Nguyen Thuy Vy, Tran Vu Minh Thu, Do Thi Nam Phuong, Tran Thi Huynh Nga, Do Thi Hao, Nguyen Thi My Hanh, Tran Huynh Bao Nam, Le Lan Anh, Nguyen Pham Ngoc Thieu, Nguyen Thi Dieu Ai, Nguyen Thi My Nuong, Le Ngoc Hong Phuong, Pham Nguyen Vinh, Ho Huynh Thuy Duong
Department of Genetics, Faculty of Biology and Biotechnology, University of Science, VNUHCM [Vietnam National University, Ho Chi Minh City].
Tam Duc Heart Hospital.
Circ J. 2021 Aug 25;85(9):1469-1478. doi: 10.1253/circj.CJ-21-0077. Epub 2021 May 20.
Dilated cardiomyopathy (DCM) is an important cause of heart failure and cardiac transplantation. This study determined the prevalence of DCM-associated genes and evaluated the genotype-phenotype correlation in Vietnamese patients.
This study analyzed 58 genes from 230 patients. The study cohort consisted of 64.3% men; age at diagnosis 47.9±13.7 years; familial (10.9%) and sporadic DCM (82.2%). The diagnostic yield was 23.5%, 44.0% in familial and 19.6% in sporadic DCM.TTNtruncating variants (TTNtv) were predominant (46.4%), followed byTPM1,DSP,LMNA,MYBPC3,MYH6,MYH7,DES,TNNT2,ACTC1,ACTN2,BAG3,DMD,FKTN,PLN,TBX5,RBM20,TCAP(2-6%). Familial DCM, genotype-positive andTTNtv-positive patients were younger than those with genotype-negative and sporadic DCM. Genotype-positive patients displayed a decreased systolic blood pressure and left ventricular wall thickness compared to genotype-negative patients. Genotype-positive patients, particularly those withTTNtv, had a family history of DCM, higher left atrial volume index and body mass index, and lower right ventricle-fractional area change than genotype-negative patients. Genotype-positive patients reached the combined outcomes more frequently and at a younger age than genotype-negative patients. Major cardiac events occurred more frequently in patients positive with genes other thanTTNtv.
The study findings provided an overview of Vietnamese DCM patients' genetic profile and suggested that management of environmental factors may be beneficial for DCM patients.
扩张型心肌病(DCM)是心力衰竭和心脏移植的重要原因。本研究确定了越南患者中DCM相关基因的患病率,并评估了基因型与表型的相关性。
本研究分析了230例患者的58个基因。研究队列中男性占64.3%;诊断时年龄为47.9±13.7岁;家族性DCM占10.9%,散发性DCM占82.2%。诊断率为23.5%,家族性DCM中为44.0%,散发性DCM中为19.6%。TTN截短变异(TTNtv)占主导(46.4%),其次是TPM1、DSP、LMNA、MYBPC3、MYH6、MYH7、DES、TNNT2、ACTC1、ACTN2、BAG3、DMD、FKTN、PLN、TBX5、RBM20、TCAP(2 - 6%)。家族性DCM、基因型阳性和TTNtv阳性患者比基因型阴性和散发性DCM患者更年轻。与基因型阴性患者相比,基因型阳性患者的收缩压和左心室壁厚度降低。基因型阳性患者,尤其是那些携带TTNtv的患者,有DCM家族史、更高的左心房容积指数和体重指数,且右心室-面积变化分数低于基因型阴性患者。基因型阳性患者比基因型阴性患者更频繁且更年轻时达到联合结局。除TTNtv外,基因阳性患者发生主要心脏事件的频率更高。
研究结果概述了越南DCM患者的基因特征,并表明环境因素的管理可能对DCM患者有益。