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Vizentin VK, Neves R, Bains S, Felix IF, Tester DJ, Bos JM, Giudicessi JR, Ackerman MJ. The Clinical and Electrocardiographic Phenotype of Patients with Genotype Negative Long QT Syndrome. Heart Rhythm 2025:S1547-5271(25)02513-5. [PMID: 40449819 DOI: 10.1016/j.hrthm.2025.05.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2025] [Revised: 05/21/2025] [Accepted: 05/24/2025] [Indexed: 06/03/2025]
Abstract
BACKGROUND Long QT syndrome (LQTS) is a genetic heart disease that increases the risk for ventricular arrhythmias and sudden cardia arrest. Despite advances in genetic testing, a small subset of LQTS patients remain genetically elusive. OBJECTIVE To determine the prevalence and clinical characteristics of patients with a phenotype of LQTS but genotype negative. METHODS This study aimed to identify phenotype-positive, genotype-negative LQTS patients seen at Mayo Clinic (2000 - 2024). Retrospective data included demographics, clinical evaluations, ECGs, and genetic results. Diagnosis adhered to established criteria, and genotype-negative LQTS was defined by the absence of pathogenic variants despite clinical presentation. RESULTS The study included 1,829 patients with LQTS. From these, 1,706 (93%) had pathogenic or likely pathogenic variants and 95 patients (5%) had upgraded clinically variants of uncertain significance, leaving 32 (1.7%) with negative genetic tests. Among the genotype-negative patients, 17 underwent next-generation sequencing, identifying a genetic cause in 6 cases (0.3% of the total). The mean age at diagnosis for the remaining 26 patients was 25 ± 15 years, 76% being female and an average initial QTc of 498 ± 41 ms. Fourteen patients (53%) experienced cardiac events prior to diagnosis, and 11 (44%) received an implantable cardioverter-defibrillator (ICD). The mean follow-up period was 8 ± 7 years. CONCLUSION Genotype-negative LQTS accounted for <2% of our cohort, highlighting diagnostic and management challenges. Comprehensive clinical evaluation and advanced genetic testing remain essential for accurate diagnosis and care.
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Affiliation(s)
- Vanessa Karlinski Vizentin
- Department of Molecular Pharmacology & Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory), Mayo Clinic, Rochester, MN
| | - Raquel Neves
- Department of Molecular Pharmacology & Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory), Mayo Clinic, Rochester, MN
| | - Sahej Bains
- Department of Molecular Pharmacology & Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory), Mayo Clinic, Rochester, MN; Medical Scientist Training Program, Mayo Clinic, Rochester, MN
| | | | - David J Tester
- Department of Molecular Pharmacology & Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory), Mayo Clinic, Rochester, MN
| | - J Martijn Bos
- Department of Molecular Pharmacology & Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory), Mayo Clinic, Rochester, MN
| | - John R Giudicessi
- Department of Molecular Pharmacology & Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory), Mayo Clinic, Rochester, MN; Department of Cardiovascular Medicine (Divisions of Heart Rhythm Services and Circulatory Failure, Windland Smith Rice Genetic Heart Rhythm Clinic), Mayo Clinic, Rochester, MN
| | - Michael J Ackerman
- Department of Molecular Pharmacology & Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory), Mayo Clinic, Rochester, MN; Department of Cardiovascular Medicine (Divisions of Heart Rhythm Services and Circulatory Failure, Windland Smith Rice Genetic Heart Rhythm Clinic), Mayo Clinic, Rochester, MN; Department of Pediatric and Adolescent Medicine (Division of Pediatric Cardiology), Mayo Clinic, Rochester, MN.
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Duignan KM, Luu H, Delgado JH, London S, Ratzan RM. Drowning incidents precipitated by unusual causes (DIPUCs): A narrative review of their diagnoses, evaluation and management. Resusc Plus 2024; 20:100770. [PMID: 39309751 PMCID: PMC11415818 DOI: 10.1016/j.resplu.2024.100770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 09/01/2024] [Accepted: 09/02/2024] [Indexed: 09/25/2024] Open
Abstract
Drowning is a cause of significant morbidity and mortality worldwide. In most circumstances, the proximate cause is attributable to human factors, such as inexperience, fatigue, intoxication, or hazardous water conditions. The phenomenon of drowning incidents precipitated by unusual circumstances (DIPUCs) - either fatal or nonfatal - involving otherwise healthy individuals under generally safe conditions has not been comprehensively addressed in the medical and drowning literature to date. In this review, we discuss etiologies of DIPUCs, diagnostic clues, suggested workup, suggested postmortem testing, and implications for surviving patients and families. Identifying the cause of a drowning incident can be extremely challenging for the initially treating physician, relying perforce on historical context, environmental clues, physical exam, medical history, eyewitness accounts or video recordings. If no clear explanation for a drowning incident emerges despite a thorough investigation, clinicians should consider some of the less common diagnoses we describe in this paper, and, when appropriate, refer for an autopsy with postmortem molecular genetic testing. While time-consuming, these efforts can prove life-saving for some non-fatal drowning victims and the families of all victims of DIPUCs.
