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左心室心肌致密化不全和肥厚型心肌病重叠表型,新型截短 DSC2 突变导致复杂心律失常和心力衰竭。

Overlap phenotypes of the left ventricular noncompaction and hypertrophic cardiomyopathy with complex arrhythmias and heart failure induced by the novel truncated DSC2 mutation.

机构信息

The Center of Cardiovascular Diseases, The Department of Cardiology, Radiology and Ultrasonography, Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, 519000, China.

Reproductive Center, The Six Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510000, China.

出版信息

Orphanet J Rare Dis. 2021 Nov 24;16(1):496. doi: 10.1186/s13023-021-02112-9.

Abstract

BACKGROUND

The left ventricular noncompaction cardiomyopathy (LVNC) is a rare subtype of cardiomyopathy associated with a high risk of heart failure (HF), thromboembolism, arrhythmia, and sudden cardiac death.

METHODS

The proband with overlap phenotypes of LVNC and hypertrophic cardiomyopathy (HCM) complicates atrial fibrillation (AF), ventricular tachycardia (VT), and HF due to the diffuse myocardial lesion, which were diagnosed by electrocardiogram, echocardiogram and cardiac magnetic resonance imaging. Peripheral blood was collected from the proband and his relatives. DNA was extracted from the peripheral blood of proband for high-throughput target capture sequencing. The Sanger sequence verified the variants. The protein was extracted from the skin of the proband and healthy volunteer. The expression difference of desmocollin2 was detected by Western blot.

RESULTS

The novel heterozygous truncated mutation (p.K47Rfs2) of the DSC2 gene encoding an important component of desmosomes was detected by targeted capture sequencing. The western blots showed that the expressing level of functional desmocollin2 protein (~ 94kd) was lower in the proband than that in the healthy volunteer, indicating that DSC2 p.K47Rfs2 obviously reduced the functional desmocollin2 protein expression in the proband.

CONCLUSION

The heterozygous DSC2 p.K47Rfs*2 remarkably and abnormally reduced the functional desmocollin2 expression, which may potentially induce the overlap phenotypes of LVNC and HCM, complicating AF, VT, and HF.

摘要

背景

左心室心肌致密化不全(LVNC)是一种罕见的心肌病亚型,与心力衰竭(HF)、血栓栓塞、心律失常和心源性猝死的风险增加有关。

方法

先证者具有 LVNC 和肥厚型心肌病(HCM)的重叠表型,由于弥漫性心肌病变,并发心房颤动(AF)、室性心动过速(VT)和 HF,这些表型通过心电图、超声心动图和心脏磁共振成像诊断。从先证者及其亲属采集外周血。从先证者外周血中提取 DNA,进行高通量靶向捕获测序。Sanger 测序验证变异。从先证者和健康志愿者的皮肤中提取蛋白。通过 Western blot 检测 desmocollin2 的表达差异。

结果

通过靶向捕获测序检测到编码桥粒重要成分的 DSC2 基因的新型杂合截断突变(p.K47Rfs2)。Western blot 显示,先证者功能性 desmocollin2 蛋白(~94kd)的表达水平低于健康志愿者,表明 DSC2 p.K47Rfs2 明显降低了先证者功能性 desmocollin2 蛋白的表达。

结论

杂合 DSC2 p.K47Rfs*2 显著且异常地降低了功能性 desmocollin2 的表达,这可能潜在地导致 LVNC 和 HCM 的重叠表型,并发 AF、VT 和 HF。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a66d/8611834/0baf035ba42c/13023_2021_2112_Fig1_HTML.jpg

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