª, Granada 18012, Spain
- Arrhythmia Unit, Cardiology Department, Virgen de las Nieves University Hospital, Avenida de las Fuerzas Armadas n° 2, Granada 18014, Spain
| | - Rosa Macías-Ruiz
- Instituto de investigación biosanitaria de Granada (FIBAO), Edificio Licinio de la Fuente, Calle Dr. Azpitarte nº 4, Planta 5ª, Granada 18012, Spain
- Arrhythmia Unit, Cardiology Department, Virgen de las Nieves University Hospital, Avenida de las Fuerzas Armadas n° 2, Granada 18014, Spain
| | - Pablo J Sánchez-Millán
- Instituto de investigación biosanitaria de Granada (FIBAO), Edificio Licinio de la Fuente, Calle Dr. Azpitarte nº 4, Planta 5ª, Granada 18012, Spain
- Arrhythmia Unit, Cardiology Department, Virgen de las Nieves University Hospital, Avenida de las Fuerzas Armadas n° 2, Granada 18014, Spain
| | - Luis Tercedor
- Instituto de investigación biosanitaria de Granada (FIBAO), Edificio Licinio de la Fuente, Calle Dr. Azpitarte nº 4, Planta 5ª, Granada 18012, Spain
- Arrhythmia Unit, Cardiology Department, Virgen de las Nieves University Hospital, Avenida de las Fuerzas Armadas n° 2, Granada 18014, Spain
| | - Miguel Álvarez
- Instituto de investigación biosanitaria de Granada (FIBAO), Edificio Licinio de la Fuente, Calle Dr. Azpitarte nº 4, Planta 5ª, Granada 18012, Spain
- Arrhythmia Unit, Cardiology Department, Virgen de las Nieves University Hospital, Avenida de las Fuerzas Armadas n° 2, Granada 18014, Spain
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5
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Cannie DE, Syrris P, Protonotarios A, Bakalakos A, Pruny JF, Ditaranto R, Martinez-Veira C, Larrañaga-Moreira JM, Medo K, Bermúdez-Jiménez FJ, Ben Yaou R, Leturcq F, Mezcua AR, Marini-Bettolo C, Cabrera E, Reuter C, Limeres Freire J, Rodríguez-Palomares JF, Mestroni L, Taylor MRG, Parikh VN, Ashley EA, Barriales-Villa R, Jiménez-Jáimez J, Garcia-Pavia P, Charron P, Biagini E, García Pinilla JM, Bourke J, Savvatis K, Wahbi K, Elliott PM. Emery-Dreifuss muscular dystrophy Type 1 is associated with a high risk of malignant ventricular arrhythmias and end-stage heart failure. Eur Heart J 2023; 44:5064-5073. [PMID: 37639473 PMCID: PMC10733739 DOI: 10.1093/eurheartj/ehad561] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/15/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND AND AIMS Emery-Dreifuss muscular dystrophy (EDMD) is caused by variants in EMD (EDMD1) and LMNA (EDMD2). Cardiac conduction defects and atrial arrhythmia are common to both, but LMNA variants also cause end-stage heart failure (ESHF) and malignant ventricular arrhythmia (MVA). This study aimed to better characterize the cardiac complications of EMD variants. METHODS Consecutively referred EMD variant-carriers were retrospectively recruited from 12 international cardiomyopathy units. MVA and ESHF incidences in male and female variant-carriers were determined. Male EMD variant-carriers with a cardiac phenotype at baseline (EMDCARDIAC) were compared with consecutively recruited male LMNA variant-carriers with a cardiac phenotype at baseline (LMNACARDIAC). RESULTS Longitudinal follow-up data were available for 38 male and 21 female EMD variant-carriers [mean (SD) ages 33.4 (13.3) and 43.3 (16.8) years, respectively]. Nine (23.7%) males developed MVA and five (13.2%) developed ESHF during a median (inter-quartile range) follow-up of 65.0 (24.3-109.5) months. No female EMD variant-carrier had MVA or ESHF, but nine (42.8%) developed a cardiac phenotype at a median (inter-quartile range) age of 58.6 (53.2-60.4) years. Incidence rates for MVA were similar for EMDCARDIAC and LMNACARDIAC (4.8 and 6.6 per 100 person-years, respectively; log-rank P = .49). Incidence rates for ESHF were 2.4 and 5.9 per 100 person-years for EMDCARDIAC and LMNACARDIAC, respectively (log-rank P = .09). CONCLUSIONS Male EMD variant-carriers have a risk of progressive heart failure and ventricular arrhythmias similar to that of male LMNA variant-carriers. Early implantable cardioverter defibrillator implantation and heart failure drug therapy should be considered in male EMD variant-carriers with cardiac disease.
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Affiliation(s)
- Douglas E Cannie
- Institute of Cardiovascular Science, University College London, London, UK
- Department of Inherited Cardiovascular Diseases, Barts Heart Centre, St Bartholomew’s Hospital, London, UK
| | - Petros Syrris
- Institute of Cardiovascular Science, University College London, London, UK
- Department of Inherited Cardiovascular Diseases, Barts Heart Centre, St Bartholomew’s Hospital, London, UK
| | - Alexandros Protonotarios
- Institute of Cardiovascular Science, University College London, London, UK
- Department of Inherited Cardiovascular Diseases, Barts Heart Centre, St Bartholomew’s Hospital, London, UK
| | - Athanasios Bakalakos
- Institute of Cardiovascular Science, University College London, London, UK
- Department of Inherited Cardiovascular Diseases, Barts Heart Centre, St Bartholomew’s Hospital, London, UK
| | - Jean-François Pruny
- APHP, Sorbonne Université, Centre de Référence pour les Maladies Cardiaques Héréditaires ou rares, ICAN Institute, Hôpital Pitié-Salpêtrière, Paris, France
| | - Raffaello Ditaranto
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-GUARDHEART)
| | - Cristina Martinez-Veira
- Unidad de Cardiopatías Familiares, Complexo Hospitalario Universitario de A Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC/CIBERCV), Servizo Galego de Saúde (SERGAS), Universidade da Coruña, A Coruña, Spain
| | - Jose M Larrañaga-Moreira
- Unidad de Cardiopatías Familiares, Complexo Hospitalario Universitario de A Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC/CIBERCV), Servizo Galego de Saúde (SERGAS), Universidade da Coruña, A Coruña, Spain
| | - Kristen Medo
- Cardiovascular Institute and Adult Medical Genetics Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Francisco José Bermúdez-Jiménez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria IBS Granada, Granada, Spain
| | - Rabah Ben Yaou
- APHP-Sorbonne Universite, Centre de Référence des Maladies Neuromusculaires, Inserm, Centre de Recherche en Myologie, Institut de Myologie, Hopital Pitie-Salpetriere, Paris, France
| | - France Leturcq
- APHP, Cochin Hospital, Department of Genomic Medicine and Systemic Diseases, University of Paris, Paris, France
| | - Ainhoa Robles Mezcua
- Heart Failure and Familial Cardiomyopathies Unit, Department of Cardiology, IBIMA, Málaga. Spain
- Ciber-Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
| | - Chiara Marini-Bettolo
- Department of Cardiology, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK
- The John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Eva Cabrera
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-GUARDHEART)
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, IDIPHISA, CIBERCV, Madrid, Spain
| | - Chloe Reuter
- Stanford Center for Inherited Cardiovascular Disease, Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, 291 Campus Drive, Stanford, CA 94305, USA
| | - Javier Limeres Freire
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-GUARDHEART)
- Ciber-Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
- Inherited Cardiovascular Diseases Unit, Department of Cardiology, Hospital Universitari Vall d´Hebron, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José F Rodríguez-Palomares
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-GUARDHEART)
- Ciber-Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
- Inherited Cardiovascular Diseases Unit, Department of Cardiology, Hospital Universitari Vall d´Hebron, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Luisa Mestroni
- Cardiovascular Institute and Adult Medical Genetics Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Matthew R G Taylor
- Cardiovascular Institute and Adult Medical Genetics Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Victoria N Parikh
- Stanford Center for Inherited Cardiovascular Disease, Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, 291 Campus Drive, Stanford, CA 94305, USA
| | - Euan A Ashley
- Stanford Center for Inherited Cardiovascular Disease, Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, 291 Campus Drive, Stanford, CA 94305, USA
| | - Roberto Barriales-Villa
- Unidad de Cardiopatías Familiares, Complexo Hospitalario Universitario de A Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC/CIBERCV), Servizo Galego de Saúde (SERGAS), Universidade da Coruña, A Coruña, Spain
| | - Juan Jiménez-Jáimez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria IBS Granada, Granada, Spain
| | - Pablo Garcia-Pavia
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-GUARDHEART)
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, IDIPHISA, CIBERCV, Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Philippe Charron
- APHP, Sorbonne Université, Centre de Référence pour les Maladies Cardiaques Héréditaires ou rares, ICAN Institute, Hôpital Pitié-Salpêtrière, Paris, France
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-GUARDHEART)
| | - Elena Biagini
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-GUARDHEART)
| | - José M García Pinilla
- Heart Failure and Familial Cardiomyopathies Unit, Department of Cardiology, IBIMA, Málaga. Spain
- Ciber-Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Medicina y Dermatología, Universidad de Malaga, Malaga, Spain
| | - John Bourke
- Department of Cardiology, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK
- The John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Konstantinos Savvatis
- Institute of Cardiovascular Science, University College London, London, UK
- Department of Inherited Cardiovascular Diseases, Barts Heart Centre, St Bartholomew’s Hospital, London, UK
- William Harvey Institute, Queen Mary University London, London, United Kingdom
- National Institute for Health Research, University College London Hospitals Biomedical Research Centre, London, United Kingdom
| | - Karim Wahbi
- AP-HP, Pitié-Salpêtrière Hospital, Reference Center for Muscle Diseases Paris-Est, Myology Institute, Paris, France
- AP-HP, Cochin Hospital, Cardiology Department, Paris Cedex, France
- Université de Paris, Paris, France; Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, Paris, France
| | - Perry M Elliott
- Institute of Cardiovascular Science, University College London, London, UK
- Department of Inherited Cardiovascular Diseases, Barts Heart Centre, St Bartholomew’s Hospital, London, UK
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6
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de Frutos F, Ochoa JP, Fernández AI, Gallego-Delgado M, Navarro-Peñalver M, Casas G, Basurte MT, Larrañaga-Moreira JM, Mogollón MV, Robles-Mezcua A, García-Granja PE, Climent V, Palomino-Doza J, García-Álvarez A, Brion M, Brugada R, Jiménez-Jáimez J, Bayes-Genis A, Ripoll-Vera T, Peña-Peña ML, Rodríguez-Palomares JF, Gonzalez-Carrillo J, Villacorta E, Espinosa MA, Garcia-Pavia P, Mirelis JG. Late gadolinium enhancement distribution patterns in non-ischaemic dilated cardiomyopathy: genotype-phenotype correlation. Eur Heart J Cardiovasc Imaging 2023; 25:75-85. [PMID: 37562008 PMCID: PMC10735304 DOI: 10.1093/ehjci/jead184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/02/2023] [Accepted: 07/25/2023] [Indexed: 08/12/2023] Open
Abstract
AIMS Late gadolinium enhancement (LGE) is frequently found in patients with dilated cardiomyopathy (DCM); there is little information about its frequency and distribution pattern according to the underlying genetic substrate. We sought to describe LGE patterns according to genotypes and to analyse the risk of major ventricular arrhythmias (MVA) according to patterns. METHODS AND RESULTS Cardiac magnetic resonance findings and LGE distribution according to genetics were performed in a cohort of 600 DCM patients followed at 20 Spanish centres. After exclusion of individuals with multiple causative gene variants or with variants in infrequent DCM-causing genes, 577 patients (34% females, mean age 53.5 years, left ventricular ejection fraction 36.9 ± 13.9%) conformed to the final cohort. A causative genetic variant was identified in 219 (38%) patients, and 147 (25.5%) had LGE. Significant differences were found comparing LGE patterns between genes (P < 0.001). LGE was absent or rare in patients with variants in TNNT2, RBM20, and MYH7 (0, 5, and 20%, respectively). Patients with variants in DMD, DSP, and FLNC showed a predominance of LGE subepicardial patterns (50, 41, and 18%, respectively), whereas patients with variants in TTN, BAG3, LMNA, and MYBPC3 showed unspecific LGE patterns. The genetic yield differed according to LGE patterns. Patients with subepicardial, lineal midwall, transmural, and right ventricular insertion points or with combinations of LGE patterns showed an increased risk of MVA compared with patients without LGE. CONCLUSION LGE patterns in DCM have a specific distribution according to the affected gene. Certain LGE patterns are associated with an increased risk of MVA and with an increased yield of genetic testing.
