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由核纤层蛋白A/C基因突变引起的埃默里-德赖富斯肌营养不良症的心脏特征。

Cardiac features of Emery-Dreifuss muscular dystrophy caused by lamin A/C gene mutations.

作者信息

Sanna Tommaso, Dello Russo Antonio, Toniolo Daniela, Vytopil Michal, Pelargonio Gemma, De Martino Giuseppe, Ricci Enzo, Silvestri Gabriella, Giglio Vincenzo, Messano Loredana, Zachara Elisabetta, Bellocci Fulvio

机构信息

Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.

出版信息

Eur Heart J. 2003 Dec;24(24):2227-36. doi: 10.1016/j.ehj.2003.09.020.

DOI:10.1016/j.ehj.2003.09.020
PMID:14659775
Abstract

AIMS

Retrospective studies have identified a mutation in the lamin A/C (LMNA) gene in patients selected on the basis of a phenotype characterized by dilated cardiomyopathy, atrioventricular conduction disturbances and sudden death. However, the features of cardiac abnormalities in patients with an initial diagnosis of Emery-Dreifuss muscular dystrophy (EDMD) are poorly known. Aim of the present study was to investigate the spectrum of cardiac disease in patients with an initial diagnosis of EDMD caused by a mutation in the LMNA gene.

METHODS AND RESULTS

Ten consecutive patients with EDMD and a LMNA gene mutation were evaluated with structured medical interview, physical examination, ECG, echocardiogram and 24-h Holter monitoring. Electrophysiological testing and cardiac catheterization were performed if a class 1 or 2 American Heart Association guidelines indication was present. Cardiac disease was found in eight of 10 patients and consisted in the variable combination of supraventricular arrhythmias, disorders of atrioventricular conduction, ventricular arrhythmias, dilated cardiomyopathy, non-dilated cardiomyopathy, restrictive cardiomyopathy and sudden death despite pacemaker implant.

CONCLUSIONS

Cardiac disease is common in patients with an initial diagnosis of EDMD caused by a mutation in the LMNA gene and consists of arrhythmias, disorders of atrioventricular conduction, cardiomyopathies and sudden death despite pacemaker implant.

摘要

目的

回顾性研究已在基于以扩张型心肌病、房室传导障碍和猝死为特征的表型所选择的患者中,鉴定出了核纤层蛋白A/C(LMNA)基因的一种突变。然而,初始诊断为埃默里-德赖富斯肌营养不良症(EDMD)的患者心脏异常的特征却鲜为人知。本研究的目的是调查初始诊断为由LMNA基因突变引起的EDMD患者的心脏疾病谱。

方法与结果

对连续10例患有EDMD且存在LMNA基因突变的患者进行了结构化医学访谈、体格检查、心电图、超声心动图和24小时动态心电图监测。如果存在美国心脏协会指南1类或2类指征,则进行电生理检查和心导管检查。10例患者中有8例发现患有心脏疾病,包括室上性心律失常、房室传导障碍、室性心律失常、扩张型心肌病、非扩张型心肌病、限制型心肌病以及尽管植入了起搏器仍发生猝死等多种组合情况。

结论

初始诊断为由LMNA基因突变引起的EDMD患者中,心脏疾病很常见,包括心律失常、房室传导障碍、心肌病以及尽管植入了起搏器仍发生猝死。

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