Di Marco Andrea, Ruiz-Cueto María, Salazar-Mendiguchía Joel, Claver Eduard, Roura Gerard, Dallaglio Paolo Domenico, Anguera Ignasi
Department of Cardiology, Hospital Universitari de Bellvitge, Barcelona, Spain.
ESC Heart Fail. 2020 Oct;7(5):3169-3173. doi: 10.1002/ehf2.12776. Epub 2020 Jul 15.
We present a case of atypical LMNA cardiomyopathy associated with the pathogenic variant p.Arg541Ser. The patient had early-onset severe ventricular arrhythmias but atrioventricular conduction was normal. Segmental motion abnormalities and a large transmural scar, mainly apical and lateral, were found at cardiac magnetic resonance, corresponding to areas of severe wall thinning at computed tomography and of low voltages at electroanatomic mapping. Ventricular tachycardia ablation was successful in controlling ventricular arrhythmias. Few other cases described patients with pathogenic variants in the Arg541 residue, and they displayed similar atypical features, suggesting a genotype-phenotype correlation which may have specific prognostic and therapeutic implications.
我们报告了一例与致病性变异p.Arg541Ser相关的非典型LMNA心肌病病例。该患者有早发性严重室性心律失常,但房室传导正常。心脏磁共振成像发现节段性运动异常和一个大的透壁瘢痕,主要位于心尖和侧壁,这与计算机断层扫描显示的严重心肌变薄区域以及电解剖标测显示的低电压区域相对应。室性心动过速消融成功控制了室性心律失常。其他很少有病例描述Arg541残基存在致病性变异的患者,且他们表现出类似的非典型特征,提示可能存在基因型-表型相关性,这可能具有特定的预后和治疗意义。