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肥厚型心肌病的基因型相关临床特征、心肌纤维化及其与预后的关系

Genotype-Related Clinical Characteristics and Myocardial Fibrosis and their Association with Prognosis in Hypertrophic Cardiomyopathy.

作者信息

Kim Hyung Yoon, Park Jong Eun, Lee Sang-Chol, Jeon Eun-Seok, On Young Keun, Kim Sung Mok, Choe Yeon Hyeon, Ki Chang-Seok, Kim Jong-Won, Kim Kye Hun

机构信息

Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju 61469, Korea.

Department of Laboratory Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri 11923, Korea.

出版信息

J Clin Med. 2020 Jun 1;9(6):1671. doi: 10.3390/jcm9061671.

Abstract

BACKGROUND

The spectrum of genetic variants and their clinical significance of Hypertrophic cardiomyopathy (HCM) have been poorly studied in Asian patients. The objectives of this study were to assess the spectrum of genetic variants and genotype-phenotype relationships within a Korean HCM population.

METHODS

Eighty-nine consecutive unrelated HCM patients were included. All patients underwent genotypic analysis for 23 HCM-associated genes. Clinical parameters including echocardiographic and cardiac magnetic resonance (CMR) parameters were evaluated. A composite of major adverse cardiac and cerebrovascular events was assessed.

RESULTS

Genetic variants were detected in 55 of 89 subjects. Pathogenic variants or likely pathogenic variants were identified in 27 of HCM patients in , , , and . Variants of uncertain significance were identified in 28 patients. There were significant differences in the presence of non-sustained ventricular tachycardia ( 0.030) and myocardial fibrosis on CMR ( 0.029) in the detected compared to the not-detected groups. Event-free survival was superior in the not-detected group ( 0.006).

CONCLUSION

Genetic variants in patients with HCM are relatively common and are associated with adverse clinical events and myocardial fibrosis on CMR. Genotypic analysis may add important information to clinical variables in the assessment of long-term risk for HCM patients.

摘要

背景

在亚洲患者中,肥厚型心肌病(HCM)的基因变异谱及其临床意义尚未得到充分研究。本研究的目的是评估韩国HCM患者群体中的基因变异谱以及基因型与表型的关系。

方法

纳入89例连续的无亲缘关系的HCM患者。所有患者均对23个与HCM相关的基因进行了基因分型分析。评估了包括超声心动图和心脏磁共振(CMR)参数在内的临床参数。评估了主要不良心脑血管事件的综合情况。

结果

89名受试者中有55名检测到基因变异。在[具体基因1]、[具体基因2]、[具体基因3]和[具体基因4]的27例HCM患者中鉴定出致病变异或可能的致病变异。28例患者鉴定出意义未明的变异。与未检测到变异的组相比,检测到变异的组中非持续性室性心动过速的发生率(P = 0.030)和CMR上的心肌纤维化情况(P = 0.029)存在显著差异。未检测到变异的组无事件生存率更高(P = 0.006)。

结论

HCM患者的基因变异相对常见,且与不良临床事件及CMR上的心肌纤维化相关。基因分型分析可能会为评估HCM患者的长期风险的临床变量增添重要信息。

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