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KCNQ1 G219E 和 TRPM4 T160M 多态性与长 QT 综合征的发病机制有关:一例报告。

KCNQ1 G219E and TRPM4 T160M polymorphisms are involved in the pathogenesis of long QT syndrome: A case report.

机构信息

Department of Cardiology, First Affiliated Hospital, Xinjiang Medical University, Urumqi, Xinjiang.

Department of Cardiology, Frontier Defence Force General Hospital of Armed Police, Shenzhen, China.

出版信息

Medicine (Baltimore). 2021 Jan 15;100(2):e24032. doi: 10.1097/MD.0000000000024032.

Abstract

RATIONALE

Long QT syndrome (LQTS) is an inheritable disease characterized by prolonged QT interval on the electrocardiogram. The pathogenesis of LQTS is related to mutations in LQTS-susceptible genes encoding cardiac ion channel proteins or subunits.

PATIENT CONCERNS

Here, we reported a 37-year-old female Uygur patient with palpitation and loss of consciousness.

DIAGNOSES

At the time of admission, a 12-lead electrocardiogram showed a QTc interval of 514 ms. Genetic analysis revealed KCNQ1 G219E and TRPM4 T160M mutations.

INTERVENTIONS

Although beta-blockers remain the mainstay in treating LQTS, the patient underwent implantation of an automatic cardioverter defibrillator due to life-threatening arrhythmias.

OUTCOMES

To explore the effect of the calcium ion antagonist verapamil on ion channels, we generated human induced pluripotent stem cell cardiomyocytes (hiPSC-CMs) from the peripheral blood mononuclear cells of the patient. The changes of action potential duration in response to verapamil were observed.

LESSONS

Our results showed that patient-derived hiPSC-CMs could recapitulate the electrophysiological features of LQTS and display pharmaceutical responses to verapamil.

摘要

背景

长 QT 综合征(LQTS)是一种遗传性疾病,其特征为心电图上 QT 间期延长。LQTS 的发病机制与编码心脏离子通道蛋白或亚基的 LQTS 易感基因的突变有关。

病例报告

我们在此报告了一位 37 岁的维吾尔族女性患者,其主要表现为心悸和意识丧失。

入院时,12 导联心电图显示 QTc 间期为 514ms。基因分析显示 KCNQ1 G219E 和 TRPM4 T160M 突变。

尽管β受体阻滞剂仍然是治疗 LQTS 的主要方法,但由于存在危及生命的心律失常,该患者接受了自动心脏复律除颤器的植入。

为了探讨钙离子拮抗剂维拉帕米对离子通道的影响,我们从患者外周血单核细胞中生成了人诱导多能干细胞心肌细胞(hiPSC-CMs)。观察了动作电位时程对维拉帕米的反应变化。

结论

我们的结果表明,患者来源的 hiPSC-CMs 可以再现 LQTS 的电生理特征,并对维拉帕米显示出药物反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2ca/7808457/9a71a74d5718/medi-100-e24032-g001.jpg

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