Stallmeyer B, Dittmann S, Seebohm G, Müller J, Schulze-Bahr E
Institut für Genetik von Herzerkrankungen (IfGH), Department für Kardiologie und Angiologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude D3, 48129, Münster, Germany.
Herz. 2017 Aug;42(5):476-484. doi: 10.1007/s00059-017-4583-0.
Inherited forms of ventricular arrhythmias are rare diseases, but a major cause for severe cardiac events, sudden unexplained death syndromes, and death in young adults, infants, and children. Each disorder is genetically heterogeneous (5-20 genes per disease) and molecular testing may include both core genes and less common disease genes as well. Owing to the rapid development and feasibility of sequencing technologies enabling a parallel analysis of several hundred genes up to a whole exome, disease mutations can be identified very efficiently, but have to be seen in the complexity and natural variance of the human genome. Precise phenotypic knowledge and advanced gene variant interpretation are important to ensure adequate patient diagnostics and management. This article focuses on the genetic causes of inherited arrhythmia forms predisposing patients to sudden cardiac death and discusses practical issues and skills for molecular testing.
遗传性室性心律失常是罕见疾病,但却是导致严重心脏事件、不明原因猝死综合征以及年轻人、婴儿和儿童死亡的主要原因。每种疾病在遗传上都是异质性的(每种疾病有5 - 20个基因),分子检测可能既包括核心基因,也包括不太常见的疾病基因。由于测序技术的快速发展及其可行性,能够对数百个基因甚至整个外显子进行平行分析,疾病突变能够被非常高效地识别,但必须在人类基因组的复杂性和自然变异的背景下看待这些突变。精确的表型知识和先进的基因变异解读对于确保对患者进行充分的诊断和管理至关重要。本文重点关注使患者易发生心源性猝死的遗传性心律失常形式的遗传原因,并讨论分子检测的实际问题和技术。