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Affiliation(s)
- Fernando de Frutos
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, Manuel de Falla, 2, Majadahonda, Madrid, 28222, Spain
- CIBER Cardiovascular, Instituto de Salud Carlos III, Avenida Monforte de Lemos 3-5, Madrid, 28029, Spain
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, Amsterdam, The Netherlands
| | - Juan Pablo Ochoa
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, Manuel de Falla, 2, Majadahonda, Madrid, 28222, Spain
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, Amsterdam, The Netherlands
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Melchor Fernández Almagro 3, Madrid, 28029, Spain
| | - Ana Isabel Fernández
- CIBER Cardiovascular, Instituto de Salud Carlos III, Avenida Monforte de Lemos 3-5, Madrid, 28029, Spain
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - María Gallego-Delgado
- CIBER Cardiovascular, Instituto de Salud Carlos III, Avenida Monforte de Lemos 3-5, Madrid, 28029, Spain
- Department of Cardiology, CSUR Cardiopatías Familiares, Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Marina Navarro-Peñalver
- CIBER Cardiovascular, Instituto de Salud Carlos III, Avenida Monforte de Lemos 3-5, Madrid, 28029, Spain
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, Amsterdam, The Netherlands
- Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, El Palmar (Murcia), Spain
| | - Guillem Casas
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, Amsterdam, The Netherlands
- Servicio de Cardiología, Hospital Universitario Vall Hebrón, Institut de Recerca Vall Hebrón (VHIR), Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María Teresa Basurte
- Department of Cardiology, Área del Corazón, Hospital Universitario de Navarra, Pamplona, Spain
- IdiSNA—Instituto de Investigación Sanitaria de Navarra, Pamplona, Navarra, Spain
| | - José María Larrañaga-Moreira
- Unidad de Cardiopatías Familiares, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña, Servizo Galego de Saúde (SERGAS), Universidade da Coruña, A Coruña, Spain
| | | | - Ainhoa Robles-Mezcua
- Heart Failure and Familial Heart Diseases Unit, Cardiology Department, Hospital Universitario Virgen de la Victoria, IBIMA, Malaga, Spain
| | - Pablo Elpidio García-Granja
- CIBER Cardiovascular, Instituto de Salud Carlos III, Avenida Monforte de Lemos 3-5, Madrid, 28029, Spain
- Cardiology Department, Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Vicente Climent
- Inherited Cardiovascular Diseases Unit, Department of Cardiology, Hospital General Universitario de Alicante, Institute of Health and Biomedical Research, Alicante, Spain
| | - Julián Palomino-Doza
- CIBER Cardiovascular, Instituto de Salud Carlos III, Avenida Monforte de Lemos 3-5, Madrid, 28029, Spain
- Cardiology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación i+12, Madrid, Spain
| | - Ana García-Álvarez
- CIBER Cardiovascular, Instituto de Salud Carlos III, Avenida Monforte de Lemos 3-5, Madrid, 28029, Spain
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Melchor Fernández Almagro 3, Madrid, 28029, Spain
- Cardiology Department, Hospital Clínic Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - María Brion
- CIBER Cardiovascular, Instituto de Salud Carlos III, Avenida Monforte de Lemos 3-5, Madrid, 28029, Spain
- Xenética Cardiovascular, Instituto de Investigación Sanitaria de Santiago, Unidad de Cardiopatías Familiares, Servicio de Cardiología, Complexo Hospitalario Universitario de Santiago de Compostela, Spain
| | - Ramón Brugada
- CIBER Cardiovascular, Instituto de Salud Carlos III, Avenida Monforte de Lemos 3-5, Madrid, 28029, Spain
- Medical Science Department, School of Medicine, University of Girona, 17003 Girona, Spain
- Cardiology Service, Hospital Josep Trueta, University of Girona, 17007 Girona, Spain
- Cardiovascular Genetics Center, University of Girona-IDIBGI, 17190 Girona, Spain
| | - Juan Jiménez-Jáimez
- Department of Cardiology, Virgen de las Nieves University Hospital, 18014 Granada, Spain
- Instituto de Investigacion Biosanitaria de Granada IBS, 18014 Granada, Spain
| | - Antoni Bayes-Genis
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Tomas Ripoll-Vera
- Hospital Universitario Son Llatzer, IdISBa, Palma de Mallorca, Spain
| | - María Luisa Peña-Peña
- Unidad de Imagen y Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - José F Rodríguez-Palomares
- CIBER Cardiovascular, Instituto de Salud Carlos III, Avenida Monforte de Lemos 3-5, Madrid, 28029, Spain
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, Amsterdam, The Netherlands
- Servicio de Cardiología, Hospital Universitario Vall Hebrón, Institut de Recerca Vall Hebrón (VHIR), Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josefa Gonzalez-Carrillo
- CIBER Cardiovascular, Instituto de Salud Carlos III, Avenida Monforte de Lemos 3-5, Madrid, 28029, Spain
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, Amsterdam, The Netherlands
- Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, El Palmar (Murcia), Spain
| | - Eduardo Villacorta
- CIBER Cardiovascular, Instituto de Salud Carlos III, Avenida Monforte de Lemos 3-5, Madrid, 28029, Spain
- Department of Cardiology, CSUR Cardiopatías Familiares, Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Maria Angeles Espinosa
- CIBER Cardiovascular, Instituto de Salud Carlos III, Avenida Monforte de Lemos 3-5, Madrid, 28029, Spain
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, Amsterdam, The Netherlands
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Pablo Garcia-Pavia
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, Manuel de Falla, 2, Majadahonda, Madrid, 28222, Spain
- CIBER Cardiovascular, Instituto de Salud Carlos III, Avenida Monforte de Lemos 3-5, Madrid, 28029, Spain
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, Amsterdam, The Netherlands
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Melchor Fernández Almagro 3, Madrid, 28029, Spain
- Universidad Francisco de Vitoria, Carretera Pozuelo KM1800, Majadajonda 28223, Spain
| | - Jesus G Mirelis
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, Manuel de Falla, 2, Majadahonda, Madrid, 28222, Spain
- CIBER Cardiovascular, Instituto de Salud Carlos III, Avenida Monforte de Lemos 3-5, Madrid, 28029, Spain
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, Amsterdam, The Netherlands
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7
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Cámara-Checa A, Perin F, Rubio-Alarcón M, Dago M, Crespo-García T, Rapún J, Marín M, Cebrián J, Gómez R, Bermúdez-Jiménez F, Monserrat L, Tamargo J, Caballero R, Jiménez-Jáimez J, Delpón E. A gain-of-function HCN4 mutant in the HCN domain is responsible for inappropriate sinus tachycardia in a Spanish family. Proc Natl Acad Sci U S A 2023; 120:e2305135120. [PMID: 38032931 DOI: 10.1073/pnas.2305135120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/12/2023] [Indexed: 12/02/2023] Open
Abstract
In a family with inappropriate sinus tachycardia (IST), we identified a mutation (p.V240M) of the hyperpolarization-activated cyclic nucleotide-gated type 4 (HCN4) channel, which contributes to the pacemaker current (If) in human sinoatrial node cells. Here, we clinically study fifteen family members and functionally analyze the p.V240M variant. Macroscopic (IHCN4) and single-channel currents were recorded using patch-clamp in cells expressing human native (WT) and/or p.V240M HCN4 channels. All p.V240M mutation carriers exhibited IST that was accompanied by cardiomyopathy in adults. IHCN4 generated by p.V240M channels either alone or in combination with WT was significantly greater than that generated by WT channels alone. The variant, which lies in the N-terminal HCN domain, increased the single-channel conductance and opening frequency and probability of HCN4 channels. Conversely, it did not modify the channel sensitivity for cAMP and ivabradine or the level of expression at the membrane. Treatment with ivabradine based on functional data reversed the IST and the cardiomyopathy of the carriers. In computer simulations, the p.V240M gain-of-function variant increases If and beating rate and thus explains the IST of the carriers. The results demonstrate the importance of the unique HCN domain in HCN4, which stabilizes the channels in the closed state.
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Affiliation(s)
- Anabel Cámara-Checa
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Francesca Perin
- Department of Pediatric Cardiology, Virgen de las Nieves University Hospital, Granada 18014, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada 18014, Spain
| | - Marcos Rubio-Alarcón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - María Dago
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Teresa Crespo-García
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Josu Rapún
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - María Marín
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Jorge Cebrián
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Ricardo Gómez
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Francisco Bermúdez-Jiménez
- Department of Pediatric Cardiology, Virgen de las Nieves University Hospital, Granada 18014, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada 18014, Spain
- Centro Nacional de Investigaciones Cardiovasculares, Madrid 28029, Spain
| | - Lorenzo Monserrat
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
- Health in Code Sociedad Limitada, A Coruña 15008, Spain
| | - Juan Tamargo
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
| | - Ricardo Caballero
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Juan Jiménez-Jáimez
- Department of Pediatric Cardiology, Virgen de las Nieves University Hospital, Granada 18014, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada 18014, Spain
| | - Eva Delpón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid 28029, Spain
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8
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Bermúdez-Jiménez FJ, Carriel V, Santos-Mateo JJ, Fernández A, García-Hernández S, Ramos KA, Piqueras-Flores J, Cabrera-Romero E, Barriales-Villa R, de la Higuera Romero L, Alcalá López JE, Gimeno Blanes JR, Sánchez-Porras D, Campos F, Alaminos M, Oyonarte-Ramírez JM, Álvarez M, Tercedor L, Brodehl A, Jiménez-Jáimez J. ROD2 domain filamin C missense mutations exhibit a distinctive cardiac phenotype with restrictive/hypertrophic cardiomyopathy and saw-tooth myocardium. Rev Esp Cardiol (Engl Ed) 2023; 76:301-311. [PMID: 35952944 DOI: 10.1016/j.rec.2022.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 07/28/2022] [Indexed: 04/29/2023]
Abstract
INTRODUCTION AND OBJECTIVES Missense mutations in the filamin C (FLNC) gene have been reported as cause of inherited cardiomyopathy. Knowledge of the pathogenicity and genotype-phenotype correlation remains scarce. Our aim was to describe a distinctive cardiac phenotype related to rare missense FLNC variants in the ROD2 domain. METHODS We recruited 21 unrelated families genetically evaluated because of hypertrophic cardiomyopathy (HCM)/restrictive cardiomyopathy (RCM) phenotype carrying rare missense variants in the ROD2 domain of FLNC (FLNC-mRod2). Carriers underwent advanced cardiac imaging and genetic cascade screening. Myocardial tissue from 3 explanted hearts of a missense FLNC carrier was histologically analyzed and compared with an FLNC-truncating variant heart sample and a healthy control. Plasmids independently containing 3 FLNC missense variants were transfected and analyzed using confocal microscopy. RESULTS Eleven families (52%) with 20 assessed individuals (37 [23.7-52.7]) years showed 15 cases with a cardiac phenotype consisting of an overlap of HCM-RCM and left ventricular hypertrabeculation (saw-tooth appearance). During a median follow-up of 6.49 years, they presented with advanced heart failure: 16 (80%) diastolic dysfunction, 3 heart transplants, 3 heart failure deaths) and absence of cardiac conduction disturbances or skeletal myopathy. A total of 6 families had moderate genotype-phenotype segregation, and the remaining were de novo variants. Differential extracellular matrix remodeling and FLNC distribution among cardiomyocytes were confirmed on histology. HT1080 and H9c2 cells did not reveal cytoplasmic aggregation of mutant FLNC. CONCLUSIONS FLNC-mRod2 variants show a high prevalence of an overlapped phenotype comprising RCM, HCM and deep hypertrabeculation with saw-tooth appearance and distinctive cardiac histopathological remodeling.
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Affiliation(s)
- Francisco José Bermúdez-Jiménez
- Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria ibsGRANADA, Granada, Spain; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
| | - Víctor Carriel
- Departamento de Histología, Grupo de Ingeniería Tisular, Universidad de Granada, Instituto de Investigación Biosanitaria ibsGRANADA, Granada, Spain
| | - Juan José Santos-Mateo
- Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca Murcia (IMIB), Murcia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-Guard Heart), Amsterdam, Netherlands
| | - Adrián Fernández
- Servicio de Cardiología, Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | - Soledad García-Hernández
- Health in Code SL, Cardiología y Departamento Científico, Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain
| | - Karina Analía Ramos
- Servicio de Cardiología, Hospital Centenario, Facultad de Ciencias Médicas, Universidad de Rosario, Argentina
| | - Jesús Piqueras-Flores
- Servicio de Cardiología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Eva Cabrera-Romero
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Roberto Barriales-Villa
- Complexo Hospitalario Universitario A Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain
| | - Luis de la Higuera Romero
- Health in Code SL, Cardiología y Departamento Científico, Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain
| | - Juan Emilio Alcalá López
- Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria ibsGRANADA, Granada, Spain
| | - Juan Ramón Gimeno Blanes
- Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca Murcia (IMIB), Murcia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-Guard Heart), Amsterdam, Netherlands
| | - David Sánchez-Porras
- Departamento de Histología, Grupo de Ingeniería Tisular, Universidad de Granada, Instituto de Investigación Biosanitaria ibsGRANADA, Granada, Spain
| | - Fernando Campos
- Departamento de Histología, Grupo de Ingeniería Tisular, Universidad de Granada, Instituto de Investigación Biosanitaria ibsGRANADA, Granada, Spain
| | - Miguel Alaminos
- Departamento de Histología, Grupo de Ingeniería Tisular, Universidad de Granada, Instituto de Investigación Biosanitaria ibsGRANADA, Granada, Spain
| | - José Manuel Oyonarte-Ramírez
- Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria ibsGRANADA, Granada, Spain
| | - Miguel Álvarez
- Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria ibsGRANADA, Granada, Spain
| | - Luis Tercedor
- Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria ibsGRANADA, Granada, Spain
| | - Andreas Brodehl
- Erich and Hanna Klessmann Institute for Cardiovascular Research & Development (EHKI), Heart and Diabetes Center NRW, University Hospital of the Ruhr-University Bochum, Bad Oeynhausen, Germany
| | - Juan Jiménez-Jáimez
- Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria ibsGRANADA, Granada, Spain.
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9
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Macías-Ruiz R, Jiménez-Jáimez J, Molina-Lerma M, Sánchez-Millán P, Álvarez-López M, Wangensteen R, Quesada A, Osuna-Ortega A, Tercedor-Sánchez L. Efecto de la cardioversión eléctrica programada de fibrilación auricular sobre la función renal. RCCAR 2022. [DOI: 10.24875/rccar.m22000158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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10
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Rubini-Costa R, Bermúdez-Jiménez F, Rivera-López R, Sola-García E, Nagib-Raya H, Moreno-Escobar E, López-Zúñiga MÁ, Briones-Través A, Sanz-Herrera F, Sequí-Sabater JM, Romero-Cabrera JL, Maíllo-Seco J, Fernández-Vázquez F, Rivadeneira-Ruiz M, López-Valero L, Gómez-Navarro C, Aparicio-Gómez JA, López MÁ, Tercedor L, Molina-Jiménez M, Macías-Ruiz R, Jiménez-Jáimez J. Prevalence of bleeding secondary to anticoagulation and mortality in patients with atrial fibrillation admitted with SARS-CoV-2 infection. Med Clin (Engl Ed) 2022; 158:569-575. [PMID: 35761979 PMCID: PMC9219541 DOI: 10.1016/j.medcle.2021.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/21/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION AND PURPOSE Atrial fibrillation (AF) is common in patients admitted with severe COVID-19. However, there is limited data about the management of chronic anticoagulation therapy in these patients. We assessed the anticoagulation and incidence of major cardiovascular events in hospitalized patients with AF and COVID-19. METHODS We retrospectively investigated all consecutive patients with AF admitted with COVID-19 between March and May 2020 in 9 Spanish hospitals. We selected a control group of non-AF patients consecutively admitted with COVID-19. We compared baseline characteristics, incidence of major bleeding, thrombotic events and mortality. We used propensity score matching (PSM) to minimize potential confounding variables, as well as a multivariate analysis to predict major bleeding and death. RESULTS 305 patients admitted with AF and COVID-19 were included. After PSM, 151 AF patients were matched with 151 control group patients. During admission, low-molecular-weight heparin was the principal anticoagulant and the incidence of major bleeding and mortality were higher in the AF group [16 (10.6%) vs 3 (2%), p = 0.003; 52 (34.4%) vs 35 (23.2%), p = 0.03, respectively]. The multivariate analysis showed the presence of AF as independent predictor of in-hospital major bleeding and mortality in COVID-19 patients. In AF group, a secondary multivariate analysis identified high levels of D-dimer as independent predictor of in-hospital major bleeding. CONCLUSIONS AF patients admitted with COVID-19 represent a population at high risk for bleeding and mortality during admission. It seems advisable to individualize anticoagulation therapy during admission, considering patient specific bleeding and thrombotic risk.
