Mėlinytė-Ankudavičė Karolina, Šukys Marius, Plisienė Jurgita, Jurkevičius Renaldas, Ereminienė Eglė
Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania.
Department of Genetics and Molecular Medicine, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania.
Genes (Basel). 2022 Feb 17;13(2):363. doi: 10.3390/genes13020363.
We report the case of a 22-year-old male who visited a cardiologist after the first episode of atrial fibrillation (AF). Echocardiography and magnetic resonance imaging revealed decreased left ventricular (LV) systolic function with dilated LV. An intermittent second-degree AV (atrioventricular) block was detected during 24 h Holter monitoring. Genetic test revealed the pathogenic variant of the (BLC2-associated athanogene 3) gene. Due to the high risk of heart failure (HF) progression and ventricular arrhythmias, an event recorder was implanted and a pathogenetic HF treatment was prescribed. The analysis of genealogy revealed that the patient's father, at the age of 32, was diagnosed with dilated cardiomyopathy (DCM) and recurrent AF episodes. Genetic testing also confirmed a pathogenic variant of the gene. Currently, with the optimal treatment of HF, the patient's disease has been stable for three years and the condition is closely monitored on an outpatient basis. So, we demonstrate the importance of early detection for genetic testing and the unusual stability exhibited by the patient's optimal medical therapy for 3 years.
我们报告了一例22岁男性病例,该患者在首次发生心房颤动(AF)后就诊于心脏病专家。超声心动图和磁共振成像显示左心室(LV)收缩功能下降伴左心室扩张。24小时动态心电图监测期间检测到间歇性二度房室(AV)阻滞。基因检测发现了(BLC2相关生原基因3)基因的致病变异。由于心力衰竭(HF)进展和室性心律失常的高风险,植入了事件记录仪并开出了针对病因的HF治疗方案。家系分析显示,患者的父亲在32岁时被诊断为扩张型心肌病(DCM)和反复发作的AF。基因检测也证实了该基因的致病变异。目前,通过对HF的优化治疗,患者的病情已稳定三年,并在门诊密切监测。因此,我们证明了早期进行基因检测的重要性以及患者通过优化药物治疗表现出的异常三年稳定性。