Tam Duc Heart Hospital.
Research Center for Genetics and Reproductive Health, School of Medicine, Viet Nam National University.
Circ J. 2019 Aug 23;83(9):1908-1916. doi: 10.1253/circj.CJ-19-0190. Epub 2019 Jul 12.
Hypertrophic cardiomyopathy (HCM) is associated primarily with pathogenic mutations in sarcomeric genes. The aim of this study was to identify the prevalence and distribution of disease-causing mutations in HCM-associated genes and the genotype-phenotype relationship in Vietnamese patients with HCM.
Genetic testing was performed by next-generation sequencing in 104 unrelated probands for 23 HCM-related genes and in 57 family members for the mutation(s) detected. Clinical manifestations were recorded for genotype-phenotype correlation analysis. Mutation detection rate was 43.4%. Mutations inMYBPC3accounted for 38.6%, followed byTPM1(20.5%),MYH7(18.2%),TNNT2(9.1%),TNNI3(4.5%) andMYL2(2.3%). A mutation inGLAassociated with Fabry disease was found in 1 patient. A mutation inTPM1(c.842T>C, p.Met281Thr) was identified in 8 unrelated probands (18.2%) and 8 family members from 5 probands. Genotype-positive status related toMYH7,TPM1, andTNNT2mutations was associated with severe clinical manifestations.MYH7-positive patients displayed worse prognosis compared withMYBPC3-positive patients. Interestingly,TPM1c.842T>C mutation was associated with high penetrance and severe HCM phenotype.
We report for the first time the prevalence of HCM-related gene variants in Vietnamese patients with HCM.MYH7,TPM1, andTNNT2mutations were associated with unfavorable prognosis.
肥厚型心肌病(HCM)主要与肌节基因的致病性突变相关。本研究旨在鉴定与 HCM 相关基因中的致病突变的流行率和分布,并分析越南 HCM 患者的基因型-表型关系。
对 104 名无血缘关系的先证者进行了 23 个 HCM 相关基因的下一代测序基因检测,并对 57 名先证者的家庭成员进行了突变检测。记录临床表现以进行基因型-表型相关性分析。突变检测率为 43.4%。MYBPC3 中的突变占 38.6%,其次是 TPM1(20.5%)、MYH7(18.2%)、TNNT2(9.1%)、TNNI3(4.5%)和 MYL2(2.3%)。1 例患者发现与 Fabry 病相关的 GLA 基因突变。在 8 名无血缘关系的先证者(18.2%)和 5 名先证者的 8 名家庭成员中发现 TPM1(c.842T>C,p.Met281Thr)突变。MYH7、TPM1 和 TNNT2 突变的阳性基因型与严重的临床表现相关。与 MYBPC3 阳性患者相比,MYH7 阳性患者的预后较差。有趣的是,TPM1 c.842T>C 突变与高外显率和严重的 HCM 表型相关。
我们首次报道了越南 HCM 患者的 HCM 相关基因突变的流行率。MYH7、TPM1 和 TNNT2 突变与不良预后相关。