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Affiliation(s)
- Ricardo Rubini-Costa
- Servicio de Cardiología, Hospital General Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain
| | - Francisco Bermúdez-Jiménez
- Servicio de Cardiología, Hospital General Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Melchor Fernández Almagro, 3, 28029 Madrid, Spain
| | - Ricardo Rivera-López
- Servicio de Cardiología, Hospital General Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain
| | - Elena Sola-García
- Servicio de Cardiología, Hospital General Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain
| | - Hadi Nagib-Raya
- Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain
- Servicio de Cardiología, Hospital Clínico San Cecilio, Av. del Conocimiento, s/n, 18016 Granada, Spain
| | - Eduardo Moreno-Escobar
- Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain
- Servicio de Cardiología, Hospital Clínico San Cecilio, Av. del Conocimiento, s/n, 18016 Granada, Spain
| | - Miguel Ángel López-Zúñiga
- Servicio de Medicina Interna, Hospital Universitario de Jaén, Av. del Ejército Español, 10, 23007 Jaén, Spain
| | - Adela Briones-Través
- Servicio de Urgencias, Consorcio Hospital General Universitario de Valencia, Av. de les Tres Creus, 2, 46014 Valencia, Spain
| | - Francisco Sanz-Herrera
- Servicio de Neumología, Consorcio Hospital General Universitario de Valencia, Av. de les Tres Creus, 2, 46014 Valencia, Spain
| | - Jose Miguel Sequí-Sabater
- Servicio de Reumatología, Hospital Universitario Reina Sofía, Av. Menendez Pidal, s/n, 14004 Córdoba, Spain
| | - Juan Luis Romero-Cabrera
- Servicio de Medicina Interna, Hospital Universitario Reina Sofía, Av. Menendez Pidal, s/n, 14004 Córdoba, Spain
| | - Javier Maíllo-Seco
- Servicio de Cardiología, Hospital Universitario de León, Altos de nava, s/n, 24071 León, Spain
| | | | - María Rivadeneira-Ruiz
- Servicio de Cardiología, Hospital Universitario Virgen Macarena, Dr. Fedriani, 3, 41009 Sevilla, Spain
| | - Lucas López-Valero
- Hospital Universitario de Castellón, Avinguda de Benicàssim, 128, 12004 Castellón, Spain
| | - Carlos Gómez-Navarro
- Servicio de Cardiología, Hospital Universitario Torrecárdenas, Hermandad de Donantes de Sangre, s/n, 04009 Almería, Spain
| | - Jose Antonio Aparicio-Gómez
- Servicio de Cardiología, Hospital Universitario Torrecárdenas, Hermandad de Donantes de Sangre, s/n, 04009 Almería, Spain
| | - Miguel Álvarez López
- Servicio de Cardiología, Hospital General Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain
| | - Luis Tercedor
- Servicio de Cardiología, Hospital General Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain
| | - María Molina-Jiménez
- Servicio de Cardiología, Hospital General Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain
| | - Rosa Macías-Ruiz
- Servicio de Cardiología, Hospital General Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain
| | - Juan Jiménez-Jáimez
- Servicio de Cardiología, Hospital General Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain
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11
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Jiménez-Jáimez J, Cabrera Ramos M, Bermúdez-Jiménez F, García Pinilla JM, Robles Mezcua A, Macías Ruiz R, Álvarez M, Tercedor L. Monomorphic and Polymorphic Ventricular Arrhythmias in Heterozygous Calsequestrin-2 Mutation Carriers. Circ Genom Precis Med 2022; 15:e003518. [DOI: 10.1161/circgen.121.003518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Juan Jiménez-Jáimez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain (J.J.-J., F.B.-J., R.M.R., M.A., L.T.)
- Cardiology Department, Hospital Universitario lozano Blesa, Zaragoza, Spain (J.J.-J., F.B.-J., R.M.R., M.A., L.T.)
| | - Mercedes Cabrera Ramos
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Universidad de Granada, Spain (M.C.R.)
| | - Francisco Bermúdez-Jiménez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain (J.J.-J., F.B.-J., R.M.R., M.A., L.T.)
- Cardiology Department, Hospital Universitario lozano Blesa, Zaragoza, Spain (J.J.-J., F.B.-J., R.M.R., M.A., L.T.)
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain (F.B.-J.)
| | | | - Ainhoa Robles Mezcua
- Cardiology Department, Hospital Universitario Virgen de la Victoria, Málaga, Spain (J.M.G.P., A.R.M.)
| | - Rosa Macías Ruiz
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain (J.J.-J., F.B.-J., R.M.R., M.A., L.T.)
- Cardiology Department, Hospital Universitario lozano Blesa, Zaragoza, Spain (J.J.-J., F.B.-J., R.M.R., M.A., L.T.)
| | - Miguel Álvarez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain (J.J.-J., F.B.-J., R.M.R., M.A., L.T.)
- Cardiology Department, Hospital Universitario lozano Blesa, Zaragoza, Spain (J.J.-J., F.B.-J., R.M.R., M.A., L.T.)
| | - Luis Tercedor
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain (J.J.-J., F.B.-J., R.M.R., M.A., L.T.)
- Cardiology Department, Hospital Universitario lozano Blesa, Zaragoza, Spain (J.J.-J., F.B.-J., R.M.R., M.A., L.T.)
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12
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Martínez-Campelo L, Cruz R, Blanco-Verea A, Moscoso I, Ramos-Luis E, Lage R, Álvarez-Barredo M, Sabater-Molina M, Peñafiel-Verdú P, Jiménez-Jáimez J, Rodríguez-Mañero M, Brion M. Searching for genetic modulators of the phenotypic heterogeneity in Brugada syndrome. PLoS One 2022; 17:e0263469. [PMID: 35231055 PMCID: PMC8887717 DOI: 10.1371/journal.pone.0263469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 01/20/2022] [Indexed: 11/19/2022] Open
Abstract
In Brugada syndrome, even within the same family where all affected individuals share the same mutation, phenotypic variation is prominent, with variable penetrance and expressivity, presenting different degrees of involvement. It is difficult to establish a direct correlation between genotype and phenotype to predict prognosis in complications and risk of sudden death. The factors that modulate this inter- and intra-familial phenotypic variability remain to be determined. With the intention of testing whether other genetic factors, in addition to the causal mutation in SCN5A, may have a modulating effect on the Brugada phenotype and the risk of sudden death, we have studied 8 families with a causal variant in SCN5A with at least two affected individuals, one of whom has suffered cardiac arrest or sudden death. Whole exome sequencing was performed looking for additional variants that modify the phenotype and allow us to predict a better or worse prognosis for the evolution of the disease. The results did not show any clear genetic modifier; nevertheless, highlight the possible implication of the cholesterol and fibrosis pathways, as well as the circadian rhythm, as possible modulators of Brugada syndrome phenotype.
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Affiliation(s)
- Laura Martínez-Campelo
- Cardiovascular Genetics, Santiago de Compostela Health Research Institute, Santiago de Compostela, Spain
- Genomic Medicine Group, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Raquel Cruz
- Genomic Medicine Group, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- CIBER of Rare Diseases, Carlos III Health Institute, Madrid, Spain
| | - Alejandro Blanco-Verea
- Cardiovascular Genetics, Santiago de Compostela Health Research Institute, Santiago de Compostela, Spain
- Genomic Medicine Group, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Isabel Moscoso
- Cardiovascular CIBER, Carlos III Health Institute, Madrid, Spain
- Cardiology Group, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Eva Ramos-Luis
- Cardiovascular Genetics, Santiago de Compostela Health Research Institute, Santiago de Compostela, Spain
- Genomic Medicine Group, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Ricardo Lage
- Cardiovascular CIBER, Carlos III Health Institute, Madrid, Spain
- Cardiology Group, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - María Álvarez-Barredo
- Cardiovascular Genetics, Santiago de Compostela Health Research Institute, Santiago de Compostela, Spain
- Cardiovascular CIBER, Carlos III Health Institute, Madrid, Spain
| | - María Sabater-Molina
- Cardiovascular CIBER, Carlos III Health Institute, Madrid, Spain
- Cardiogenetics Laboratory, Murcian Institute for Biosanitary Research, Cardiology Service, Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain
| | - Pablo Peñafiel-Verdú
- Cardiovascular CIBER, Carlos III Health Institute, Madrid, Spain
- Cardiogenetics Laboratory, Murcian Institute for Biosanitary Research, Cardiology Service, Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain
| | - Juan Jiménez-Jáimez
- Cardiovascular CIBER, Carlos III Health Institute, Madrid, Spain
- Arrhythmia Unit, Virgen de las Nieves University Hospital, Granada, Spain
| | - Moisés Rodríguez-Mañero
- Cardiovascular CIBER, Carlos III Health Institute, Madrid, Spain
- Cardiology Service, Santiago de Compostela University Hospital, Santiago de Compostela, Spain
| | - María Brion
- Cardiovascular Genetics, Santiago de Compostela Health Research Institute, Santiago de Compostela, Spain
- Genomic Medicine Group, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Cardiovascular CIBER, Carlos III Health Institute, Madrid, Spain
- Family Heart Disease Unit, Cardiology Service, Santiago de Compostela University Hospital, Santiago de Compostela, Spain
- * E-mail:
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13
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Bermúdez-Jiménez FJ, Molina-Lerma M, Macías-Ruiz R, Sánchez-Millán P, Jiménez-Jáimez J, Álvarez M. Initial experience with left bundle branch area pacing in patients with transthyretin cardiac amyloidosis. Rev Esp Cardiol (Engl Ed) 2022; 75:182-184. [PMID: 34674964 DOI: 10.1016/j.rec.2021.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/09/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Francisco José Bermúdez-Jiménez
- Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
| | - Manuel Molina-Lerma
- Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Rosa Macías-Ruiz
- Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Pablo Sánchez-Millán
- Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Juan Jiménez-Jáimez
- Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Miguel Álvarez
- Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
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14
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Segura-Rodríguez D, Bermúdez-Jiménez FJ, González-Camacho L, Moreno Escobar E, García-Orta R, Alcalá-López JE, Bautista Pavés A, Oyonarte-Ramírez JM, López-Fernández S, Álvarez M, Tercedor L, Jiménez-Jáimez J. Layer-Specific Global Longitudinal Strain Predicts Arrhythmic Risk in Arrhythmogenic Cardiomyopathy. Front Cardiovasc Med 2021; 8:748003. [PMID: 34869653 PMCID: PMC8634435 DOI: 10.3389/fcvm.2021.748003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/15/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Arrhythmogenic cardiomyopathy (AC) is a life-threatening disease which predispose to malignant arrhythmias and sudden cardiac death (SCD) in the early stages of the disease. Risk stratification relies on the electrical, genetic, and imaging data. Our study aimed to investigate how myocardial deformation parameters may identify the subjects at risk of known predictors of major ventricular arrhythmias. Methods: A cohort of 45 subjects with definite or borderline diagnosis of AC was characterized using the advanced transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) and divided into the groups according to the potential arrhythmic risk markers, such as non-sustained ventricular tachycardia (NSVT), late gadolinium enhancement (LGE), and genetic status. Layer-specific global longitudinal strain (GLS) by TTE 2D speckle tracking was compared in patients with and without these arrhythmic risk markers. Results: In this study, 23 (51.1%) patients were men with mean age of 43 ± 16 years. Next-generation sequencing identified a potential pathogenic mutation in 39 (86.7%) patients. Thirty-nine patients presented LGE (73.3%), mostly located at the subepicardial-to-mesocardial layers. A layer-specific-GLS analysis showed worse GLS values at the epicardial and mesocardial layers in the subjects with NSVT and LGE. The epicardial GLS values of −15.4 and −16.1% were the best cut-off values for identifying the individuals with NSVT and LGE, respectively, regardless of left ventricular ejection fraction (LVEF). Conclusions: The layer-specific GLS assessment identified the subjects with high-risk arrhythmic features in AC, such as NSVT and LGE. An epicardial GLS may emerge as a potential instrument for detecting the subjects at risk of SCD in AC.
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Affiliation(s)
- Diego Segura-Rodríguez
- Cardiology Department, Hospital Universitario San Cecilio, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Francisco José Bermúdez-Jiménez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Centro Nacional de Investigaciones Cardiovasculares, CNIC, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Eduardo Moreno Escobar
- Cardiology Department, Hospital Universitario San Cecilio, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Rocío García-Orta
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Juan Emilio Alcalá-López
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Alicia Bautista Pavés
- Cardiology Department, Hospital Universitario San Cecilio, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - José Manuel Oyonarte-Ramírez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Silvia López-Fernández
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Miguel Álvarez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Luis Tercedor
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Juan Jiménez-Jáimez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
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15
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Álvarez Rubio J, Manovel Sánchez AJ, González-Costello J, García-Pavía P, Limeres Freire J, García-Pinilla JM, Zorio Grima E, García-Álvarez A, Valverde Gómez M, Espinosa Castro MÁ, Barge-Caballero G, Gimeno Blanes JR, Bosch Rovira MT, Rincón Díaz LM, Aibar Arregui MÁ, Gallego-Delgado M, Jiménez-Jáimez J, Martínez Moreno M, Basurte M, Arana Achaga X, Hernández Baldomero IF, Ripoll-Vera T. Characterization of hereditary transthyretin cardiac amyloidosis in Spain. ACTA ACUST UNITED AC 2021; 75:488-495. [PMID: 34711514 DOI: 10.1016/j.rec.2021.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/20/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION AND OBJECTIVES Hereditary transthyretin amyloidosis (hATTR) is a disease caused by mutations in the transthyretin gene that frequently shows cardiac involvement due to amyloid deposition in the myocardium. Our objective was to identify cardiac involvement in a Spanish cohort. METHODS Retrospective multicenter study of patients diagnosed with hATTR with cardiac involvement from Spanish centers. We collected demographic, clinical, and genetic data. RESULTS A total of 181 patients from 26 centers were included (65.2% men, with a median age at diagnosis of 62 years). The most frequent mutations were Val50Met (67.7%) and Val142Ile (12.4%). The main reason for consultation was extracardiac symptoms (69%), mainly neurological. The mean N-terminal pro-B-type natriuretic peptide level was 2145±3586 pg/mL. The most characteristic electrocardiogram findings were a pseudoinfarct pattern (25.9%) and atrioventricular block (25.3%). Mean ventricular thickness was 15.4±4.1mm. Longitudinal strain was reduced in basal segments by 29.4%. Late diffuse subendocardial enhancement was observed in 58.8%. Perugini grade 2 or 3 uptake was observed in 75% of scintigraphy scans. During follow-up, 24.9% of the patients were admitted for heart failure, 34.3% required a pacemaker, and 31.6% required a liver transplant. One third (32.5%) died during follow-up, mainly due to heart failure (28.8%). The presence of non-Val50Met mutations was associated with a worse prognosis. CONCLUSIONS HATTR cardiac amyloidosis in Spain shows heterogeneous genetic and clinical involvement. The prognosis is poor, mainly due to cardiac complications. Consequently early diagnosis and treatment are vital.
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Affiliation(s)
- Jorge Álvarez Rubio
- Unidad de Cardiopatías Familiares y Unidad Multidisciplinar de Amiloidosis TTR, Servicio de Cardiología, Hospital Universitario Son Llàtzer, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma de Mallorca, Balearic Islands, Spain
| | | | - José González-Costello
- Unidad Multidisciplinar de Amiloidosis Familiar, Servicio de Cardiología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Pablo García-Pavía
- Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Medicina, Universidad Francisco de Vitoria (UFV), Pozuelo de Alarcón, Madrid, Spain
| | - Javier Limeres Freire
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Manuel García-Pinilla
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain
| | - Esther Zorio Grima
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario y Politécnico La Fe de Valencia, Instituto de Investigación Sanitaria La Fe de Valencia, Valencia, Spain
| | - Ana García-Álvarez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - María Valverde Gómez
- Unidad de Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain; Laboratorio de Genética, Health in Code, A Coruña, Spain
| | - M Ángeles Espinosa Castro
- Unidad de Cardiopatías Familiares, Servicio de Cardiología, Hospital Gregorio Marañón, Madrid, Spain
| | - Gonzalo Barge-Caballero
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Insuficiencia Cardiaca, Servicio de Cardiología, Complexo Hospitalario Universitario de A Coruña, Instituto de Investigación Biomédica de A Coruña, A Coruña, Spain
| | - Juan Ramón Gimeno Blanes
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Cardiopatías Familiares, Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - María Teresa Bosch Rovira
- Servicio de Medicina Interna, Hospital Universitario Son Espases, Palma de Mallorca, Balearic Islands, Spain
| | - Luis Miguel Rincón Díaz
- Unidad de Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Miguel Ángel Aibar Arregui
- Servicio de Medicina Interna, Hospital Clínico Universitario de Zaragoza, Instituto de Investigación Sanitaria de Aragón (IIS-A), Zaragoza, Spain
| | - María Gallego-Delgado
- Unidad de Cardiopatías Familiares, Servicio de Cardiología, Instituto de Investigación Biomédica de Salamanca (IBSAL), Complejo Asistencial Universitario de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Salamanca, Spain
| | - Juan Jiménez-Jáimez
- Unidad de Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Marina Martínez Moreno
- Servicio de Cardiología, Hospital General Universitario de Elche, Elche, Alicante, Spain
| | - Mayte Basurte
- Servicio de Cardiología, Complejo Universitario de Navarra, Navarra, Pamplona, Spain
| | - Xabier Arana Achaga
- Servicio de Cardiología, Hospital Universitario Donostia, Donostia, Guipúzcoa, Spain
| | - Idaira Famara Hernández Baldomero
- Unidad de Insuficiencia Cardiaca, Servicio de Cardiología, Complejo Hospitalario Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
| | - Tomás Ripoll-Vera
- Unidad de Cardiopatías Familiares y Unidad Multidisciplinar de Amiloidosis TTR, Servicio de Cardiología, Hospital Universitario Son Llàtzer, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma de Mallorca, Balearic Islands, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Spain.