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Affiliation(s)
- Kevin M. Duignan
- University of Connecticut School of Medicine, Emergency Medicine Residency, MC 1930, 263 Farmington Ave., Farmington, CT 06030-1930, United States
| | - Hannah Luu
- University of Connecticut School of Medicine, Emergency Medicine Residency, MC 1930, 263 Farmington Ave., Farmington, CT 06030-1930, United States
| | - João H. Delgado
- Hartford Hospital, 80 Seymour St, Hartford, CT 06102, United States
| | - Shawn London
- Hartford Hospital, 80 Seymour St, Hartford, CT 06102, United States
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Bukaeva A, Ershova A, Kharlap M, Kiseleva A, Kutsenko V, Sotnikova E, Divashuk M, Pokrovskaya M, Garbuzova E, Blokhina A, Kopylova O, Zotova E, Petukhova A, Zharikova A, Ramensky V, Zaicenoka M, Vyatkin Y, Meshkov A, Drapkina O. The Yield of Genetic Testing and Putative Genetic Factors of Disease Heterogeneity in Long QT Syndrome Patients. Int J Mol Sci 2024; 25:11976. [PMID: 39596046 PMCID: PMC11593843 DOI: 10.3390/ijms252211976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Revised: 11/02/2024] [Accepted: 11/05/2024] [Indexed: 11/28/2024] Open
Abstract
Genetic overdiagnosis of long QT syndrome (LQTS) becomes a critical concern due to the high clinical significance of DNA diagnosis. Current guidelines for LQTS genetic testing recommend a limited scope and strict referral based on the Schwartz score. Nevertheless, LQTS may be underdiagnosed in patients with borderline phenotypes. We aimed to evaluate the total yield of rare variants in cardiac genes in LQTS patients. The cohort of 82 patients with LQTS referral diagnosis underwent phenotyping, Schwartz score counting, and exome sequencing. We assessed known LQTS genes for diagnostics, as per guidelines, and a broader set of genes for research. Diagnostic testing yield reached 75% in index patients; all causal variants were found in KCNQ1, KCNH2, and SCN5A genes. Research testing of 248 heart-related genes achieved a 50% yield of molecular diagnosis in patients with a low Schwartz score (<3.5). In patients with LQTS-causing variants, each additional rare variant in heart-related genes added 0.94 points to the Schwartz score (p value = 0.04), reflecting the more severe disease in such patients than in those with causal variants but without additional findings. We conclude that the current LQTS genetic diagnosis framework is highly specific but may lack sensitivity for patients with a Schwartz score <3.5. Improving referral criteria for these patients could enhance DNA diagnosis. Also, our results suggest that additional variants in cardiac genes may affect the severity of the disease in the carriers of LQTS-causing variants, which may aid in identifying new modifier genes.
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Affiliation(s)
- Anna Bukaeva
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
| | - Alexandra Ershova
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
| | - Maria Kharlap
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
| | - Anna Kiseleva
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
| | - Vladimir Kutsenko
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
| | - Evgeniia Sotnikova
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
| | - Mikhail Divashuk
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
- All-Russia Research Institute of Agricultural Biotechnology, 127550 Moscow, Russia
| | - Maria Pokrovskaya
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
| | - Elizaveta Garbuzova
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
| | - Anastasia Blokhina
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
| | - Oksana Kopylova
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
| | - Evgenia Zotova
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
| | - Anna Petukhova
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
| | - Anastasia Zharikova
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
- Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Vasily Ramensky
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
- Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, 119991 Moscow, Russia
- MSU Institute for Artificial Intelligence, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Marija Zaicenoka
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
- Moscow Center for Advanced Studies, 123592 Moscow, Russia
| | - Yuri Vyatkin
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
- MSU Institute for Artificial Intelligence, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Alexey Meshkov
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
| | - Oxana Drapkina
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (A.E.); (M.K.); (A.K.); (V.K.); (M.D.); (M.P.); (E.G.); (A.B.); (A.P.); (A.Z.); (V.R.); (M.Z.); (Y.V.); (A.M.); (O.D.)
