Department of Cardiology, Health Science University, Gazi Yaşargil Training and Research Hospital, 21070, Diyarbakır, Turkey.
Sadi Konuk Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
Int J Cardiovasc Imaging. 2023 Jun;39(6):1143-1155. doi: 10.1007/s10554-023-02826-w. Epub 2023 Mar 15.
In this prospective study we aimed to determine the rate of Fabry Disease (FD) in patients with left ventricular hypertrophy (LVH), and to evaluate the clinical presentations of patients with FD in a comprehensive manner. In addition, we aimed to raise awareness about this issue by allowing early diagnosis and treatment of FD.
Our study was planned as national, multicenter, observational. Totally 22 different centers participated in this study. A total of 886 patients diagnosed with LVH by echocardiography (ECHO) were included in the study. Demographic data, biochemical parameters, electrocardiography (ECG) findings, ECHO findings, treatments and clinical findings of the patients were recorded. Dry blood samples were sent from male patients with suspected FD. The α-Gal A enzyme level was checked and genetic testing was performed in patients with low enzyme levels. Female patients suspected of FD were genetically tested with the GLA Gene Mutation Analysis.
FD was suspected in a total of 143 (16.13%) patients included in the study. The α-Gal-A enzyme level was found to be low in 43 (4.85%) patients whom enzyme testing was requested. GLA gene mutation analysis was positive in 14 (1.58%) patients. Male gender, E/e' mean ,and severe hypertrophy are important risk factor for FD.
In daily cardiology practice, FD should be kept in mind not only in adult patients with unexplained LVH but also in the entire LVH population. Dry blood test (DBS) should be considered in high-risk patients, and mutation analysis should be considered in required patients.
在这项前瞻性研究中,我们旨在确定左心室肥厚(LVH)患者中 Fabry 病(FD)的发生率,并全面评估 FD 患者的临床表现。此外,我们旨在通过早期诊断和治疗 FD 来提高对此问题的认识。
我们的研究是全国性、多中心、观察性的。共有 22 个不同的中心参与了这项研究。共有 886 名通过超声心动图(ECHO)诊断为 LVH 的患者纳入了这项研究。记录了患者的人口统计学数据、生化参数、心电图(ECG)结果、ECHO 结果、治疗和临床发现。从疑似 FD 的男性患者中采集了干血样。检查α-Gal A 酶水平,并在酶水平低的患者中进行基因检测。疑似 FD 的女性患者进行 GLA 基因突变分析。
在纳入研究的 143 名(16.13%)患者中,共怀疑有 FD。请求进行酶检测的 43 名(4.85%)患者中发现α-Gal-A 酶水平较低。14 名(1.58%)患者的 GLA 基因突变分析呈阳性。男性、E/e'均值和严重肥厚是 FD 的重要危险因素。
在日常心脏病学实践中,不仅应在原因不明的 LVH 的成年患者中,而且应在整个 LVH 人群中都要考虑 FD。应在高危患者中考虑干血测试(DBS),并在需要的患者中考虑突变分析。