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16
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Cabrera-Borrego E, Montero-Vilchez T, Bermúdez-Jiménez FJ, Tercedor-Sánchez J, Tercedor-Sánchez L, Sánchez-Díaz M, Macías-Ruiz R, Molina-Jiménez M, Cañizares-García FJ, Fernández-Segura E, Fernandez-Flores A, Arias-Santiago S, Jiménez-Jáimez J. Heterozygous Arrhythmogenic Cardiomyopathy- desmoplakin Mutation Carriers Exhibit a Subclinical Cutaneous Phenotype with Cell Membrane Disruption and Lack of Intercellular Adhesion. J Clin Med 2021; 10:jcm10194608. [PMID: 34640625 PMCID: PMC8509745 DOI: 10.3390/jcm10194608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/03/2021] [Accepted: 10/05/2021] [Indexed: 01/20/2023] Open
Abstract
Genetic variants that result in truncation in desmoplakin (DSP) are a known cause of arrhythmogenic cardiomyopathy (AC). In homozygous carriers, the combined involvement of skin and heart muscle is well defined, however, this is not the case in heterozygous carriers. The aim of this work is to describe cutaneous findings and analyze the molecular and ultrastructural cutaneous changes in this group of patients. Four women and eight men with a mean age of 48 ± 14 years were included. Eight met definitive criteria for AC, one was borderline and three were silent carriers. No relevant macroscopic changes in skin and hair were detected. However, significantly lower skin temperature (29.56 vs. 30.97 °C, p = 0.036) and higher transepidermal water loss (TEWL) (37.62 vs. 23.95 g m 2 h 1, p = 0.028) were observed compared to sex- and age-matched controls. Histopathology of the skin biopsy showed widening of intercellular spaces and acantholysis of keratinocytes in the spinous layer. Immunohistochemistry showed a strongly reduced expression of DSP in all samples. Trichogram showed regular nodules (thickening) compatible with pseudomonilethrix. Therefore, regardless of cardiac involvement, heterozygous patients with truncation-type variants in DSP have lower skin temperature and higher TEWL, constant microscopic skin involvement with specific patterns and pseudomonilethrix in the trichogram.
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Affiliation(s)
- Eva Cabrera-Borrego
- Cardiology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain; (E.C.-B.); (F.J.B.-J.); (L.T.-S.); (R.M.-R.); (M.M.-J.); (J.J.-J.)
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
| | - Trinidad Montero-Vilchez
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
- Dermatology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain
| | - Francisco José Bermúdez-Jiménez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain; (E.C.-B.); (F.J.B.-J.); (L.T.-S.); (R.M.-R.); (M.M.-J.); (J.J.-J.)
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 28029 Madrid, CP, Spain
| | - Jesús Tercedor-Sánchez
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
- Dermatology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain
| | - Luis Tercedor-Sánchez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain; (E.C.-B.); (F.J.B.-J.); (L.T.-S.); (R.M.-R.); (M.M.-J.); (J.J.-J.)
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
| | - Manuel Sánchez-Díaz
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
- Dermatology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain
| | - Rosa Macías-Ruiz
- Cardiology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain; (E.C.-B.); (F.J.B.-J.); (L.T.-S.); (R.M.-R.); (M.M.-J.); (J.J.-J.)
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
| | - María Molina-Jiménez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain; (E.C.-B.); (F.J.B.-J.); (L.T.-S.); (R.M.-R.); (M.M.-J.); (J.J.-J.)
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
| | | | - Eduardo Fernández-Segura
- Department of Histology, University of Granada, 18016 Granada, CP, Spain; (F.J.C.-G.); (E.F.-S.)
| | | | - Salvador Arias-Santiago
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
- Dermatology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain
- Correspondence:
| | - Juan Jiménez-Jáimez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain; (E.C.-B.); (F.J.B.-J.); (L.T.-S.); (R.M.-R.); (M.M.-J.); (J.J.-J.)
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
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17
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Akhtar MM, Lorenzini M, Pavlou M, Ochoa JP, O’Mahony C, Restrepo-Cordoba MA, Segura-Rodriguez D, Bermúdez-Jiménez F, Molina P, Cuenca S, Ader F, Larrañaga-Moreira JM, Sabater-Molina M, Garcia-Alvarez MI, Arantzamendi LG, Truszkowska G, Ortiz-Genga M, Ruiz IS, Nielsen SK, Rasmussen TB, Robles Mezcua A, Alvarez-Rubio J, Eiskjaer H, Gautel M, Garcia-Pinilla JM, Ripoll-Vera T, Mogensen J, Limeres Freire J, Rodríguez-Palomares JF, Peña-Peña ML, Rangel-Sousa D, Palomino-Doza J, Arana Achaga X, Bilinska Z, Zamarreño Golvano E, Climent V, Peñalver MN, Barriales-Villa R, Charron P, Yotti R, Zorio E, Jiménez-Jáimez J, Garcia-Pavia P, Elliott PM. Association of Left Ventricular Systolic Dysfunction Among Carriers of Truncating Variants in Filamin C With Frequent Ventricular Arrhythmia and End-stage Heart Failure. JAMA Cardiol 2021; 6:891-901. [PMID: 33978673 PMCID: PMC8117057 DOI: 10.1001/jamacardio.2021.1106] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 02/22/2021] [Indexed: 12/28/2022]
Abstract
Importance Truncating variants in the gene encoding filamin C (FLNCtv) are associated with arrhythmogenic and dilated cardiomyopathies with a reportedly high risk of ventricular arrhythmia. Objective To determine the frequency of and risk factors associated with adverse events among FLNCtv carriers compared with individuals carrying TTN truncating variants (TTNtv). Design, Setting, and Participants This cohort study recruited 167 consecutive FLNCtv carriers and a control cohort of 244 patients with TTNtv matched for left ventricular ejection fraction (LVEF) from 19 European cardiomyopathy referral units between 1990 and 2018. Data analyses were conducted between June and October, 2020. Main Outcomes and Measures The primary end point was a composite of malignant ventricular arrhythmia (MVA) (sudden cardiac death, aborted sudden cardiac death, appropriate implantable cardioverter-defibrillator shock, and sustained ventricular tachycardia) and end-stage heart failure (heart transplant or mortality associated with end-stage heart failure). The secondary end point comprised MVA events only. Results In total, 167 patients with FLNCtv were studied (55 probands [33%]; 89 men [53%]; mean [SD] age at baseline evaluation, 43 [18] years). For a median follow-up of 20 months (interquartile range, 7-60 months), 29 patients (17.4%) reached the primary end point (19 patients with MVA and 10 patients with end-stage heart failure). Eight (44%) arrhythmic events occurred among individuals with baseline mild to moderate left ventricular systolic dysfunction (LVSD) (LVEF = 36%-49%). Univariable risk factors associated with the primary end point included proband status, LVEF decrement per 10%, ventricular ectopy (≥500 in 24 hours) and myocardial fibrosis detected on cardiac magnetic resonance imaging. The LVEF decrement (hazard ratio [HR] per 10%, 1.83 [95% CI, 1.30-2.57]; P < .001) and proband status (HR, 3.18 [95% CI, 1.12-9.04]; P = .03) remained independent risk factors on multivariable analysis (excluding myocardial fibrosis and ventricular ectopy owing to case censoring). There was no difference in freedom from MVA between FLNCtv carriers with mild to moderate or severe (LVEF ≤35%) LVSD (HR, 1.29 [95% CI, 0.45-3.72]; P = .64). Carriers of FLNCtv with impaired LVEF at baseline evaluation (n = 69) had reduced freedom from MVA compared with 244 TTNtv carriers with similar baseline LVEF (for mild to moderate LVSD: HR, 16.41 [95% CI, 3.45-78.11]; P < .001; for severe LVSD: HR, 2.47 [95% CI, 1.04-5.87]; P = .03). Conclusions and Relevance The high frequency of MVA among patients with FLNCtv with mild to moderate LVSD suggests that higher LVEF values than those currently recommended should be considered for prophylactic implantable cardioverter-defibrillator therapy in FLNCtv carriers.
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MESH Headings
- Adult
- Cardiomyopathy, Dilated/genetics
- Cardiomyopathy, Dilated/mortality
- Cardiomyopathy, Dilated/physiopathology
- Cardiomyopathy, Dilated/therapy
- Codon, Nonsense
- Connectin/genetics
- Death, Sudden, Cardiac/prevention & control
- Defibrillators, Implantable
- Female
- Filamins/genetics
- Heart Failure/genetics
- Heart Failure/mortality
- Heart Failure/physiopathology
- Heart Failure/therapy
- Heart Transplantation/statistics & numerical data
- Humans
- Male
- Middle Aged
- Mutation
- Stroke Volume
- Tachycardia, Ventricular/epidemiology
- Tachycardia, Ventricular/genetics
- Tachycardia, Ventricular/physiopathology
- Ventricular Dysfunction, Left/genetics
- Ventricular Dysfunction, Left/physiopathology
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Affiliation(s)
- Mohammed Majid Akhtar
- Department of Inherited Cardiovascular Diseases, Bart’s Heart Centre St Bartholomew’s Hospital, London, United Kingdom
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Massimiliano Lorenzini
- Department of Inherited Cardiovascular Diseases, Bart’s Heart Centre St Bartholomew’s Hospital, London, United Kingdom
| | - Menelaos Pavlou
- Department of Statistical Science, University College London, London, United Kingdom
| | | | - Constantinos O’Mahony
- Department of Inherited Cardiovascular Diseases, Bart’s Heart Centre St Bartholomew’s Hospital, London, United Kingdom
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Maria Alejandra Restrepo-Cordoba
- Department of Cardiology, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Spain
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARDHEART)
| | | | | | - Pilar Molina
- Pathology Department, Institute of Legal Medicine and Forensic Sciences of Valencia and Faculty of Medicine of the Universitat de València, CAFAMUSME Research Group, IIS La Fe, Valencia, Spain
| | - Sofia Cuenca
- Hospital General Universitario Gregorio Marañon, Madrid, Spain
- Instituto de Investigación Sanitarias Gregorio Marañón, Spain
| | - Flavie Ader
- APHP, UF Cardiogénétique et Myogénétique, Service de Biochimie Métabolique, Hôpitaux Universitaires de la Pitié- Salpêtrière- Charles Foix, 47-83 Bd de l’Hôpital, Paris, France
- Sorbonne Universités, UPMC Univ. Paris 06, INSERM, UMR_S 1166 and ICAN Institute for Cardiometabolism and Nutrition, Paris, France
| | - Jose M. Larrañaga-Moreira
- Unidad de Cardiopatías Familiares, Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain
- Complexo Hospitalario Universitario de A Coruña, Servizo Galego de Saúde (SERGAS), A Coruña, Spain
- Department of Cardiology, Universidade da Coruña, A Coruña, Spain
- Centro de Investigación Biomédica en Red (CIBERCV), Madrid, Spain
| | - Maria Sabater-Molina
- Inherited Cardiac Disease Unit, Hospital Universitario Virgen Arrixaca, Murcia, Spain
- Universidad de Murcia, Murcia, Spain
| | - Maria I. Garcia-Alvarez
- Cardiology Department, University General Hospital of Alicante, Alicante, Spain
- Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | | | - Grazyna Truszkowska
- Molecular Biology Laboratory, Department of Medical Biology, The Cardinal Stefan Wyszynski Institute of Cardiology, Warsaw, Poland
| | | | - Itziar Solla Ruiz
- Cardiology Specialist in Heart Failure and Inherited Cardiac Diseases, Department of Cardiology, Hospital Universitario Donostia, Spain
| | | | | | - Ainhoa Robles Mezcua
- Heart Failure and Familial Heart Diseases Unit, Cardiology Department, Hospital Universitario Virgen de la Victoria, CIBER-CV, IBIMA, Malaga, Spain
| | - Jorge Alvarez-Rubio
- Inherited Cardiovascular Diseases Unit, Son Llatzer University Hospital & IdISBa, Palma de Mallorca, Spain
| | - Hans Eiskjaer
- Department of Cardiology, Aarhus University Hospital, Hjertesygdomme, Aarhus, Denmark
| | - Mathias Gautel
- Randall Institute, King’s College London, London, United Kingdom
| | - José M. Garcia-Pinilla
- Heart Failure and Familial Heart Diseases Unit, Cardiology Department, Hospital Universitario Virgen de la Victoria, CIBER-CV, IBIMA, Malaga, Spain
| | - Tomas Ripoll-Vera
- Inherited Cardiovascular Diseases Unit, Son Llatzer University Hospital & IdISBa, Palma de Mallorca, Spain
| | - Jens Mogensen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Javier Limeres Freire
- Department of Cardiology, Vall d’ Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d’ Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jose F. Rodríguez-Palomares
- Department of Cardiology, Vall d’ Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d’ Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria Luisa Peña-Peña
- Heart Failure and Heart Transplantation Unit, Virgen del Rocio University Hospital, Sevilla, Spain
| | - Diego Rangel-Sousa
- Heart Failure and Heart Transplantation Unit, Virgen del Rocio University Hospital, Sevilla, Spain
| | - Julian Palomino-Doza
- Hereditary Cardiopathies Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Instituto de Investigación 12 de Octubre i+12, Madrid, Spain
| | - Xabier Arana Achaga
- Cardiology Specialist in Heart Failure and Inherited Cardiac Diseases, Department of Cardiology, Hospital Universitario Donostia, Spain
| | - Zofia Bilinska
- Unit for Screening Studies in Inherited Cardiovascular Diseases, The Cardinal Stefan Wyszynski Institute of Cardiology, Warsaw, Poland
| | | | - Vincent Climent
- Cardiology Department, University General Hospital of Alicante, Alicante, Spain
- Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | | | - Roberto Barriales-Villa
- Unidad de Cardiopatías Familiares, Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain
- Complexo Hospitalario Universitario de A Coruña, Servizo Galego de Saúde (SERGAS), A Coruña, Spain
- Department of Cardiology, Universidade da Coruña, A Coruña, Spain
- Centro de Investigación Biomédica en Red (CIBERCV), Madrid, Spain
| | - Philippe Charron
- Sorbonne Universités, UPMC Univ. Paris 06, INSERM, UMR_S 1166 and ICAN Institute for Cardiometabolism and Nutrition, Paris, France
- APHP, Centre de Référence pour les Maladies Cardiaques Héréditaires, Département de Génétique, Hôpital Pitié-Salpêtrière, Paris, France
| | - Raquel Yotti
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Hospital General Universitario Gregorio Marañon, Madrid, Spain
- Instituto de Investigación Sanitarias Gregorio Marañón, Spain
| | - Esther Zorio
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Cardiology Department at Hospital Universitario y Politécnico La Fe and Research Group on Inherited Heart Diseases, Sudden Death and Mechanisms of Disease (CaFaMuSMe) from the Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Juan Jiménez-Jáimez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Pablo Garcia-Pavia
- Department of Cardiology, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Spain
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARDHEART)
| | - Perry M. Elliott
- Department of Inherited Cardiovascular Diseases, Bart’s Heart Centre St Bartholomew’s Hospital, London, United Kingdom
- Institute of Cardiovascular Science, University College London, London, United Kingdom
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18
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Casas G, Limeres J, Oristrell G, Gutierrez-Garcia L, Andreini D, Borregan M, Larrañaga-Moreira JM, Lopez-Sainz A, Codina-Solà M, Teixido-Tura G, Sorolla-Romero JA, Fernández-Álvarez P, González-Carrillo J, Guala A, La Mura L, Soler-Fernández R, Sao Avilés A, Santos-Mateo JJ, Marsal JR, Ribera A, de la Pompa JL, Villacorta E, Jiménez-Jáimez J, Ripoll-Vera T, Bayes-Genis A, Garcia-Pinilla JM, Palomino-Doza J, Tiron C, Pontone G, Bogaert J, Aquaro GD, Gimeno-Blanes JR, Zorio E, Garcia-Pavia P, Barriales-Villa R, Evangelista A, Masci PG, Ferreira-González I, Rodríguez-Palomares JF. Clinical Risk Prediction in Patients With Left Ventricular Myocardial Noncompaction. J Am Coll Cardiol 2021; 78:643-662. [PMID: 34384546 DOI: 10.1016/j.jacc.2021.06.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Left ventricular noncompaction (LVNC) is a heterogeneous entity with uncertain prognosis. OBJECTIVES This study sought to develop and validate a prediction model of major adverse cardiovascular events (MACE) and to identify LVNC cases without events during long-term follow-up. METHODS This is a retrospective longitudinal multicenter cohort study of consecutive patients fulfilling LVNC criteria by echocardiography or cardiovascular magnetic resonance. MACE were defined as heart failure (HF), ventricular arrhythmias (VAs), systemic embolisms, or all-cause mortality. RESULTS A total of 585 patients were included (45 ± 20 years of age, 57% male). LV ejection fraction (LVEF) was 48% ± 17%, and 18% presented late gadolinium enhancement (LGE). After a median follow-up of 5.1 years, MACE occurred in 223 (38%) patients: HF in 110 (19%), VAs in 87 (15%), systemic embolisms in 18 (3%), and 34 (6%) died. LVEF was the main variable independently associated with MACE (P < 0.05). LGE was associated with HF and VAs in patients with LVEF >35% (P < 0.05). A prediction model of MACE was developed using Cox regression, composed by age, sex, electrocardiography, cardiovascular risk factors, LVEF, and family aggregation. C-index was 0.72 (95% confidence interval: 0.67-0.75) in the derivation cohort and 0.72 (95% confidence interval: 0.71-0.73) in an external validation cohort. Patients with no electrocardiogram abnormalities, LVEF ≥50%, no LGE, and negative family screening presented no MACE at follow-up. CONCLUSIONS LVNC is associated with an increased risk of heart failure and ventricular arrhythmias. LVEF is the variable most strongly associated with MACE; however, LGE confers additional risk in patients without severe systolic dysfunction. A risk prediction model is developed and validated to guide management.