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Ibrahim AOKZ, Prabhakar AP, Lopez-Candales A. QTc Interval: A frequently unrecognized electrocardiographic interval. Am J Med Sci 2024; 368:532-537. [PMID: 38701971 DOI: 10.1016/j.amjms.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 02/19/2024] [Accepted: 04/29/2024] [Indexed: 05/06/2024]
Abstract
The QT interval, an electrocardiographic temporal representation of the ventricular depolarization and repolarization, is an integral parameter that must be carefully evaluated to gather critical information regarding electrical instability that may cause malignant ventricular dysrhythmias or sudden cardiac death. The QT interval is affected by several inheritable and acquired factors, such as genetic mutations, electrolyte disturbances, and medication interactions. We strongly believe that prompt and accurate recognition of any QT interval abnormalities is critical in many clinical settings. This concise review article highlights the importance of accurate measurement of the QT interval, enhances understanding of the most prevalent factors yielding abnormalities within the QT interval and the prognostic value of the QT interval, as well as provides several key practical reminders for healthcare professionals to strengthen our clinical practice.
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Affiliation(s)
- Ali Osama Kamal Zaki Ibrahim
- Department of Medicine, University Health Truman Medical Center, University of Missouri-Kansas City, Kansas City, MO
| | - Akruti Patel Prabhakar
- Department of Medicine, Wright State University Boonshoft School of Medicine, Dayton, Ohio
| | - Angel Lopez-Candales
- Division of Cardiovascular Diseases, University Health Truman Medical Center, Hospital Hill University of Missouri-Kansas City, 2301 Holmes Street, Kansas City, MO 64108, USA.
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Shimamoto K, Aiba T. How Can We Evaluate Arrhythmic Risk in Children With Long QT Syndrome? Circ J 2024; 88:1185-1186. [PMID: 38171808 DOI: 10.1253/circj.cj-23-0884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Affiliation(s)
- Keiko Shimamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Clinical Laboratory Medicine and Genetics, National Cerebral and Cardiovascular Center
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Asatryan B, Murray B, Gasperetti A, McClellan R, Barth AS. Unraveling Complexities in Genetically Elusive Long QT Syndrome. Circ Arrhythm Electrophysiol 2024; 17:e012356. [PMID: 38264885 DOI: 10.1161/circep.123.012356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Genetic testing has become standard of care for patients with long QT syndrome (LQTS), providing diagnostic, prognostic, and therapeutic information for both probands and their family members. However, up to a quarter of patients with LQTS do not have identifiable Mendelian pathogenic variants in the currently known LQTS-associated genes. This absence of genetic confirmation, intriguingly, does not lessen the severity of LQTS, with the prognosis in these gene-elusive patients with unequivocal LQTS mirroring genotype-positive patients in the limited data available. Such a conundrum instigates an exploration into the causes of corrected QT interval (QTc) prolongation in these cases, unveiling a broad spectrum of potential scenarios and mechanisms. These include multiple environmental influences on QTc prolongation, exercise-induced repolarization abnormalities, and the profound implications of the constantly evolving nature of genetic testing and variant interpretation. In addition, the rapid advances in genetics have the potential to uncover new causal genes, and polygenic risk factors may aid in the diagnosis of high-risk patients. Navigating this multifaceted landscape requires a systematic approach and expert knowledge, integrating the dynamic nature of genetics and patient-specific influences for accurate diagnosis, management, and counseling of patients. The role of a subspecialized expert cardiogenetic clinic is paramount in evaluation to navigate this complexity. Amid these intricate aspects, this review outlines potential causes of gene-elusive LQTS. It also provides an outline for the evaluation of patients with negative and inconclusive genetic test results and underscores the need for ongoing adaptation and reassessment in our understanding of LQTS, as the complexities of gene-elusive LQTS are increasingly deciphered.
