Mangum Kevin D, Ferns Sunita J
University of North Carolina, School of Medicine, Chapel Hill, NC, United States.
University of North Carolina, School of Medicine, Chapel Hill, NC, United States; UNC Department of Pediatrics, Chapel Hill, NC, United States.
Eur J Med Genet. 2019 Apr;62(4):282-285. doi: 10.1016/j.ejmg.2018.08.006. Epub 2018 Aug 14.
The authors report for the first time a novel mutation in the FLNC gene associated with cardiac arrhythmias in two half-siblings. The FLNC gene on chromosome 7q32 encodes filamin C, which stabilizes the actin network within the cardiomyocyte. The proband is an 8-year-old asymptomatic patient with frequent premature ventricular contractions noted on serial monitoring. Interestingly, the proband and his half-brother harbored a heterozygous 13 base pair deletion that resulted in a frameshift mutation and introduction of a premature stop codon. Notably, the proband also had a very tragic family history of sudden death in young individuals involving three generations and five family members. Because of their concerning family history and arrhythmias, both siblings underwent off-label implantable cardiac device placement for primary prevention of sudden cardiac death. Whether or not the FLNC mutation is associated with sudden cardiac death requires additional investigation and is beyond the scope of this manuscript. While previous studies have identified several mutations in the FLNC gene associated with dilated and hypertrophic cardiomyopathies, the goal of this study was to report a novel mutation in the FLNC gene that is associated with cardiac arrhythmias. The current study indicates that this mutation may help identify patients at risk for cardiac arrhythmias who would benefit from further cardiac evaluation.
作者首次报告了在两个同父异母的兄弟姐妹中发现的与心律失常相关的FLNC基因的一种新突变。位于7号染色体q32上的FLNC基因编码细丝蛋白C,它可稳定心肌细胞内的肌动蛋白网络。先证者是一名8岁无症状患者,连续监测发现其频发室性早搏。有趣的是,先证者和他的同父异母兄弟携带一个13个碱基对的杂合缺失,导致移码突变并引入了一个提前终止密码子。值得注意的是,先证者还有一个非常悲惨的家族史,涉及三代五名家庭成员的年轻人猝死。由于他们令人担忧的家族史和心律失常,两兄弟都接受了标签外植入式心脏装置植入,以预防心脏性猝死。FLNC突变是否与心脏性猝死相关需要进一步研究,且超出了本手稿的范围。虽然先前的研究已经在FLNC基因中鉴定出与扩张型和肥厚型心肌病相关的几种突变,但本研究的目的是报告一种与心律失常相关的FLNC基因新突变。当前研究表明,这种突变可能有助于识别心律失常风险患者,这些患者将从进一步的心脏评估中受益。