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韩国复发性神经介导性晕厥患者心脏晕厥相关基因的遗传分析

Genetic Analysis of Cardiac Syncope-Related Genes in Korean Patients with Recurrent Neurally Mediated Syncope.

作者信息

Lee Sung Ho, Park Jong Eun, Ki Chang-Seok, Park Seung-Jung, On Young Keun, Park Kyoung-Min, Kim June Soo

机构信息

Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea.

Department of Laboratory Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri 11923, Korea.

出版信息

J Cardiovasc Dev Dis. 2022 Aug 14;9(8):265. doi: 10.3390/jcdd9080265.

Abstract

Neurally mediated syncope (NMS) is a common clinical problem. The underlying genetic factors of NMS remain controversial. We hypothesized that cardiac syncope-related genes may contribute to NMS in patients with previous frequent syncopal episodes and/or a family history of syncope. A total of 54 consecutive patients diagnosed with NMS were prospectively enrolled between 2013 and 2016. Inclusion criteria were more than five syncopal episodes with a family history of syncope ( = 17) or more than five syncopal episodes with no family history of syncope ( = 37). Ninety-eight cardiac syncope-related genes (channelopathy: 43 genes, cardiomyopathy: 50 genes, primary pulmonary hypertension: 5 genes) were screened by exome sequencing. All identified variants were classified according to the standards and guidelines by the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Of the 54 patients, 17 patients (31.5%) had a family history of syncope. Two patients (3.7%) had pathogenic and likely pathogenic variants (PV/LPV) in cardiac syncope-related genes and . We investigated genetic variation in patients with frequent NMS with a positive family history of syncope in Korea. PV/LPVs in genes related to cardiomyopathy were associated with recurrent NMS in Korean patients. Closer follow-up of these patients might be needed.

摘要

神经介导性晕厥(NMS)是一个常见的临床问题。NMS的潜在遗传因素仍存在争议。我们推测,心脏晕厥相关基因可能在既往有频繁晕厥发作和/或晕厥家族史的患者的NMS中起作用。2013年至2016年期间,前瞻性纳入了连续54例诊断为NMS的患者。纳入标准为有晕厥家族史且晕厥发作超过5次(n = 17)或无晕厥家族史且晕厥发作超过5次(n = 37)。通过外显子组测序筛选了98个心脏晕厥相关基因(通道病:43个基因,心肌病:50个基因,原发性肺动脉高压:5个基因)。所有鉴定出的变异均根据美国医学遗传学与基因组学学会和分子病理学协会的标准和指南进行分类。在这54例患者中,17例(31.5%)有晕厥家族史。2例患者(3.7%)在心脏晕厥相关基因 和 中存在致病性和可能致病性变异(PV/LPV)。我们调查了韩国有晕厥家族史的频繁发作NMS患者的基因变异情况。心肌病相关基因中的PV/LPV与韩国患者复发性NMS有关。可能需要对这些患者进行更密切的随访。

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