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10个中国家族性肥厚型心肌病家系的MYH7、MYBPC3和TNNT2基因突变分析及基因型与表型的相关性

[Analysis of MYH7, MYBPC3 and TNNT2 gene mutations in 10 Chinese pedigrees with familial hypertrophic cardiomyopathy and the correlation between genotype and phenotype].

作者信息

Liu Wen-ling, Xie Wen-li, Hu Da-Yi, Zhu Tian-gang, Li Yun-tian, Sun Yi-hong, Li Cui-lan, Li Lei, Li Tian-chang, Bian Hong, Tong Qi-guang, Yang Song-na, Fan Rui-yun, Cui Wei

机构信息

Cardiology Division, People's Hospital, Peking University, Beijing 100044, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2006 Mar;34(3):202-7.

Abstract

OBJECTIVE

The aim of this study was to screen the disease-causing gene mutations and investigate the genotype-phenotype correlation in 10 Chinese pedigrees with familial hypertrophic cardiomyopathy (HCM).

METHODS

There are 91 family members from these 10 pedigrees and 5 members were normal mutated carriers, 23 members were HCM patients (14 male) aged from 1.5 to 73 years old. The functional regions of myosin heavy chain gene (MYH7), cardiac myosin-binding protein C (MYBPC3) and cardiac troponin T gene (TNNT2) were screened with PCR and direct sequencing technique. Clinical information from all patients was also evaluated in regard to the genotype.

RESULTS

Mutations were found in 5 out of 10 pedigrees. Mutations in MYH7 (Arg663His, Glu924Lys and Ile736Thr) were found in 3 pedigrees and 3 patients from these pedigrees suffered sudden death at age 20-48 years old during sport. Mutations in MYBPC3 were found in 2 pedigrees, 1 with complex mutation (Arg502Trp and splicing mutation IVS27 + 12C > T) and 1 with novel frame shift mutation (Gly347fs) and the latter pedigree has sudden death history. No mutation was identified in TNNT2.

CONCLUSIONS

Although the Han Chinese is a relatively homogeneous ethnic group, different HCM gene mutations were responsible for familiar HCM suggesting the heterogeneity nature of the disease-causing genes and HCM MYH7 mutations are associated with a higher risk of sudden death in this cohort. Furthermore, identical mutation might result in different phenotypes suggesting that multiple factors might be involved in the pathogenesis of familiar HCM.

摘要

目的

本研究旨在筛查10个中国家族性肥厚型心肌病(HCM)家系的致病基因突变,并研究其基因型与表型的相关性。

方法

这10个家系共有91名家庭成员,其中5名成员为正常突变携带者,23名成员为HCM患者(14名男性),年龄在1.5至73岁之间。采用聚合酶链反应(PCR)和直接测序技术筛查肌球蛋白重链基因(MYH7)、心肌肌球蛋白结合蛋白C(MYBPC3)和心肌肌钙蛋白T基因(TNNT2)的功能区域。还对所有患者的临床信息进行了基因型评估。

结果

10个家系中有5个发现了突变。在3个家系中发现了MYH7突变(Arg663His、Glu924Lys和Ile736Thr),这些家系中的3名患者在运动时于20至48岁时猝死。在2个家系中发现了MYBPC3突变,1个家系为复合突变(Arg502Trp和剪接突变IVS27 + 12C > T),1个家系为新的移码突变(Gly347fs),后一个家系有猝死病史。TNNT2未发现突变。

结论

尽管汉族是一个相对同质的民族,但不同的HCM基因突变导致了家族性HCM,提示致病基因具有异质性,并且在该队列中HCM的MYH7突变与猝死风险较高相关。此外,相同的突变可能导致不同的表型,这表明家族性HCM的发病机制可能涉及多种因素。

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