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
Cardiology Division, People's Hospital, Peking University, Beijing 100044, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2006 Mar;34(3):202-7.
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).
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.
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.
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.
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。
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。
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。
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。