Jääskeläinen P, Soranta M, Miettinen R, Saarinen L, Pihlajamäki J, Silvennoinen K, Tikanoja T, Laakso M, Kuusisto J
Department of Medicine, University of Kuopio, Finland.
J Am Coll Cardiol. 1998 Nov 15;32(6):1709-16. doi: 10.1016/s0735-1097(98)00448-3.
The aim of the study was to screen 36 unrelated patients with hypertrophic cardiomyopathy (HCM; 16 familial and 20 sporadic cases) from a genetically homogeneous area in eastern Finland for variants in the cardiac beta-myosin heavy chain (beta-MHC) and alpha-tropomyosin (alpha-TM) genes.
Mutations in the beta-MHC and alpha-TM genes have been reported to be responsible for 30% to 40% and less than 5% of familial HCM cases, respectively. However, most genetic studies have included patients from tertiary care centers and are subject to referral bias.
Exons 3-26 and 40 of the beta-MHC gene and the nine exons of the alpha-TM gene were screened with the PCR-SSCP (polymerase chain reaction-single strand conformation polymorphism) method. Linkage analyses between familial HCM locus and two intragenic polymorphic markers (MYO I and MYO II) of the beta-MHC gene were performed in 16 familial HCM kindreds.
A previously reported Arg719Trp (arginine converted to tryptophan in codon 719) mutation of the beta-MHC gene was found in one proband and two relatives. In addition, a novel Asn696Ser (asparagine converted to serine in codon 696) substitution was found in one HCM patient. No linkage between familial HCM and the beta-MHC gene was observed in 16 familial kindreds. A previously reported Aspl75Asn (aspartic acid converted to asparagine in codon 175) mutation of the alpha-TM gene was found in four probands and 16 relatives. Mutations in the beta-MHC and alpha-TM genes accounted for 6% and 25% familial HCM cases and 3% and 11% of all cases, respectively.
Our results indicate that the beta-MHC gene is not the predominant gene for HCM in the Finnish population, whereas HCM caused by the Aspl75Asn mutation of the a-TM gene is more common than previously reported.
本研究旨在对来自芬兰东部一个基因同质地区的36例肥厚型心肌病(HCM;16例家族性和20例散发性病例)无关患者进行心脏β-肌球蛋白重链(β-MHC)和α-原肌球蛋白(α-TM)基因变异筛查。
据报道,β-MHC和α-TM基因的突变分别导致30%至40%和不到5%的家族性HCM病例。然而,大多数基因研究纳入的是三级医疗中心的患者,存在转诊偏倚。
采用PCR-SSCP(聚合酶链反应-单链构象多态性)方法对β-MHC基因的外显子3-26和40以及α-TM基因的9个外显子进行筛查。对16个家族性HCM家系进行家族性HCM位点与β-MHC基因的两个基因内多态性标记(MYO I和MYO II)之间的连锁分析。
在1例先证者和2名亲属中发现了先前报道的β-MHC基因的Arg719Trp(密码子719处精氨酸转换为色氨酸)突变。此外,在1例HCM患者中发现了一种新的Asn696Ser(密码子696处天冬酰胺转换为丝氨酸)替代。在16个家族性家系中未观察到家族性HCM与β-MHC基因之间的连锁。在4例先证者和16名亲属中发现了先前报道的α-TM基因的Asp175Asn(密码子175处天冬氨酸转换为天冬酰胺)突变。β-MHC和α-TM基因的突变分别占家族性HCM病例的6%和25%,占所有病例的3%和11%。
我们的结果表明,β-MHC基因不是芬兰人群中HCM的主要基因,而由α-TM基因的Asp175Asn突变引起的HCM比先前报道的更为常见。