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Affiliation(s)
- Guillem Casas
- Cardiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain
| | - Javier Limeres
- Cardiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Inherited Cardiovascular Disease Unit and Cardiovascular Genetics. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Gerard Oristrell
- Cardiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain
| | - Laura Gutierrez-Garcia
- Cardiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Inherited Cardiovascular Disease Unit and Cardiovascular Genetics. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Daniele Andreini
- Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | - Mar Borregan
- Genetics and Molecular Medicine Department and Pediatric Institute of Rare Diseases, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jose M Larrañaga-Moreira
- Inherited Cardiovascular Diseases Unit, Cardiology Department, Instituto de Investigación Biomédica de A Coruña, Complexo Hospitalario Universitario de A Coruña, Servizo Galego de Saúde, Universidade da Coruña, A Coruña, Spain
| | - Angela Lopez-Sainz
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Heart Failure and Inherited Cardiac Diseases Unit, Cardiology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-GUARD-Heart), Madrid, Spain
| | - Marta Codina-Solà
- Inherited Cardiovascular Disease Unit and Cardiovascular Genetics. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Gisela Teixido-Tura
- Cardiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Inherited Cardiovascular Disease Unit and Cardiovascular Genetics. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Paula Fernández-Álvarez
- Inherited Cardiovascular Disease Unit and Cardiovascular Genetics. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Andrea Guala
- Cardiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Lucia La Mura
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Rafaela Soler-Fernández
- Radiology Department, Instituto de Investigación Biomédica de A Coruña, Complexo Hospitalario Universitario de A Coruña, Servizo Galego de Saúde, Universidade da Coruña, A Coruña, Spain
| | - Augusto Sao Avilés
- Cardiology Department, Vall d'Hebron Hospital, Barcelona, Spain; Neurology/Neuroimmunology Department, Vall d'Hebron Hospital, Barcelona, Spain; Statistics and Bioinformatics Unit (UEB-VHIR), Vall d'Hebron Hospital, Barcelona, Spain
| | | | - Josep Ramon Marsal
- Epidemiology Unit of the Cardiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid, Spain
| | - Aida Ribera
- Epidemiology Unit of the Cardiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid, Spain
| | - José Luis de la Pompa
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Intercellular Signalling in Cardiovascular Development and Disease Laboratory, Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain
| | - Eduardo Villacorta
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Cardiology Department, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Juan Jiménez-Jáimez
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Tomás Ripoll-Vera
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Cardiology Department, Hospital Universitario Son Llatzer and Institut d'Investigaciò Sanitària Illes Balears, Mallorca, Spain
| | - Antoni Bayes-Genis
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Cardiology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Manuel Garcia-Pinilla
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Heart Failure and Familial Cardiomyopathies Unit, Cardiology Department, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga, Málaga, Spain
| | - Julián Palomino-Doza
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Cardiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Coloma Tiron
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitari Dr Josep Trueta, Girona, Spain; Medical Science Department, School of Medicine, University of Girona, Girona, Spain
| | | | - Jan Bogaert
- Gasthuisberg University Hospital, Leuven, Belgium
| | | | - Juan Ramon Gimeno-Blanes
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Cardiology Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Esther Zorio
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Inherited Heart Diseases Unit, Cardiology Department, Hospital Universitario y Politécnico La Fe de Valencia, Valencia, Spain; CAFAMUSME Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Pablo Garcia-Pavia
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Heart Failure and Inherited Cardiac Diseases Unit, Cardiology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-GUARD-Heart), Madrid, Spain; Universidad Francisco de Vitoria, Pozuelo de Alarcón, Spain
| | - Roberto Barriales-Villa
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Inherited Cardiovascular Diseases Unit, Cardiology Department, Instituto de Investigación Biomédica de A Coruña, Complexo Hospitalario Universitario de A Coruña, Servizo Galego de Saúde, Universidade da Coruña, A Coruña, Spain
| | - Artur Evangelista
- Cardiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Inherited Cardiovascular Disease Unit and Cardiovascular Genetics. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Pier Giorgio Masci
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Ignacio Ferreira-González
- Cardiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain; Epidemiology Unit of the Cardiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid, Spain.
| | - José F Rodríguez-Palomares
- Cardiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Inherited Cardiovascular Disease Unit and Cardiovascular Genetics. Hospital Universitari Vall d'Hebron, Barcelona, Spain.
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19
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Gutiérrez-Ballesteros G, Jiménez-Jáimez J, Sánchez-Millán P, Álvarez M. Persistent left superior vena cava isolation in a patient with paroxysmal atrial fibrillation and absence of right superior vena cava. Indian Pacing Electrophysiol J 2021; 21:397-398. [PMID: 34298115 PMCID: PMC8577085 DOI: 10.1016/j.ipej.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/12/2021] [Accepted: 07/16/2021] [Indexed: 11/08/2022] Open
Affiliation(s)
- Guillermo Gutiérrez-Ballesteros
- Cardiac Arrhythmia and Electrophysiology Unit, Department of Cardiology, Hospital Universitario Virgen de las Nieves, Granada, Spain.
| | - Juan Jiménez-Jáimez
- Cardiac Arrhythmia and Electrophysiology Unit, Department of Cardiology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Pablo Sánchez-Millán
- Cardiac Arrhythmia and Electrophysiology Unit, Department of Cardiology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Miguel Álvarez
- Cardiac Arrhythmia and Electrophysiology Unit, Department of Cardiology, Hospital Universitario Virgen de las Nieves, Granada, Spain
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20
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Rubini-Costa R, Bermúdez-Jiménez F, Rivera-López R, Sola-García E, Nagib-Raya H, Moreno-Escobar E, López-Zúñiga MÁ, Briones-Través A, Sanz-Herrera F, Sequí-Sabater JM, Romero-Cabrera JL, Maíllo-Seco J, Fernández-Vázquez F, Rivadeneira-Ruiz M, López-Valero L, Gómez-Navarro C, Aparicio-Gómez JA, López MÁ, Tercedor L, Molina-Jiménez M, Macías-Ruiz R, Jiménez-Jáimez J. Prevalence of bleeding secondary to anticoagulation and mortality in patients with atrial fibrillation admitted with SARS-CoV-2 infection. Med Clin (Barc) 2021; 158:569-575. [PMID: 34364707 PMCID: PMC8279935 DOI: 10.1016/j.medcli.2021.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 01/04/2023]
Abstract
Introduction and purpose Atrial fibrillation (AF) is common in patients admitted with severe COVID-19. However, there is limited data about the management of chronic anticoagulation therapy in these patients. We assessed the anticoagulation and incidence of major cardiovascular events in hospitalized patients with AF and COVID-19. Methods We retrospectively investigated all consecutive patients with AF admitted with COVID-19 between March and May 2020 in 9 Spanish hospitals. We selected a control group of non-AF patients consecutively admitted with COVID-19. We compared baseline characteristics, incidence of major bleeding, thrombotic events and mortality. We used propensity score matching (PSM) to minimize potential confounding variables, as well as a multivariate analysis to predict major bleeding and death. Results 305 patients admitted with AF and COVID-19 were included. After PSM, 151 AF patients were matched with 151 control group patients. During admission, low-molecular-weight heparin was the principal anticoagulant and the incidence of major bleeding and mortality were higher in the AF group [16 (10.6%) vs 3 (2%), p = 0.003; 52 (34.4%) vs 35 (23.2%), p = 0.03, respectively]. The multivariate analysis showed the presence of AF as independent predictor of in-hospital major bleeding and mortality in COVID-19 patients. In AF group, a secondary multivariate analysis identified high levels of D-dimer as independent predictor of in-hospital major bleeding. Conclusions AF patients admitted with COVID-19 represent a population at high risk for bleeding and mortality during admission. It seems advisable to individualize anticoagulation therapy during admission, considering patient specific bleeding and thrombotic risk.
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Affiliation(s)
- Ricardo Rubini-Costa
- Servicio de Cardiología, Hospital General Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18014 Granada, Spain; Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain
| | - Francisco Bermúdez-Jiménez
- Servicio de Cardiología, Hospital General Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18014 Granada, Spain; Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Melchor Fernández Almagro, 3, 28029 Madrid, Spain
| | - Ricardo Rivera-López
- Servicio de Cardiología, Hospital General Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18014 Granada, Spain; Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain
| | - Elena Sola-García
- Servicio de Cardiología, Hospital General Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18014 Granada, Spain; Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain
| | - Hadi Nagib-Raya
- Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain; Servicio de Cardiología, Hospital Clínico San Cecilio, Av. del Conocimiento, s/n, 18016 Granada, Spain
| | - Eduardo Moreno-Escobar
- Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain; Servicio de Cardiología, Hospital Clínico San Cecilio, Av. del Conocimiento, s/n, 18016 Granada, Spain
| | - Miguel Ángel López-Zúñiga
- Servicio de Medicina Interna, Hospital Universitario de Jaén, Av. del Ejército Español, 10, 23007 Jaén, Spain
| | - Adela Briones-Través
- Servicio de Urgencias, Consorcio Hospital General Universitario de Valencia, Av. de les Tres Creus, 2, 46014 Valencia, Spain
| | - Francisco Sanz-Herrera
- Servicio de Neumología, Consorcio Hospital General Universitario de Valencia, Av. de les Tres Creus, 2, 46014 Valencia, Spain
| | - Jose Miguel Sequí-Sabater
- Servicio de Reumatología, Hospital Universitario Reina Sofía, Av. Menendez Pidal, s/n, 14004 Córdoba, Spain
| | - Juan Luis Romero-Cabrera
- Servicio de Medicina Interna, Hospital Universitario Reina Sofía, Av. Menendez Pidal, s/n, 14004 Córdoba, Spain
| | - Javier Maíllo-Seco
- Servicio de Cardiología, Hospital Universitario de León, Altos de nava, s/n, 24071 León, Spain
| | | | - María Rivadeneira-Ruiz
- Servicio de Cardiología, Hospital Universitario Virgen Macarena, Dr. Fedriani, 3, 41009 Sevilla, Spain
| | - Lucas López-Valero
- Hospital Universitario de Castellón, Avinguda de Benicàssim, 128, 12004 Castellón, Spain
| | - Carlos Gómez-Navarro
- Servicio de Cardiología, Hospital Universitario Torrecárdenas, Hermandad de Donantes de Sangre, s/n, 04009 Almería, Spain
| | - Jose Antonio Aparicio-Gómez
- Servicio de Cardiología, Hospital Universitario Torrecárdenas, Hermandad de Donantes de Sangre, s/n, 04009 Almería, Spain
| | - Miguel Álvarez López
- Servicio de Cardiología, Hospital General Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18014 Granada, Spain; Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain
| | - Luis Tercedor
- Servicio de Cardiología, Hospital General Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18014 Granada, Spain; Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain
| | - María Molina-Jiménez
- Servicio de Cardiología, Hospital General Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18014 Granada, Spain; Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain
| | - Rosa Macías-Ruiz
- Servicio de Cardiología, Hospital General Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18014 Granada, Spain; Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain
| | - Juan Jiménez-Jáimez
- Servicio de Cardiología, Hospital General Universitario Virgen de las Nieves, Avda. de las Fuerzas Armadas 2, 18014 Granada, Spain; Instituto de Investigación Biosanitaria IBS, Universidad de Granada, Hospital Real, Avenida del Hospicio, s/n, 18010 Granada, Spain.
