Asadi Marzieh, Foo Roger, Samienasab Mohammad Reza, Salehi Ahmad Reza, Kheirollahi Majid, Khanahmad Hossein, Salehi Rasoul
Department of Genetic and Molecular Biology, Isfahan University of Medical Sciences, Isfahan, Iran.
Cardiovascular Research Institute, and Genome Institute of Singapore, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Adv Biomed Res. 2016 Mar 16;5:55. doi: 10.4103/2277-9175.178801. eCollection 2016.
Cardiac arrhythmias are responsible for several cases of syncope and sudden cardiac death annually worldwide. Due to overlapping clinical symptoms in some cardiac arrhythmias genetic studies would help to confirm the primary clinical diagnosis made on the basis of solely clinical findings. In addition clinical management of the patient, family screening and provide appropriate counseling and risk assessment for the family members are other advantages of genetic study.
Totally nine patients from a family included in this study. The primary diagnosis on the basis of clinical findings was second-degree atrioventricular (AV) block for this family. Mutation in SCN5A gene is frequently reported for second-degree AV block and hence the gene was analyzed using whole gene sequencing but no mutation was detected. Subsequently, the samples were subjected to customized Ampliseq 77 gene panel using next generation sequencing to detect the underlying molecular defects.
We found c. 5570T>A missense mutation in ANK2 gene for this family. Based on the Online Mendelian Inheritance in Man, ANK2 gene and the mutation detected correspond to long QT syndrome type 4.
This mutation, although already known in other populations, but is reported for the first time in Iranian patients with cardiac arrhythmias. As the case with this family, genetic analysis of patients with cardiac arrhythmias would be helpful in reassessment of clinical diagnosis and therefore would help for patients' management and in some cases re-evaluation of ongoing treatment may be needed.
心律失常每年在全球导致数例晕厥和心源性猝死。由于某些心律失常的临床症状重叠,基因研究有助于证实仅基于临床发现做出的初步临床诊断。此外,对患者进行临床管理、对家族进行筛查并为家庭成员提供适当的咨询和风险评估是基因研究的其他优势。
本研究纳入了来自一个家族的9名患者。基于临床发现,该家族的初步诊断为二度房室传导阻滞。SCN5A基因的突变常与二度房室传导阻滞相关,因此使用全基因测序对该基因进行分析,但未检测到突变。随后,使用下一代测序技术对样本进行定制的Ampliseq 77基因panel检测潜在的分子缺陷。
我们在该家族的ANK2基因中发现了c. 5570T>A错义突变。根据《人类孟德尔遗传在线》,ANK2基因及检测到的突变对应4型长QT综合征。
这种突变虽然在其他人群中已为人所知,但在伊朗心律失常患者中首次报道。就这个家族的情况而言,对心律失常患者进行基因分析有助于重新评估临床诊断,从而有助于患者管理,在某些情况下可能需要重新评估正在进行的治疗。