Wang Shu-Xia, Zou Yu-Bao, Fu Chun-Yan, Song Lei, Wang Hu, Wang Ji-Zheng, Song Xiao-Dong, Chen Jing-Zhou, Hui Ru-Tai
Sino-German Laboratory for Molecular Medicine, Fuwai Cardiovascular Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences, Beijing 100037, China.
Zhonghua Yi Xue Za Zhi. 2007 Feb 6;87(6):371-4.
To study the disease-causing gene mutation in Chinese patients with familial hypertrophic cardiomyopathy (FHC) and to analyze the correlation between the genotype and the phenotype.
Peripheral blood samples were collected from 40 members from a family affected with FHC, and 120 healthy volunteers. PCR was performed to analyze the exons and flanking introns of the cardiac troponin T gene (TNNT2), beta-myosin heavy chain gene (MYH7), and myosin-binding protein C gene (MYBPC3) and the products were sequenced. The clinical data including symptom, physical examination, echocardiography and electrocardiography were collected.
A 14035c > t mutation, which causes a missense mutation (R130C) in exon 10 of TNNT2 gene were identified in 4 family members, including the proband, female, aged 53, with the onset at the age of 30. The 4 persons with the 14035c > t mutation, all FHC patients, presented left ventricular dysfunction with a penetrance of 100%. Two of the patients died of sudden cardiac death during follow-up. No mutation was identified in the MYH7 and MYBPC3 genes.
The 14035c > t mutation of TNNT2 gene is the causal mutation of FHC which is associated with malignant phenotype with a penetrance of 100%. It is a reasonable procedure in HCM patients with malignant phenotype to screen mutation in the TNNT2 gene.
研究中国家族性肥厚型心肌病(FHC)患者的致病基因突变情况,并分析基因型与表型之间的相关性。
采集了一个FHC家族的40名成员以及120名健康志愿者的外周血样本。采用聚合酶链反应(PCR)分析心肌肌钙蛋白T基因(TNNT2)、β-肌球蛋白重链基因(MYH7)和肌球蛋白结合蛋白C基因(MYBPC3)的外显子及侧翼内含子,并对产物进行测序。收集包括症状、体格检查、超声心动图和心电图在内的临床资料。
在4名家庭成员(包括先证者,53岁女性,30岁起病)中鉴定出一个14035c>t突变,该突变导致TNNT2基因第10外显子发生错义突变(R130C)。这4名携带14035c>t突变的个体均为FHC患者,均表现为左心室功能障碍,外显率为100%。其中2例患者在随访期间死于心源性猝死。在MYH7和MYBPC3基因中未鉴定出突变。
TNNT2基因的14035c>t突变是FHC的致病突变,与恶性表型相关,外显率为100%。对具有恶性表型的肥厚型心肌病患者筛查TNNT2基因的突变是一种合理的做法。