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21
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Molina-Lerma M, Macías-Ruiz R, Sánchez-Millán P, Jiménez-Jáimez J, Tercedor-Sánchez L, Álvarez M. Comparative analysis of His-bundle pacing and left bundle branch area pacing: acute and short-term results. Rev Esp Cardiol (Engl Ed) 2021; 74:628-630. [PMID: 33485807 DOI: 10.1016/j.rec.2020.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/10/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Manuel Molina-Lerma
- Unidad de Arritmias, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain.
| | - Rosa Macías-Ruiz
- Unidad de Arritmias, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
| | - Pablo Sánchez-Millán
- Unidad de Arritmias, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
| | - Juan Jiménez-Jáimez
- Unidad de Arritmias, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
| | - Luis Tercedor-Sánchez
- Unidad de Arritmias, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
| | - Miguel Álvarez
- Unidad de Arritmias, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
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22
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Restrepo-Cordoba MA, Wahbi K, Florian AR, Jiménez-Jáimez J, Politano L, Arad M, Climent-Paya V, Garcia-Alvarez A, Hansen RB, Larrañaga-Moreira JM, Kubanek M, Lopes LR, Ros A, Jurcut R, Rasmussen TB, Ruiz-Guerrero L, Pribe-Wolferts R, Palomino-Doza J, Bilinska Z, Rodríguez-Palomares JF, Van Loon RLE, Basurte Elorz MT, Quarta G, Robledo Iñarritu M, Verdonschot JAJ, Stojkovic T, Shomanova Z, Bermudez-Jimenez F, Palladino A, Freimark D, García-Álvarez MI, Jorda P, Dominguez F, Ochoa JP, Girolami F, Brugada R, Meder B, Barriales-Villa R, Mogensen J, Laforêt P, Yilmaz A, Elliott P, Garcia-Pavia P. Prevalence and clinical outcomes of dystrophin-associated dilated cardiomyopathy without severe skeletal myopathy. Eur J Heart Fail 2021; 23:1276-1286. [PMID: 34050592 DOI: 10.1002/ejhf.2250] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 04/12/2021] [Accepted: 05/18/2021] [Indexed: 12/28/2022] Open
Abstract
AIMS Dilated cardiomyopathy (DCM) associated with dystrophin gene (DMD) mutations in individuals with mild or absent skeletal myopathy is often indistinguishable from other DCM forms. We sought to describe the phenotype and prognosis of DMD associated DCM in DMD mutation carriers without severe skeletal myopathy. METHODS AND RESULTS At 26 European centres, we retrospectively collected clinical characteristics and outcomes of 223 DMD mutation carriers (83% male, 33 ± 15 years). A total of 112 individuals (52%) had DCM at first evaluation [n = 85; left ventricular ejection fraction (LVEF) 34 ± 11.2%] or developed DCM (n = 27; LVEF 41.3 ± 7.5%) after a median follow-up of 96 months (interquartile range 5-311 months). DCM penetrance was 45% in carriers older than 40 years. DCM appeared earlier in males and was independent of the type of mutation, presence of skeletal myopathy, or elevated serum creatine kinase levels. Major adverse cardiac events (MACE) occurred in 22% individuals with DCM, 18% developed end-stage heart failure and 9% sudden cardiac death or equivalent. Skeletal myopathy was not associated with survival free of MACE in patients with DCM. Decreased LVEF and increased left ventricular end-diastolic diameter at baseline were associated with MACE. Individuals without DCM had favourable prognosis without MACE or death during follow-up. CONCLUSIONS DMD-associated DCM without severe skeletal myopathy is characterized by incomplete penetrance but high risk of MACE, including progression to end-stage heart failure and ventricular arrhythmias. DCM onset is the major determinant of prognosis with similar survival regardless of the presence of skeletal myopathy.
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Affiliation(s)
- Maria A Restrepo-Cordoba
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, Madrid, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.,European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-GUARDHEART), Amsterdam, The Netherlands
| | - Karim Wahbi
- APHP, Cochin Hospital, Cardiology Department, FILNEMUS, Paris-Descartes, Sorbonne Paris Cité University, Paris, France
| | - Anca R Florian
- Division of Cardiovascular Imaging, Department of Cardiology I, University Hospital Muenster, Muenster, Germany
| | - Juan Jiménez-Jáimez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Luisa Politano
- Cardiomyology and Medical Genetics, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Michael Arad
- Leviev Heart Center, Sheba Medical Center and The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Vicente Climent-Paya
- Cardiology Department, University General Hospital of Alicante, Alicante, Spain. Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Ana Garcia-Alvarez
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.,Institut Clinic Cardiovascular, IDIBAPS, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Rasmus B Hansen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - José M Larrañaga-Moreira
- Inherited Cardiovascular Diseases Unit, Cardiology Service, Complexo Hospitalario Universitario de A Coruña, Servizo Galego de Saúde (SERGAS), Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, A Coruña, Spain
| | - Milos Kubanek
- Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Luis R Lopes
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-GUARDHEART), Amsterdam, The Netherlands.,Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.,Centre for Heart Muscle Disease, Institute of Cardiovascular Science, University College London, London, UK
| | - Andrea Ros
- Cardiogenetics Unit, Clinical Genetics Department, University Hospital Germans Trias i Pujol, Badalona, Spain
| | - Ruxandra Jurcut
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-GUARDHEART), Amsterdam, The Netherlands.,Expert Center for Rare Cardiovascular Genetic Diseases, 3rd Cardiology Department, Emergency Institute for Cardiovascular Diseases "Prof. Dr. C.C. Iliescu", Bucharest, Romania
| | | | - Luis Ruiz-Guerrero
- Department of Cardiology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Regina Pribe-Wolferts
- Institute for Cardiomyopathies Heidelberg, University Hospital Heidelberg, Heidelberg, Germany
| | - Julian Palomino-Doza
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.,Inherited cardiac diseases unit, Cardiology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación i+12, Madrid, Spain
| | - Zofia Bilinska
- Unit for Screening Studies in Inherited Cardiovascular Diseases, National Institute of Cardiology, Warsaw, Poland
| | - José F Rodríguez-Palomares
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.,Hospital Universitari Vall d'Hebron, Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rosa L E Van Loon
- Department of Genetics, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | | | - Giovanni Quarta
- Cardiology Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Job A J Verdonschot
- Department of Cardiology and Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Tanya Stojkovic
- Referral Center of Neuromuscular Diseases, Myology Institute, Pitié-Salpêtrière Hospital, Paris, France
| | - Zornitsa Shomanova
- Division of Cardiovascular Imaging, Department of Cardiology I, University Hospital Muenster, Muenster, Germany
| | | | - Alberto Palladino
- Cardiomyology and Medical Genetics, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Dov Freimark
- Leviev Heart Center, Sheba Medical Center and The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maria I García-Álvarez
- Cardiology Department, University General Hospital of Alicante, Alicante, Spain. Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Paloma Jorda
- Institut Clinic Cardiovascular, IDIBAPS, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Fernando Dominguez
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, Madrid, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.,European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-GUARDHEART), Amsterdam, The Netherlands
| | - Juan Pablo Ochoa
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, Madrid, Spain.,Cardiology Department, Health in Code, A Coruña, Spain
| | - Francesca Girolami
- Department of Paediatric Cardiology, Meyer Children's Hospital, Florence, Italy
| | - Ramon Brugada
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.,Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitari Dr Josep Trueta, Girona, Spain.,Medical Science Department, School of Medicine, University of Girona, Girona, Spain
| | - Benjamin Meder
- Institute for Cardiomyopathies Heidelberg, University Hospital Heidelberg, Heidelberg, Germany.,Stanford University School of Medicine, Department of Genetics, Stanford, CA, USA
| | - Roberto Barriales-Villa
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.,Inherited Cardiovascular Diseases Unit, Cardiology Service, Complexo Hospitalario Universitario de A Coruña, Servizo Galego de Saúde (SERGAS), Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, A Coruña, Spain
| | - Jens Mogensen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Pascal Laforêt
- APHP, Hôpital Raymond Poincaré, Centre de Référence des Maladies Neuromusculaires Nord-Est-Île de France, Garches, France
| | - Ali Yilmaz
- Division of Cardiovascular Imaging, Department of Cardiology I, University Hospital Muenster, Muenster, Germany
| | - Perry Elliott
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-GUARDHEART), Amsterdam, The Netherlands.,Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.,Centre for Heart Muscle Disease, Institute of Cardiovascular Science, University College London, London, UK
| | - Pablo Garcia-Pavia
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, Madrid, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.,European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-GUARDHEART), Amsterdam, The Netherlands.,Universidad Francisco de Vitoria (UFV), Pozuelo de Alarcon, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
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23
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Perin F, Molina-Lerma M, Jiménez-Jáimez J, Rodríguez-Vázquez del Rey MDM, Ortega Á, Álvarez M. Uso combinado de desfibrilador subcutáneo y marcapasos transvenoso con estimulación de rama izquierda en una niña con miocardiopatía hipertrófica. Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2020.06.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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24
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Perin F, Molina-Lerma M, Jiménez-Jáimez J, Rodríguez-Vázquez Del Rey MDM, Ortega Á, Álvarez M. Combined use of subcutaneous implantable defibrillator with endovenous left bundle branch pacing in a child with hypertrophic cardiomyopathy. Rev Esp Cardiol (Engl Ed) 2021; 74:265-267. [PMID: 32800489 DOI: 10.1016/j.rec.2020.06.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 06/18/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Francesca Perin
- Unidad de Cardiología Pediátrica, Servicio de Pediatría, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain.
| | - Manuel Molina-Lerma
- Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain; Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Juan Jiménez-Jáimez
- Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain; Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - María Del Mar Rodríguez-Vázquez Del Rey
- Unidad de Cardiología Pediátrica, Servicio de Pediatría, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain
| | - Ángeles Ortega
- Unidad de Cardiología Pediátrica, Hospital Universitario Torrecárdenas, Almería, Spain
| | - Miguel Álvarez
- Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain; Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain
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Gutiérrez-Ballesteros G, Bermúdez-Jiménez FJ, Jiménez-Jáimez J. To the Editor-Mexiletine in myotonic dystrophy: Beware of ventricular arrhythmias! Heart Rhythm 2020; 18:660. [PMID: 33346138 DOI: 10.1016/j.hrthm.2020.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 11/19/2020] [Accepted: 11/19/2020] [Indexed: 11/18/2022]
Affiliation(s)
| | - Francisco José Bermúdez-Jiménez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, España; Instituto de Investigación Biosanitaria ibs.GRANADA, Universidad de Granada, Granada, España; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
| | - Juan Jiménez-Jáimez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, España; Instituto de Investigación Biosanitaria ibs.GRANADA, Universidad de Granada, Granada, España.
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26
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Jiménez-Jáimez J, Segura-Rodríguez D, Bermúdez-Jiménez F. Resonancia magnética cardiaca en la miocardiopatía arritmogénica: ¿hay que actualizar los criterios de 2010? Rev Esp Cardiol (Engl Ed) 2020. [DOI: 10.1016/j.recesp.2020.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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27
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Jiménez-Jáimez J, Segura-Rodríguez D, Bermúdez-Jiménez F. Cardiac magnetic resonance in arrhythmogenic cardiomyopathy: is it time to update the 2010 criteria? Rev Esp Cardiol (Engl Ed) 2020; 73:871-873. [PMID: 32505459 DOI: 10.1016/j.rec.2020.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 04/29/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Juan Jiménez-Jáimez
- Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
| | - Diego Segura-Rodríguez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Servicio de Cardiología, Hospital Universitario San Cecilio, Granada, Spain
| | - Francisco Bermúdez-Jiménez
- Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
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28
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Sánchez-Millán PJ, Tercedor L, Jiménez-Jáimez J, Macías-Ruiz R, Molina-Lerma M, Álvarez M. Steam pop visualized in live intracardiac echocardiography during ablation of the anterolateral papillary muscle. Europace 2020; 22:1205. [PMID: 32355958 DOI: 10.1093/europace/euaa062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 02/18/2020] [Accepted: 02/25/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Pablo J Sánchez-Millán
- Department of Cardiology, Hospital Universitario Virgen de las Nieves, Granada Institute of Biohealth Research, Avda. de las Fuerzas Armadas 2. 18014, Granada, Spain
| | - Luis Tercedor
- Department of Cardiology, Hospital Universitario Virgen de las Nieves, Granada Institute of Biohealth Research, Avda. de las Fuerzas Armadas 2. 18014, Granada, Spain
| | - Juan Jiménez-Jáimez
- Department of Cardiology, Hospital Universitario Virgen de las Nieves, Granada Institute of Biohealth Research, Avda. de las Fuerzas Armadas 2. 18014, Granada, Spain
| | - Rosa Macías-Ruiz
- Department of Cardiology, Hospital Universitario Virgen de las Nieves, Granada Institute of Biohealth Research, Avda. de las Fuerzas Armadas 2. 18014, Granada, Spain
| | - Manuel Molina-Lerma
- Department of Cardiology, Hospital Universitario Virgen de las Nieves, Granada Institute of Biohealth Research, Avda. de las Fuerzas Armadas 2. 18014, Granada, Spain
| | - Miguel Álvarez
- Department of Cardiology, Hospital Universitario Virgen de las Nieves, Granada Institute of Biohealth Research, Avda. de las Fuerzas Armadas 2. 18014, Granada, Spain
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Macías-Ruiz R, Jiménez-Jáimez J, Álvarez-López M, Molina-Lerma M, Sánchez-Millán P, Wangensteen R, Quesada A, Osuna-Ortega A, Tercedor-Sánchez L. Efecto de la ablación con catéter de venas pulmonares en la función renal de pacientes con fibrilación auricular. Estudio de cohortes prospectivo. Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2019.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Cabrera Borrego E, Bermúdez-Jiménez FJ, Ruiz RM, Perin F, Jiménez-Jáimez J. Regression of Left Ventricular Hypertrophy in a Case of Sarcomeric Hypertrophic Cardiomyopathy. JACC Case Rep 2020; 2:935-937. [PMID: 34317385 PMCID: PMC8302042 DOI: 10.1016/j.jaccas.2020.04.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 03/02/2020] [Accepted: 04/15/2020] [Indexed: 11/19/2022]
Abstract
We present a case of sarcomeric hypertrophy cardiomyopathy diagnosed in a child who had hypertrophy degree regression during adolescence, with no left ventricular dysfunction and no increase of the ventricular diameters. (Level of Difficulty: Intermediate.)
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Macías-Ruiz R, Jiménez-Jáimez J, Álvarez-López M, Molina-Lerma M, Sánchez-Millán P, Wangensteen R, Quesada A, Osuna-Ortega A, Tercedor-Sánchez L. Effect of pulmonary vein catheter ablation on kidney function in patients with atrial fibrillation. A prospective cohort study. ACTA ACUST UNITED AC 2020; 73:471-478. [DOI: 10.1016/j.rec.2019.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 08/23/2019] [Indexed: 11/29/2022]
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Ramos-Maqueda J, Bermúdez-Jiménez F, Ruiz RM, Ramos MC, Lerma MM, Millán PS, López MÁ, Sánchez LT, Jiménez-Jáimez J. Prognostic impact of misdiagnosis of cardiac channelopathies as epilepsy. PLoS One 2020; 15:e0231442. [PMID: 32298319 PMCID: PMC7161979 DOI: 10.1371/journal.pone.0231442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 03/10/2020] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Cardiac channelopathies are a frequent cause of sudden cardiac death (SCD) and often manifest with convulsive syncope, leading to a misdiagnosis of epilepsy. We aim to evaluate the clinical impact of epilepsy misdiagnosis in a cohort of patients with cardiac channelopathies. METHODS Fifty probands/families with a cardiac channelopathy were included. We retrospectively collected information from medical records to identify all patients who presented with convulsive syncope and were diagnosed with epilepsy after neurological evaluation. Clinical data and outcome were compared with those of patients without a previous epilepsy diagnosis. RESULTS Eight patients had a previous diagnosis of epilepsy. At first episode, 3 of them presented a positive family history of SCD and 5 showed a pathological electrocardiogram; half presented with sudden cardiac arrest (SCA) and the rest with recurrent syncope despite treatment with 1 or more anti-epileptic drugs. Five patients had long QT syndrome, 2 had catecholaminergic polymorphic ventricular tachycardia, and 1 had Brugada syndrome. Epilepsy misdiagnosis was associated with an increased risk of SCA/SCD (OR 6.92, P = .04), a delay of 12 years (P = .047) in correct diagnosis, and a delay from first symptom to channelopathy diagnosis of 18.45 years (P < .0001). CONCLUSION Cardiac channelopathy patients can be misdiagnosed with epilepsy. This involves a delayed diagnosis, a delay from the first symptom to a correct diagnosis, and an increased risk of SCA/SCD.
