2
|
Rucinski C, Yunis LK, Rosas F, Santacruz D, Camargo JM, Yunis JJ. Genetic variants in Colombian patients with inherited cardiac conditions. Mol Genet Genomic Med 2022; 10:e2046. [PMID: 36204818 PMCID: PMC9651603 DOI: 10.1002/mgg3.2046] [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: 08/17/2021] [Revised: 08/07/2022] [Accepted: 08/09/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Clinical and molecular diagnosis of inherited cardiac conditions is key to find at-risk subjects and avoid preventable deaths. This study aimed to identify genetic variants in a sample of Colombian patients diagnosed with inherited cardiac conditions. METHODS Next-generation sequencing (Illumina platform) using a 231 gene panel was performed in blood samples of 25 unrelated patients with age disease onset between 9 and 55 years. RESULTS Genetic testing yield was 52%. Two novel likely pathogenic/ pathogenic variants were found: a DSP nonsense variant in a patient with arrhythmogenic cardiomyopathy and a KCNE1 frameshift variant in two patients with long QT syndrome. Younger individuals (<18 years) had the highest genetic testing yield (66.6%) compared to 50% and 20% in young adults and patients over 40 years, respectively. All subjects affected with long QT syndrome with a severe event while exercising had a positive genetic test. They also had four times more loss of consciousness events and, resuscitated sudden cardiac arrest was more representative. CONCLUSION This study is the first one undertaken in Colombia to evaluate inherited cardiac conditions. It highlights the need to perform mutational analysis to provide adequate genetic counseling and to be able to identify patients at risk of severe events.
Collapse
Affiliation(s)
- Cynthia Rucinski
- Grupo de Patología Molecular, Facultad de Medicina e Instituto de GenéticaUniversidad Nacional de ColombiaBogotáColombia
| | - Luz Karime Yunis
- Grupo de Patología Molecular, Facultad de Medicina e Instituto de GenéticaUniversidad Nacional de ColombiaBogotáColombia,Servicios Médico Yunis Turbay y Cia, SASBogotáColombia
| | | | | | | | - Juan José Yunis
- Grupo de Patología Molecular, Facultad de Medicina e Instituto de GenéticaUniversidad Nacional de ColombiaBogotáColombia,Servicios Médico Yunis Turbay y Cia, SASBogotáColombia
| |
Collapse
|
3
|
Pena JLB, Santos WC, Siqueira MHA, Sampaio IH, Moura ICG, Sternick EB. Glycogen storage cardiomyopathy (PRKAG2): diagnostic findings of standard and advanced echocardiography techniques. Eur Heart J Cardiovasc Imaging 2021; 22:800-807. [PMID: 32747946 DOI: 10.1093/ehjci/jeaa176] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 05/28/2020] [Indexed: 11/12/2022] Open
Abstract
AIMS Describe the findings obtained using standard echocardiography (Echo) and deformation indices (2D and 3D speckle tracking strain) in patients (Pts) with PRKAG2 cardiomyopathy. Seek to identify any peculiar characteristics and possible strain patterns that may distinguish this condition from other causes of left ventricular hypertrophy (LVH). METHODS AND RESULTS Thirty Pts with genetically proven PRKAG2 (R302Q and H401Q), 16 (53.3%) male, mean age 39.1± 15.4 years old, were examined using standard, speckle tracking (STE), and 3D Echo. Pacemaker (PM) had been implanted in 12 (40%) Pts with a mean age of 38.1 ± 13 years. Hypertrophy was found in varying degrees in 18 (86%) Pts. Seven Pts (24%) presented 3D ejection fraction (EF) below normal limits. Diastolic function was abnormal in 17 (63%) Pts. Global longitudinal strain (GLS) on 2D measured -16.4% ± 5.3%. GLS measured -13.2% ± 4.8%, global radial strain 40.8% ± 13.8%, global circumferential strain (GCS) -16.1% ± 4.4%, and global area strain -26.1% ± 6.7% by 3D Echo offline analyses. Pts with PM presented lower EF and GCS compared with those without PM. EF/GLS measured 3.65 ± 1.00. In the bull's eye map, a strain pattern similar to stripes in 18 (60%) Pts was identified, which might be a differentiating signal among LVH. CONCLUSION Echocardiography is a valuable tool in detecting diffuse and focal myocardial abnormalities in PRKAG2 cardiomyopathy. The deformation indices are especially revealing because they may help distinguish this rare infiltrative disease, thereby favouring early diagnosis, enhanced treatment, and improved outcome.
