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一名患有索托斯综合征的儿童出现双孔二尖瓣合并左心室心肌致密化不全。

Double orifice mitral valve combined with left ventricular noncompaction in a child with Sotos syndrome.

作者信息

Nakamura Akihiro, Horigome Hitoshi, Ishizu Tomoko, Seo Yoshihiro, Sumazaki Ryo

机构信息

Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.

Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.

出版信息

J Cardiol Cases. 2014 Dec 11;11(3):88-90. doi: 10.1016/j.jccase.2014.11.002. eCollection 2015 Mar.

Abstract

Sotos syndrome is an autosomal dominant condition, sometimes complicated with cardiovascular malformations. We report the case of a 10-year-old Japanese male with Sotos syndrome found to have double orifice mitral valve (DOMV) combined with left ventricular noncompaction (LVNC) by transthoracic echocardiography. Three-dimensional echocardiography clearly demonstrated the trabecular meshwork, two separate mitral orifices with subvalvular apparatuses, and multiple tendinous cords. To the best of our knowledge, this is the first case of Sotos syndrome associated with DOMV and LVNC. Considering that mitral valve leaflets, chordae, papillary muscles, and primitive trabeculations of the left ventricle originate from the endomyocardial cushions in the developing heart, both cardiac defects in the present case might be explained by a common developmental aberrancy of endomyocardium. Patients with Sotos syndrome should be screened for mitral valve anomaly, subvalvular apparatuses, and left ventricular myocardial function as well as structural abnormalities. < Sotos syndrome is sometimes complicated with cardiovascular malformations, including left ventricular noncompaction (LVNC) as reported in some previous articles. Considering the rarity of both the syndrome and LVNC, this combination might not be coincidental. It is intriguing that the present case had double orifice mitral valve in addition to LVNC, as both mitral valve leaflets and primitive trabeculations of LV might be derived in common from aberrant development of the endomyocardial cushions.>.

摘要

索托斯综合征是一种常染色体显性遗传病,有时会并发心血管畸形。我们报告一例10岁日本男性索托斯综合征患者,经胸超声心动图检查发现其患有双孔二尖瓣(DOMV)合并左心室心肌致密化不全(LVNC)。三维超声心动图清晰显示了小梁网状结构、两个带有瓣下装置的独立二尖瓣口以及多条腱索。据我们所知,这是首例索托斯综合征合并DOMV和LVNC的病例。鉴于二尖瓣叶、腱索、乳头肌以及左心室的原始小梁均起源于发育中心内膜垫,本病例中的两种心脏缺陷可能由心内膜的共同发育异常来解释。索托斯综合征患者应接受二尖瓣异常、瓣下装置、左心室心肌功能以及结构异常的筛查。<索托斯综合征有时会并发心血管畸形,如先前一些文章所报道的包括左心室心肌致密化不全(LVNC)。考虑到该综合征和LVNC均较为罕见,这种组合可能并非偶然。有趣的是,本病例除LVNC外还患有双孔二尖瓣,因为二尖瓣叶和左心室的原始小梁可能共同源于心内膜垫的异常发育。>

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本文引用的文献

3
Left ventricular noncompaction in Sotos syndrome.
Am J Med Genet A. 2011 May;155A(5):1115-8. doi: 10.1002/ajmg.a.33838. Epub 2011 Apr 11.
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A combination of left ventricular noncompaction and double orifice mitral valve.
Cardiovasc Ultrasound. 2009 Mar 9;7:11. doi: 10.1186/1476-7120-7-11.
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Double-orifice mitral valve associated with noncompaction of left ventricular myocardium.
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Double-orifice mitral valve associated with nonisolated left ventricular noncompaction--a case report.
Angiology. 2004 Nov-Dec;55(6):707-10. doi: 10.1177/00033197040550i614.
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Haploinsufficiency of NSD1 causes Sotos syndrome.
Nat Genet. 2002 Apr;30(4):365-6. doi: 10.1038/ng863. Epub 2002 Mar 18.

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