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Affiliation(s)
- Javier Ramos-Maqueda
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Francisco Bermúdez-Jiménez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Rosa Macías Ruiz
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | | | - Manuel Molina Lerma
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Pablo Sánchez Millán
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Miguel Álvarez López
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Luis Tercedor Sánchez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Juan Jiménez-Jáimez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada, Spain
- * E-mail:
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Segura-Rodríguez D, Bermúdez-Jiménez FJ, Carriel V, López-Fernández S, González-Molina M, Oyonarte Ramírez JM, Fernández-Navarro L, García-Roa MD, Cabrerizo EM, Durand-Herrera D, Alaminos M, Campos A, Macías R, Álvarez M, Tercedor L, Jiménez-Jáimez J. Myocardial fibrosis in arrhythmogenic cardiomyopathy: a genotype–phenotype correlation study. Eur Heart J Cardiovasc Imaging 2019; 21:378-386. [DOI: 10.1093/ehjci/jez277] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 09/09/2019] [Accepted: 10/16/2019] [Indexed: 01/12/2023] Open
Abstract
Abstract
Aims
Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is a life-threatening entity with a highly heterogeneous genetic background. Cardiac magnetic resonance (CMR) imaging can identify fibrofatty scar by late gadolinium enhancement (LGE). Our aim is to investigate genotype–phenotype correlation in ARVC/D mutation carriers, focusing on CMR-LGE and myocardial fibrosis patterns.
Methods and results
A cohort of 44 genotyped patients, 33 with definite and 11 with borderline ARVC/D diagnosis, was characterized using CMR and divided into groups according to their genetic condition (desmosomal, non-desmosomal mutation, or negative). We collected information on cardiac volumes and function, as well as LGE pattern and extension. In addition, available ventricular myocardium samples from patients with pathogenic gene mutations were histopathologically analysed. Half of the patients were women, with a mean age of 41.6 ± 17.5 years. Next-generation sequencing identified a potential pathogenic mutation in 71.4% of the probands. The phenotype varied according to genetic status, with non-desmosomal male patients showing lower left ventricular (LV) systolic function. LV fibrosis was similar between groups, but distribution in non-desmosomal patients was frequently located at the posterolateral LV wall; a characteristic LV subepicardial circumferential LGE pattern was significantly associated with ARVC/D caused by desmin mutation. Histological analysis showed increased fibrillar connective tissue and intercellular space in all the samples.
Conclusion
Desmosomal and non-desmosomal mutation carriers showed different morphofunctional features but similar LV LGE presence. DES mutation carriers can be identified by a specific and extensive LV subepicardial circumferential LGE pattern. Further studies should investigate the specificity of LGE in ARVC/D.
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Affiliation(s)
- Diego Segura-Rodríguez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Avda. De las Fuerzas Armadas 2, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Av. De las Fuerzas Armadas 2, 18014, Granada, Spain
| | - Francisco José Bermúdez-Jiménez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Avda. De las Fuerzas Armadas 2, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Av. De las Fuerzas Armadas 2, 18014, Granada, Spain
| | - Víctor Carriel
- Instituto de Investigación Biosanitaria ibs.GRANADA, Av. De las Fuerzas Armadas 2, 18014, Granada, Spain
- Department of Histology and Tissue Engineering Group, Faculty of Medicine, University of Granada, Avda. De la Investigación, 11, 18016, Granada, Spain
| | - Silvia López-Fernández
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Avda. De las Fuerzas Armadas 2, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Av. De las Fuerzas Armadas 2, 18014, Granada, Spain
| | - Mercedes González-Molina
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Avda. De las Fuerzas Armadas 2, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Av. De las Fuerzas Armadas 2, 18014, Granada, Spain
| | - José Manuel Oyonarte Ramírez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Avda. De las Fuerzas Armadas 2, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Av. De las Fuerzas Armadas 2, 18014, Granada, Spain
| | - Laura Fernández-Navarro
- Radiology Department, Hospital Universitario Virgen de las Nieves, Avda. De las Fuerzas Armadas 2, 18014, Granada, Spain
| | - María Dolores García-Roa
- Radiology Department, Hospital Universitario Virgen de las Nieves, Avda. De las Fuerzas Armadas 2, 18014, Granada, Spain
| | - Elisa M Cabrerizo
- Servicio de Patología Forense, Instituto de Medicina Legal, Avda. De la Innovación, 1, 18016, Granada, Spain
| | - Daniel Durand-Herrera
- Instituto de Investigación Biosanitaria ibs.GRANADA, Av. De las Fuerzas Armadas 2, 18014, Granada, Spain
- Department of Histology and Tissue Engineering Group, Faculty of Medicine, University of Granada, Avda. De la Investigación, 11, 18016, Granada, Spain
| | - Miguel Alaminos
- Instituto de Investigación Biosanitaria ibs.GRANADA, Av. De las Fuerzas Armadas 2, 18014, Granada, Spain
- Department of Histology and Tissue Engineering Group, Faculty of Medicine, University of Granada, Avda. De la Investigación, 11, 18016, Granada, Spain
| | - Antonio Campos
- Instituto de Investigación Biosanitaria ibs.GRANADA, Av. De las Fuerzas Armadas 2, 18014, Granada, Spain
- Department of Histology and Tissue Engineering Group, Faculty of Medicine, University of Granada, Avda. De la Investigación, 11, 18016, Granada, Spain
| | - Rosa Macías
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Avda. De las Fuerzas Armadas 2, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Av. De las Fuerzas Armadas 2, 18014, Granada, Spain
| | - Miguel Álvarez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Avda. De las Fuerzas Armadas 2, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Av. De las Fuerzas Armadas 2, 18014, Granada, Spain
| | - Luis Tercedor
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Avda. De las Fuerzas Armadas 2, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Av. De las Fuerzas Armadas 2, 18014, Granada, Spain
| | - Juan Jiménez-Jáimez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Avda. De las Fuerzas Armadas 2, 18014 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Av. De las Fuerzas Armadas 2, 18014, Granada, Spain
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Wren LM, Jiménez-Jáimez J, Al-Ghamdi S, Al-Aama JY, Bdeir A, Al-Hassnan ZN, Kuan JL, Foo RY, Potet F, Johnson CN, Aziz MC, Carvill GL, Kaski JP, Crotti L, Perin F, Monserrat L, Burridge PW, Schwartz PJ, Chazin WJ, Bhuiyan ZA, George AL. Genetic Mosaicism in Calmodulinopathy. Circ Genom Precis Med 2019; 12:375-385. [PMID: 31454269 DOI: 10.1161/circgen.119.002581] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND CaM (calmodulin) mutations are associated with congenital arrhythmia susceptibility (calmodulinopathy) and are most often de novo. In this report, we sought to broaden the genotype-phenotype spectrum of calmodulinopathies with 2 novel calmodulin mutations and to investigate mosaicism in 2 affected families. METHODS CaM mutations were identified in 4 independent cases by DNA sequencing. Biochemical and electrophysiological studies were performed to determine functional consequences of each mutation. RESULTS Genetic studies identified 2 novel CaM variants (CALM3-E141K in 2 cases; CALM1-E141V) and one previously reported CaM pathogenic variant (CALM3-D130G) among 4 probands with shared clinical features of prolonged QTc interval (range 505-725 ms) and documented ventricular arrhythmia. A fatal outcome occurred for 2 of the cases. The parents of all probands were asymptomatic with normal QTc duration. However, 2 of the families had multiple affected offspring or multiple occurrences of intrauterine fetal demise. The mother from the family with recurrent intrauterine fetal demise exhibited the CALM3-E141K mutant allele in 25% of next-generation sequencing reads indicating somatic mosaicism, whereas CALM3-D130G was present in 6% of captured molecules of the paternal DNA sample, also indicating mosaicism. Two novel mutations (E141K and E141V) impaired Ca2+ binding affinity to the C-domain of CaM. Human-induced pluripotent stem cell-derived cardiomyocytes overexpressing mutant or wild-type CaM showed that both mutants impaired Ca2+-dependent inactivation of L-type Ca2+ channels and prolonged action potential duration. CONCLUSIONS We report 2 families with somatic mosaicism associated with arrhythmogenic calmodulinopathy, and demonstrate dysregulation of L-type Ca2+ channels by 2 novel CaM mutations affecting the same residue. Parental mosaicism should be suspected in families with unexplained fetal arrhythmia or fetal demise combined with a documented CaM mutation.
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Affiliation(s)
- Lisa M Wren
- From the Department of Pharmacology (L.M.W., F.P., P.W.B., A.L.G.), Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Juan Jiménez-Jáimez
- Cardiology Department (J.J.-J.), Virgen de las Nieves Hospital, Granada, Spain
| | - Saleh Al-Ghamdi
- Cardiac Sciences Department, Section of Pediatric Cardiology, King Abdulaziz Cardiac Center, Ministry of National Guard Health Affairs, Riyadh (S.A.-G.)
| | - Jumana Y Al-Aama
- Department of Genetic Medicine, Faculty of Medicine (J.Y.A.-A.), King Abdulaziz University, Jeddah.,Princess Al Jawhara Albrahim Center of Excellence in Research of Hereditary Disorders (J.Y.A.-A., A.B.), King Abdulaziz University, Jeddah
| | - Amnah Bdeir
- Princess Al Jawhara Albrahim Center of Excellence in Research of Hereditary Disorders (J.Y.A.-A., A.B.), King Abdulaziz University, Jeddah
| | - Zuhair N Al-Hassnan
- The Cardiovascular Genetics Program, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia (Z.N.A.-H.)
| | - Jyn L Kuan
- Department of Cardiology, National University Heart Center and Cardiovascular Research Institute, National University of Singapore (J.L.K., R.Y.F.)
| | - Roger Y Foo
- Department of Cardiology, National University Heart Center and Cardiovascular Research Institute, National University of Singapore (J.L.K., R.Y.F.)
| | - Franck Potet
- From the Department of Pharmacology (L.M.W., F.P., P.W.B., A.L.G.), Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Christopher N Johnson
- Department of Biochemistry and Center for Structural Biology, Vanderbilt University, Nashville, TN (C.N.J., W.J.C.)
| | - Miriam C Aziz
- Department of Neurology (M.C.A., G.L.C.), Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Gemma L Carvill
- Department of Neurology (M.C.A., G.L.C.), Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Juan-Pablo Kaski
- Institute of Cardiovascular Science, University College London, United Kingdom (J.-P.K.)
| | - Lia Crotti
- Department of Medicine and Surgery, University of Milano-Bicocca (L.C.).,IRCCS Istituto Auxologico Italiano, Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Milan, Italy (L.C., P.J.S.).,Cardiology Department, Health in Code SL, A Coruña, Spain (L.M.)
| | - Francesca Perin
- Pediatric Cardiology Division (F.P.), Virgen de las Nieves Hospital, Granada, Spain
| | | | - Paul W Burridge
- From the Department of Pharmacology (L.M.W., F.P., P.W.B., A.L.G.), Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Peter J Schwartz
- IRCCS Istituto Auxologico Italiano, Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Milan, Italy (L.C., P.J.S.)
| | - Walter J Chazin
- Department of Biochemistry and Center for Structural Biology, Vanderbilt University, Nashville, TN (C.N.J., W.J.C.)
| | - Zahurul A Bhuiyan
- Unité de Recherche Cardiogénétique, Service de Médecine Génétique, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland (Z.A.B.)
| | - Alfred L George
- From the Department of Pharmacology (L.M.W., F.P., P.W.B., A.L.G.), Northwestern University Feinberg School of Medicine, Chicago, IL
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Nieto-Marín P, Jiménez-Jáimez J, Tinaquero D, Alfayate S, Utrilla RG, Rodríguez Vázquez del Rey MDM, Perin F, Sarquella-Brugada G, Monserrat L, Brugada J, Tercedor L, Tamargo J, Delpón E, Caballero R. La expresividad variable del síndrome de QT largo de una familia española se explica por la heterocigosis digénica en SCN5A y CACNA1C. Rev Esp Cardiol (Engl Ed) 2019. [DOI: 10.1016/j.recesp.2018.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Vargas-Hitos JA, Jiménez-Jáimez J, Molina Navarro E, Salmerón Ruiz A, López Milena G, Jiménez-Alonso J. Takayasu arteritis, malignant hypertension and severe left ventricular hypertrophy. Int J Rheum Dis 2019; 22:951-955. [PMID: 30861323 DOI: 10.1111/1756-185x.13541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 02/12/2019] [Accepted: 02/15/2019] [Indexed: 11/30/2022]
Affiliation(s)
- José Antonio Vargas-Hitos
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Virgen de las Nieves¨ University Hospital, Granada, Spain
| | - Juan Jiménez-Jáimez
- Cardiology Department, ¨Virgen de las Nieves¨ University Hospital, Granada, Spain
| | | | - Angela Salmerón Ruiz
- Radiology Department, ¨Virgen de las Nieves¨ University Hospital, Granada, Spain
| | - Genaro López Milena
- Radiology Department, ¨Virgen de las Nieves¨ University Hospital, Granada, Spain
| | - Juan Jiménez-Alonso
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Virgen de las Nieves¨ University Hospital, Granada, Spain
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Molina-Lerma M, Jiménez-Jáimez J, Macías-Ruiz R, Sánchez-Millán P, Tercedor L, Álvarez M. His-bundle pacing in a patient with dextrocardia, severe systolic dysfunction, and complete atrioventricular block. HeartRhythm Case Rep 2019; 5:148-151. [PMID: 30891412 PMCID: PMC6404377 DOI: 10.1016/j.hrcr.2018.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Manuel Molina-Lerma
- Address reprint requests and correspondence: Dr Manuel Molina-Lerma, Cardiology Department, Arrhythmia Unit, Hospital Universitario Virgen de las Nieves, Avda de las Fuerzas Armadas 2, 18014 Granada, Spain.