Collapse
Affiliation(s)
- José Luiz Barros Pena
- Post Graduation Department Ciências Médicas de Minas Gerais, Alameda Ezequiel Dias 275 30130-110, Belo Horizonte, Brazil.,Echocardiography Department Hospital Felício Rocho, Av. Contorno 9530 30110-934 Belo Horizonte, Brazil
| | - Wander Costa Santos
- Post Graduation Department Ciências Médicas de Minas Gerais, Alameda Ezequiel Dias 275 30130-110, Belo Horizonte, Brazil
| | - Maria Helena Albernaz Siqueira
- Post Graduation Department Ciências Médicas de Minas Gerais, Alameda Ezequiel Dias 275 30130-110, Belo Horizonte, Brazil
| | - Isaac Hermes Sampaio
- Echocardiography Department Hospital Felício Rocho, Av. Contorno 9530 30110-934 Belo Horizonte, Brazil
| | - Isabel Cristina Gomes Moura
- Post Graduation Department Ciências Médicas de Minas Gerais, Alameda Ezequiel Dias 275 30130-110, Belo Horizonte, Brazil
| | - Eduardo Back Sternick
- Post Graduation Department Ciências Médicas de Minas Gerais, Alameda Ezequiel Dias 275 30130-110, Belo Horizonte, Brazil
| |
Collapse
|
4
|
Hu D, Hu D, Liu L, Barr D, Liu Y, Balderrabano-Saucedo N, Wang B, Zhu F, Xue Y, Wu S, Song B, McManus H, Murphy K, Loes K, Adler A, Monserrat L, Antzelevitch C, Gollob MH, Elliott PM, Barajas-Martinez H. Identification, clinical manifestation and structural mechanisms of mutations in AMPK associated cardiac glycogen storage disease. EBioMedicine 2020; 54:102723. [PMID: 32259713 PMCID: PMC7132172 DOI: 10.1016/j.ebiom.2020.102723] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 02/08/2020] [Accepted: 03/03/2020] [Indexed: 01/25/2023] Open
Abstract
Background Although 21 causative mutations have been associated with PRKAG2 syndrome, our understanding of the syndrome remains incomplete. The aim of this project is to further investigate its unique genetic background, clinical manifestations, and underlying structural changes. Methods We recruited 885 hypertrophic cardiomyopathy (HCM) probands and their families internationally. Targeted next-generation sequencing of sudden cardiac death (SCD) genes was performed. The role of the identified variants was assessed using histological techniques and computational modeling. Findings Twelve PRKAG2 syndrome kindreds harboring 5 distinct variants were identified. The clinical penetrance of 25 carriers was 100.0%. Twenty-two family members died of SCD or heart failure (HF). All probands developed bradycardia (HRmin, 36.3 ± 9.8 bpm) and cardiac conduction defects, and 33% had evidence of atrial fibrillation/paroxysmal supraventricular tachycardia (PSVT) and 67% had ventricular preexcitation, respectively. Some carriers presented with apical hypertrophy, hypertension, hyperlipidemia, and renal insufficiency. Histological study revealed reduced AMPK activity and major cardiac channels in the heart tissue with K485E mutation. Computational modelling suggests that K485E disrupts the salt bridge connecting the β and γ subunits of AMPK, R302Q/P decreases the binding affinity for ATP, T400N and H401D alter the orientation of H383 and R531 residues, thus altering nucleotide binding, and N488I and L341S lead to structural instability in the Bateman domain, which disrupts the intramolecular regulation. Interpretation Including 4 families with 3 new mutations, we describe a cohort of 12 kindreds with PRKAG2 syndrome with novel pathogenic mechanisms by computational modelling. Severe clinical cardiac phenotypes may be developed, including HF, requiring close follow-up.
Collapse
Affiliation(s)
- Dan Hu
- Department of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan 430060, China; Hubei Key Laboratory of Cardiology, Wuhan 430060, China.
| | - Dong Hu
- Center for Stem Cell Research and Application, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liwen Liu
- Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Daniel Barr
- Department of Chemistry, University of Mary, 7500 University Drive, Bismarck, ND, USA
| | - Yang Liu
- Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou 510080, China
| | | | - Bo Wang
- Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Feng Zhu
- Clinic Center of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Yumei Xue
- Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou 510080, China
| | - Shulin Wu
- Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou 510080, China
| | - BaoLiang Song
- College of Life Sciences, Wuhan University, Wuhan, China
| | - Heather McManus
- Department of Chemistry and Biochemistry, Utica College, Utica, NY, USA
| | - Katherine Murphy
- Department of Chemistry, University of Mary, 7500 University Drive, Bismarck, ND, USA
| | - Katherine Loes
- Department of Chemistry, University of Mary, 7500 University Drive, Bismarck, ND, USA
| | - Arnon Adler
- Department of Physiology and the Peter Munk Cardiovascular Molecular Medicine Laboratory, Toronto General Hospital, University of Toronto, Toronto, ON, Canada
| | | | - Charles Antzelevitch
- Lankenau Institute for Medical Research, Wynnewood, PA, USA; Lankenau Heart Institute, Sidney Kimmel College of Medicine, Thomas Jefferson University, USA
| | - Michael H Gollob
- Department of Physiology and the Peter Munk Cardiovascular Molecular Medicine Laboratory, Toronto General Hospital, University of Toronto, Toronto, ON, Canada
| | - Perry M Elliott
- University College London and St. Bartholomew's Hospital, London, United Kingdom
| | - Hector Barajas-Martinez
- Lankenau Institute for Medical Research, Wynnewood, PA, USA; Lankenau Heart Institute, Sidney Kimmel College of Medicine, Thomas Jefferson University, USA
| |
Collapse
|