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Affiliation(s)
- Babken Asatryan
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Brittney Murray
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Alessio Gasperetti
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rebecca McClellan
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Andreas S Barth
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
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Spencer R, Quraishi S. Athlete Screening and Sudden Cardiac Death. Pediatr Rev 2023; 44:669-681. [PMID: 38036435 DOI: 10.1542/pir.2023-005975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Affiliation(s)
- Robert Spencer
- Division of Pediatric Cardiology, Department of Pediatrics, Staten Island University Hospital, Northwell Health, Staten Island, NY
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Shahed Quraishi
- Division of Pediatric Cardiology, Department of Pediatrics, Staten Island University Hospital, Northwell Health, Staten Island, NY
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Jeong JH, Oh SK, Kim YG, Choi YY, Lee HS, Shim J, Park YM, Kim JH, Oh YS, Kim NH, Pak HN, On YK, Park HW, Hwang GS, Kim DK, Park YA, Park HS, Cho Y, Oh S, Choi JI, Kim YH. Clinical and Genetic Features of Korean Inherited Arrhythmia Probands. Korean Circ J 2023; 53:693-707. [PMID: 37653714 PMCID: PMC10625850 DOI: 10.4070/kcj.2023.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/30/2023] [Accepted: 06/13/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Inherited arrhythmia (IA) is a more common cause of sudden cardiac death in Asian population, but little is known about the genetic background of Asian IA probands. We aimed to investigate the clinical characteristics and analyze the genetic underpinnings of IA in a Korean cohort. METHODS This study was conducted in a multicenter cohort of the Korean IA Registry from 2014 to 2017. Genetic testing was performed using a next-generation sequencing panel including 174 causative genes of cardiovascular disease. RESULTS Among the 265 IA probands, idiopathic ventricular fibrillation (IVF) and Brugada Syndrome (BrS) was the most prevalent diseases (96 and 95 cases respectively), followed by long QT syndrome (LQTS, n=54). Two-hundred-sixteen probands underwent genetic testing, and 69 probands (31.9%) were detected with genetic variant, with yield of pathogenic or likely pathogenic variant as 6.4%. Left ventricular ejection fraction was significantly lower in genotype positive probands (54.7±11.3 vs. 59.3±9.2%, p=0.005). IVF probands showed highest yield of positive genotype (54.0%), followed by LQTS (23.8%), and BrS (19.5%). CONCLUSIONS There were significant differences in clinical characteristics and genetic yields among BrS, LQTS, and IVF. Genetic testing did not provide better yield for BrS and LQTS. On the other hand, in IVF, genetic testing using multiple gene panel might enable the molecular diagnosis of concealed genotype, which may alter future clinical diagnosis and management strategies.
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Affiliation(s)
- Joo Hee Jeong
- Division of Cardiology, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea
| | - Suk-Kyu Oh
- Division of Cardiology, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea
| | - Yun Gi Kim
- Division of Cardiology, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea
| | - Yun Young Choi
- Division of Cardiology, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea
| | - Hyoung Seok Lee
- Division of Cardiology, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea
| | - Jaemin Shim
- Division of Cardiology, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea
| | - Yae Min Park
- Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Jun-Hyung Kim
- Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Yong-Seog Oh
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Nam-Ho Kim
- Department of Internal Medicine, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
| | - Hui-Nam Pak
- Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Keun On
- Department of Internal Medicine, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyung Wook Park
- Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea
| | - Gyo-Seung Hwang
- Department of Cardiology, Ajou University School of Medicine, Suwon, Korea
| | - Dae-Kyeong Kim
- Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Young-Ah Park
- Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hyoung-Seob Park
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University College of Medicine, Daegu, Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Seil Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jong-Il Choi
- Division of Cardiology, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea.
| | - Young-Hoon Kim
- Division of Cardiology, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea
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Pagani A, Hellwig LD, Dobson CP, Hughes BN, Schacht JP, Haigney M. Exercise-induced QTc prolongation and implications for military service members: A case series. HeartRhythm Case Rep 2023; 9:759-763. [PMID: 38047202 PMCID: PMC10691940 DOI: 10.1016/j.hrcr.2023.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Affiliation(s)
- Austin Pagani
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
- Center for Military Precision Health (CMPH), Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Lydia D. Hellwig
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland
- Center for Military Precision Health (CMPH), Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Craig P. Dobson
- Department of Pediatric Subspecialties, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Brian N. Hughes
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - John P. Schacht
- Department of Pediatric Subspecialties, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Mark Haigney
- Military Cardiovascular Outcomes Research, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Chumakova OS, Baulina NM. Advanced searching for hypertrophic cardiomyopathy heritability in real practice tomorrow. Front Cardiovasc Med 2023; 10:1236539. [PMID: 37583586 PMCID: PMC10425241 DOI: 10.3389/fcvm.2023.1236539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/17/2023] [Indexed: 08/17/2023] Open
Abstract
Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disease associated with morbidity and mortality at any age. As studies in recent decades have shown, the genetic architecture of HCM is quite complex both in the entire population and in each patient. In the rapidly advancing era of gene therapy, we have to provide a detailed molecular diagnosis to our patients to give them the chance for better and more personalized treatment. In addition to emphasizing the importance of genetic testing in routine practice, this review aims to discuss the possibility to go a step further and create an expanded genetic panel that contains not only variants in core genes but also new candidate genes, including those located in deep intron regions, as well as structural variations. It also highlights the benefits of calculating polygenic risk scores based on a combination of rare and common genetic variants for each patient and of using non-genetic HCM markers, such as microRNAs that can enhance stratification of risk for HCM in unselected populations alongside rare genetic variants and clinical factors. While this review is focusing on HCM, the discussed issues are relevant to other cardiomyopathies.
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Affiliation(s)
- Olga S. Chumakova
- Laboratory of Functional Genomics of Cardiovascular Diseases, National Medical Research Centre of Cardiology Named After E.I. Chazov, Moscow, Russia
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