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Bermúdez-Jiménez FJ, Jiménez-Jáimez J, González Molina M, Tercedor L. Giant biventricular aneurysms: a novel cardiac phenotype in myotubular/centronuclear myopathy. Eur Heart J 2018; 39:4289-4290. [PMID: 29668875 DOI: 10.1093/eurheartj/ehy207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Juan Jiménez-Jáimez
- Department of Cardiology, Virgen de las Nieves University Hospital, Av. Fuerzas Armadas s/n, Granada, Spain.,Biosanitary Research Institute of Granada (ibs.GRANADA), Av. del Conocimiento s/n, Granada, Spain
| | - Mercedes González Molina
- Department of Cardiology, Virgen de las Nieves University Hospital, Av. Fuerzas Armadas s/n, Granada, Spain.,Biosanitary Research Institute of Granada (ibs.GRANADA), Av. del Conocimiento s/n, Granada, Spain
| | - Luis Tercedor
- Department of Cardiology, Virgen de las Nieves University Hospital, Av. Fuerzas Armadas s/n, Granada, Spain.,Biosanitary Research Institute of Granada (ibs.GRANADA), Av. del Conocimiento s/n, Granada, Spain
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Rodríguez-Torres D, Jiménez-Jáimez J, Macías-Ruiz R, Álvarez-López M, Tercedor L. Manifestaciones cardiacas de las enfermedades neuromusculares. Rev Esp Cardiol 2018. [DOI: 10.1016/j.recesp.2017.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Rodríguez-Torres D, Jiménez-Jáimez J, Macías-Ruiz R, Álvarez-López M, Tercedor L. Cardiac Manifestations of Neuromuscular Disease. Rev Esp Cardiol (Engl Ed) 2018; 71:580-582. [PMID: 28601412 DOI: 10.1016/j.rec.2017.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 03/14/2017] [Indexed: 06/07/2023]
Affiliation(s)
| | - Juan Jiménez-Jáimez
- Unidad de Arritmias, Hospital Universitario Virgen de las Nieves, Granada, Spain.
| | - Rosa Macías-Ruiz
- Unidad de Arritmias, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Miguel Álvarez-López
- Unidad de Arritmias, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Luis Tercedor
- Unidad de Arritmias, Hospital Universitario Virgen de las Nieves, Granada, Spain
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Bermudez-Jiménez FJ, Jiménez-Jáimez J. Genotype, Family History, and Outcomes in Noncompaction Cardiomyopathy. J Am Coll Cardiol 2018; 71:2864. [PMID: 29903360 DOI: 10.1016/j.jacc.2018.03.527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 03/18/2018] [Indexed: 11/16/2022]
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42
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Jiménez-Jáimez J, Macías Ruiz R, Molina Lerma M, Bermúdez Jiménez F, Álvarez López M, Tercedor L. Selección de lo mejor del año 2017 en arritmología clínica. Rev Esp Cardiol (Engl Ed) 2018. [DOI: 10.1016/j.recesp.2017.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Jiménez-Jáimez J, Macías Ruiz R, Molina Lerma M, Bermúdez Jiménez F, Álvarez López M, Tercedor L. Selection of the Best of 2017 in Clinical Arrhythmology. Rev Esp Cardiol (Engl Ed) 2018; 71:305-307. [PMID: 29402592 DOI: 10.1016/j.rec.2017.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 11/06/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Juan Jiménez-Jáimez
- Unidad de Arritmias, Hospital Universitario Virgen de las Nieves, Granada, Spain.
| | - Rosa Macías Ruiz
- Unidad de Arritmias, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Manuel Molina Lerma
- Unidad de Arritmias, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | - Miguel Álvarez López
- Unidad de Arritmias, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Luis Tercedor
- Unidad de Arritmias, Hospital Universitario Virgen de las Nieves, Granada, Spain
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Bermúdez-Jiménez FJ, Carriel V, Brodehl A, Alaminos M, Campos A, Schirmer I, Milting H, Abril BÁ, Álvarez M, López-Fernández S, García-Giustiniani D, Monserrat L, Tercedor L, Jiménez-Jáimez J. Novel Desmin Mutation p.Glu401Asp Impairs Filament Formation, Disrupts Cell Membrane Integrity, and Causes Severe Arrhythmogenic Left Ventricular Cardiomyopathy/Dysplasia. Circulation 2017; 137:1595-1610. [PMID: 29212896 DOI: 10.1161/circulationaha.117.028719] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 11/09/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Desmin (DES) mutations cause severe skeletal and cardiac muscle disease with heterogeneous phenotypes. Recently, DES mutations were described in patients with inherited arrhythmogenic right ventricular cardiomyopathy/dysplasia, although their cellular and molecular pathomechanisms are not precisely known. Our aim is to describe clinically and functionally the novel DES-p.Glu401Asp mutation as a cause of inherited left ventricular arrhythmogenic cardiomyopathy/dysplasia. METHODS We identified the novel DES mutation p.Glu401Asp in a large Spanish family with inherited left ventricular arrhythmogenic cardiomyopathy/dysplasia and a high incidence of adverse cardiac events. A full clinical evaluation was performed on all mutation carriers and noncarriers to establish clinical and genetic cosegregation. In addition, desmin, and intercalar disc-related proteins expression were histologically analyzed in explanted cardiac tissue affected by the DES mutation. Furthermore, mesenchymal stem cells were isolated and cultured from 2 family members with the DES mutation (1 with mild and 1 with severe symptomatology) and a member without the mutation (control) and differentiated ex vivo to cardiomyocytes. Then, important genes related to cardiac differentiation and function were analyzed by real-time quantitative polymerase chain reaction. Finally, the p.Glu401Asp mutated DES gene was transfected into cell lines and analyzed by confocal microscopy. RESULTS Of the 66 family members screened for the DES-p.Glu401Asp mutation, 23 of them were positive, 6 were obligate carriers, and 2 were likely carriers. One hundred percent of genotype-positive patients presented data consistent with inherited arrhythmogenic cardiomyopathy/dysplasia phenotype with variable disease severity expression, high-incidence of sudden cardiac death, and absence of skeletal myopathy or conduction system disorders. Immunohistochemistry was compatible with inherited arrhythmogenic cardiomyopathy/dysplasia, and the functional study showed an abnormal growth pattern and cellular adhesion, reduced desmin RNA expression, and some other membrane proteins, as well, and desmin aggregates in transfected cells expressing the mutant desmin. CONCLUSIONS The DES-p.Glu401Asp mutation causes predominant inherited left ventricular arrhythmogenic cardiomyopathy/dysplasia with a high incidence of adverse clinical events in the absence of skeletal myopathy or conduction system disorders. The pathogenic mechanism probably corresponds to an alteration in desmin dimer and oligomer assembly and its connection with membrane proteins within the intercalated disc.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Arrhythmias, Cardiac/diagnosis
- Arrhythmias, Cardiac/genetics
- Arrhythmias, Cardiac/physiopathology
- Cardiomyopathies/diagnosis
- Cardiomyopathies/genetics
- Cardiomyopathies/physiopathology
- Cell Differentiation/genetics
- Cells, Cultured
- Child
- Desmin/genetics
- Desmin/metabolism
- Electrocardiography
- Female
- Genetic Predisposition to Disease
- Heart Defects, Congenital/diagnosis
- Heart Defects, Congenital/genetics
- Heart Defects, Congenital/physiopathology
- Heart Ventricles/abnormalities
- Heart Ventricles/metabolism
- Heart Ventricles/physiopathology
- Heredity
- Heterozygote
- Humans
- Magnetic Resonance Imaging
- Male
- Mesenchymal Stem Cells/metabolism
- Mesenchymal Stem Cells/pathology
- Middle Aged
- Mutation
- Myocytes, Cardiac/metabolism
- Myocytes, Cardiac/pathology
- Pedigree
- Phenotype
- Spain
- Young Adult
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Affiliation(s)
- Francisco José Bermúdez-Jiménez
- Cardiology Department, Virgen de las Nieves University Hospital, Granada, Spain (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F., L.T., J.J.-J.).
- Department of Histology, Tissue Engineering Group, Faculty of Medicine, University of Granada, Spain (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F, L.T., J.J.-J., V.C., M. Alaminos, A.C.)
- Instituto de Investigación Biosanitaria (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F, L.T., J.J.-J., V.C., M. Alaminos, A.C.)
| | - Víctor Carriel
- Department of Histology, Tissue Engineering Group, Faculty of Medicine, University of Granada, Spain (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F, L.T., J.J.-J., V.C., M. Alaminos, A.C.)
- Instituto de Investigación Biosanitaria (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F, L.T., J.J.-J., V.C., M. Alaminos, A.C.)
| | - Andreas Brodehl
- Erich and Hanna Klessmann Institute for Cardiovascular Research and Development, Heart and Diabetes Centre North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.B., I.S., H.M.)
| | - Miguel Alaminos
- Department of Histology, Tissue Engineering Group, Faculty of Medicine, University of Granada, Spain (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F, L.T., J.J.-J., V.C., M. Alaminos, A.C.)
- Instituto de Investigación Biosanitaria (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F, L.T., J.J.-J., V.C., M. Alaminos, A.C.)
| | - Antonio Campos
- Department of Histology, Tissue Engineering Group, Faculty of Medicine, University of Granada, Spain (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F, L.T., J.J.-J., V.C., M. Alaminos, A.C.)
- Instituto de Investigación Biosanitaria (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F, L.T., J.J.-J., V.C., M. Alaminos, A.C.)
| | - Ilona Schirmer
- Erich and Hanna Klessmann Institute for Cardiovascular Research and Development, Heart and Diabetes Centre North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.B., I.S., H.M.)
| | - Hendrik Milting
- Erich and Hanna Klessmann Institute for Cardiovascular Research and Development, Heart and Diabetes Centre North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.B., I.S., H.M.)
| | - Beatriz Álvarez Abril
- Cardiology Department, Virgen de las Nieves University Hospital, Granada, Spain (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F., L.T., J.J.-J.)
- Department of Histology, Tissue Engineering Group, Faculty of Medicine, University of Granada, Spain (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F, L.T., J.J.-J., V.C., M. Alaminos, A.C.)
- Instituto de Investigación Biosanitaria (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F, L.T., J.J.-J., V.C., M. Alaminos, A.C.)
| | - Miguel Álvarez
- Cardiology Department, Virgen de las Nieves University Hospital, Granada, Spain (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F., L.T., J.J.-J.)
- Department of Histology, Tissue Engineering Group, Faculty of Medicine, University of Granada, Spain (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F, L.T., J.J.-J., V.C., M. Alaminos, A.C.)
- Instituto de Investigación Biosanitaria (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F, L.T., J.J.-J., V.C., M. Alaminos, A.C.)
| | - Silvia López-Fernández
- Cardiology Department, Virgen de las Nieves University Hospital, Granada, Spain (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F., L.T., J.J.-J.)
- Department of Histology, Tissue Engineering Group, Faculty of Medicine, University of Granada, Spain (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F, L.T., J.J.-J., V.C., M. Alaminos, A.C.)
- Instituto de Investigación Biosanitaria (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F, L.T., J.J.-J., V.C., M. Alaminos, A.C.)
| | | | - Lorenzo Monserrat
- Cardiology Department, Health in Code, A Coruña, Spain (D.G.-G., L.M.)
| | - Luis Tercedor
- Cardiology Department, Virgen de las Nieves University Hospital, Granada, Spain (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F., L.T., J.J.-J.)
- Department of Histology, Tissue Engineering Group, Faculty of Medicine, University of Granada, Spain (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F, L.T., J.J.-J., V.C., M. Alaminos, A.C.)
- Instituto de Investigación Biosanitaria (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F, L.T., J.J.-J., V.C., M. Alaminos, A.C.)
| | - Juan Jiménez-Jáimez
- Cardiology Department, Virgen de las Nieves University Hospital, Granada, Spain (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F., L.T., J.J.-J.)
- Department of Histology, Tissue Engineering Group, Faculty of Medicine, University of Granada, Spain (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F, L.T., J.J.-J., V.C., M. Alaminos, A.C.)
- Instituto de Investigación Biosanitaria (F.J.B.-J., B.A.A., M. Álvarez, S.L.-F, L.T., J.J.-J., V.C., M. Alaminos, A.C.)
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Perin F, Rodríguez-Vázquez Del Rey MDM, Carreras-Blesa C, Arrabal-Fernández L, Jiménez-Jáimez J, Tercedor L. Dilated Cardiomyopathy With Short QT Interval Suggests Primary Carnitine Deficiency. Rev Esp Cardiol (Engl Ed) 2017; 71:1074-1075. [PMID: 29198778 DOI: 10.1016/j.rec.2017.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 08/07/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Francesca Perin
- Unidad de Cardiología Infantil, Servicio de Pediatría, Hospital Universitario Virgen de las Nieves de Granada, Granada, Spain.
| | | | - Carmen Carreras-Blesa
- Unidad de Cardiología Infantil, Servicio de Pediatría, Hospital Universitario Virgen de las Nieves de Granada, Granada, Spain
| | - Luisa Arrabal-Fernández
- Unidad de Neuropediatría, Servicio de Pediatría, Hospital Universitario Virgen de las Nieves de Granada, Granada, Spain
| | - Juan Jiménez-Jáimez
- Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Virgen de las Nieves de Granada, Granada, Spain
| | - Luis Tercedor
- Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Virgen de las Nieves de Granada, Granada, Spain
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Jiménez-Jáimez J, Alcalde Martínez V, Jiménez Fernández M, Bermúdez Jiménez F, Rodríguez Vázquez del Rey MDM, Perin F, Oyonarte Ramírez JM, López Fernández S, de la Torre I, García Orta R, González Molina M, Cabrerizo EM, Álvarez Abril B, Álvarez M, Macías Ruiz R, Correa C, Tercedor L. Diagnóstico clínico y genético de la muerte súbita cardiaca de origen no isquémico. Rev Esp Cardiol 2017. [DOI: 10.1016/j.recesp.2017.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Soriano-Maldonado A, Vargas-Hitos JA, Jiménez-Jáimez J. Exercise for Patients With Hypertrophic Cardiomyopathy. JAMA 2017; 318:480-481. [PMID: 28763541 DOI: 10.1001/jama.2017.8193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - José A Vargas-Hitos
- Department of Internal Medicine, Virgen de las Nieves University Hospital, Granada, Spain
| | - Juan Jiménez-Jáimez
- Cardiology Clinical Management Unit, Virgen de las Nieves University Hospital, Granada, Spain
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48
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Bermúdez-Jiménez FJ, Jiménez-Jáimez J. Letter to Editor: Functional study is not the only criterion to predict the pathogenicity of a novel mutation for cardiomyopathy. J Mol Cell Cardiol 2017; 109:58-59. [PMID: 28732691 DOI: 10.1016/j.yjmcc.2016.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 06/15/2016] [Indexed: 11/13/2022]
Affiliation(s)
- Francisco José Bermúdez-Jiménez
- Cardiology Department, Complejo Hospitalario Universitario de Granada, Granada, Spain; Instituto de Investigación Biosanitario de Granada, Spain
| | - Juan Jiménez-Jáimez
- Cardiology Department, Complejo Hospitalario Universitario de Granada, Granada, Spain; Instituto de Investigación Biosanitario de Granada, Spain
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49
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Bermúdez-Jiménez FJ, Jiménez-Jáimez J, López-Fernández S. Overlap of Arrhythmogenic Cardiomyopathy, Spongiform Cardiomyopathy, and Congenital Heart Disease. Rev Esp Cardiol (Engl Ed) 2017; 70:51. [PMID: 27211786 DOI: 10.1016/j.rec.2016.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 02/04/2016] [Indexed: 12/01/2022]
Affiliation(s)
| | - Juan Jiménez-Jáimez
- Servicio de Cardiología, Complejo Hospitalario Universitario de Granada, Granada, Spain
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50
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Bermúdez-Jiménez FJ, Jiménez-Jáimez J, López-Fernández S. Solapamiento de miocardiopatía arritmogénica y espongiforme con cardiopatía congénita. Rev Esp Cardiol 2017. [DOI: 10.1016/j.recesp.2016.02.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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