Genetic determinants of clinical phenotype in hypertrophic cardiomyopathy.


Journal

BMC cardiovascular disorders
ISSN: 1471-2261
Titre abrégé: BMC Cardiovasc Disord
Pays: England
ID NLM: 100968539

Informations de publication

Date de publication:
09 12 2020
Historique:
received: 17 06 2020
accepted: 02 12 2020
entrez: 10 12 2020
pubmed: 11 12 2020
medline: 2 2 2021
Statut: epublish

Résumé

Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiovascular disease that affects approximately one in 500 people. HCM is a recognized genetic disorder most often caused by mutations involving myosin-binding protein C (MYBPC3) and β-myosin heavy chain (MYH7) which are responsible for approximately three-quarters of the identified mutations. As a part of the international multidisciplinary SILICOFCM project ( www.silicofcm.eu ) the present study evaluated the association between underlying genetic mutations and clinical phenotype in patients with HCM. Only patients with confirmed single pathogenic mutations in either MYBPC3 or MYH7 genes were included in the study and divided into two groups accordingly. The MYBPC3 group was comprised of 48 patients (76%), while the MYH7 group included 15 patients (24%). Each patient underwent clinical examination and echocardiography. The most prevalent symptom in patients with MYBPC3 was dyspnea (44%), whereas in patients with MYH7 it was palpitations (33%). The MYBPC3 group had a significantly higher number of patients with a positive family history of HCM (46% vs. 7%; p = 0.014). There was a numerically higher prevalence of atrial fibrillation in the MYH7 group (60% vs. 35%, p = 0.085). Laboratory analyses revealed normal levels of creatinine (85.5 ± 18.3 vs. 81.3 ± 16.4 µmol/l; p = 0.487) and blood urea nitrogen (10.2 ± 15.6 vs. 6.9 ± 3.9 mmol/l; p = 0.472) which were similar in both groups. The systolic anterior motion presence was significantly more frequent in patients carrying MYH7 mutation (33% vs. 10%; p = 0.025), as well as mitral leaflet abnormalities (40% vs. 19%; p = 0.039). Calcifications of mitral annulus were registered only in MYH7 patients (20% vs. 0%; p = 0.001). The difference in diastolic function, i.e. E/e' ratio between the two groups was also noted (MYBPC3 8.8 ± 3.3, MYH7 13.9 ± 6.9, p = 0.079). Major findings of the present study corroborate the notion that MYH7 gene mutation patients are presented with more pronounced disease severity than those with MYBPC3.

Sections du résumé

BACKGROUND
Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiovascular disease that affects approximately one in 500 people. HCM is a recognized genetic disorder most often caused by mutations involving myosin-binding protein C (MYBPC3) and β-myosin heavy chain (MYH7) which are responsible for approximately three-quarters of the identified mutations.
METHODS
As a part of the international multidisciplinary SILICOFCM project ( www.silicofcm.eu ) the present study evaluated the association between underlying genetic mutations and clinical phenotype in patients with HCM. Only patients with confirmed single pathogenic mutations in either MYBPC3 or MYH7 genes were included in the study and divided into two groups accordingly. The MYBPC3 group was comprised of 48 patients (76%), while the MYH7 group included 15 patients (24%). Each patient underwent clinical examination and echocardiography.
RESULTS
The most prevalent symptom in patients with MYBPC3 was dyspnea (44%), whereas in patients with MYH7 it was palpitations (33%). The MYBPC3 group had a significantly higher number of patients with a positive family history of HCM (46% vs. 7%; p = 0.014). There was a numerically higher prevalence of atrial fibrillation in the MYH7 group (60% vs. 35%, p = 0.085). Laboratory analyses revealed normal levels of creatinine (85.5 ± 18.3 vs. 81.3 ± 16.4 µmol/l; p = 0.487) and blood urea nitrogen (10.2 ± 15.6 vs. 6.9 ± 3.9 mmol/l; p = 0.472) which were similar in both groups. The systolic anterior motion presence was significantly more frequent in patients carrying MYH7 mutation (33% vs. 10%; p = 0.025), as well as mitral leaflet abnormalities (40% vs. 19%; p = 0.039). Calcifications of mitral annulus were registered only in MYH7 patients (20% vs. 0%; p = 0.001). The difference in diastolic function, i.e. E/e' ratio between the two groups was also noted (MYBPC3 8.8 ± 3.3, MYH7 13.9 ± 6.9, p = 0.079).
CONCLUSIONS
Major findings of the present study corroborate the notion that MYH7 gene mutation patients are presented with more pronounced disease severity than those with MYBPC3.

Identifiants

pubmed: 33297970
doi: 10.1186/s12872-020-01807-4
pii: 10.1186/s12872-020-01807-4
pmc: PMC7727200
doi:

Substances chimiques

Carrier Proteins 0
MYH7 protein, human 0
myosin-binding protein C 0
Cardiac Myosins EC 3.6.1.-
Myosin Heavy Chains EC 3.6.4.1

Types de publication

Comparative Study Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

516

Subventions

Organisme : Horizon 2020 Framework Programme
ID : Grant Agreement No 777204.
Pays : International

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Auteurs

Lazar Velicki (L)

Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia. lazar.velicki@mf.uns.ac.rs.
Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia. lazar.velicki@mf.uns.ac.rs.

Djordje G Jakovljevic (DG)

Cardiovascular Research, Translational and Clinical Research Institute, Medicine, Newcastle University, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK. djordje.jakovljevic@newcastle.ac.uk.
Faculty of Health and Life Sciences, Coventry University, and University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK. djordje.jakovljevic@newcastle.ac.uk.

Andrej Preveden (A)

Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.

Miodrag Golubovic (M)

Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.

Marija Bjelobrk (M)

Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.

Aleksandra Ilic (A)

Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.

Snezana Stojsic (S)

Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.

Fausto Barlocco (F)

Careggi University Hospital, University of Florence, Florence, Italy.

Maria Tafelmeier (M)

Department of Internal Medicine II (Cardiology, Pneumology, and Intensive Care), University Medical Centre Regensburg, Regensburg, Germany.

Nduka Okwose (N)

Cardiovascular Research, Translational and Clinical Research Institute, Medicine, Newcastle University, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.

Milorad Tesic (M)

Cardiology Department, Clinical Centre of Serbia, Faculties of Medicine and Pharmacy, University of Belgrade, Belgrade, Serbia.

Paul Brennan (P)

Cardiovascular Research, Translational and Clinical Research Institute, Medicine, Newcastle University, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.

Dejana Popovic (D)

Cardiology Department, Clinical Centre of Serbia, Faculties of Medicine and Pharmacy, University of Belgrade, Belgrade, Serbia.

Arsen Ristic (A)

Cardiology Department, Clinical Centre of Serbia, Faculties of Medicine and Pharmacy, University of Belgrade, Belgrade, Serbia.

Guy A MacGowan (GA)

Cardiovascular Research, Translational and Clinical Research Institute, Medicine, Newcastle University, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.

Nenad Filipovic (N)

Bioengineering Research and Development Center, BioIRC, Kragujevac, Serbia.
Faculty of Engineering, University of Kragujevac, Kragujevac, Serbia.

Lars S Maier (LS)

Department of Internal Medicine II (Cardiology, Pneumology, and Intensive Care), University Medical Centre Regensburg, Regensburg, Germany.

Iacopo Olivotto (I)

Careggi University Hospital, University of Florence, Florence, Italy.

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