Erschienen in:
14.03.2019 | Original Communication
Congenital myopathies are mainly associated with a mild cardiac phenotype
verfasst von:
Helle Petri, Karim Wahbi, Nanna Witting, Lars Køber, Henning Bundgaard, Emna Kamoun, Geoffroy Vellieux, Tanya Stojkovic, Anthony Béhin, Pascal Laforet, John Vissing
Erschienen in:
Journal of Neurology
|
Ausgabe 6/2019
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Abstract
Background
To evaluate the prevalence of cardiac involvement in patients with congenital myopathies and the association to specific genotypes.
Methods
We evaluated patients with physical examination, electrocardiogram, echocardiography, and 48-h Holter monitoring. Follow-up was performed for major events.
Results
We included 130 patients, 55 men (42%), with a mean age of 34 ± 17 years. A genetic diagnosis was established in 97 patients (75%). Right bundle branch block was observed in three patients: 2/34 patients with a ryanodine receptor 1 (RYR1) and 1/6 with a tropomyosin two gene (TPM2) gene mutation. Echocardiography showed left-ventricular hypertrophy in five patients: 2/17 and 3/34 patients with a Dynamin 2 (DNM2) and a RYR1 mutation, respectively. One patient with a myosin heavy-chain (MYH7) mutation had dilated cardiomyopathy and heart failure. On Holter monitoring, frequent ventricular premature contractions were observed in one patient with a DNM2 mutation. Two patients with a TPM2 and a RYR1 mutation, respectively, had a single short run of non-sustained ventricular tachycardia. Atrioventricular nodal re-entry tachycardia was observed in a 20-year-old man with an actin 1 gene mutation. During follow-up (median 8.4 years), four patients died, all of non-cardiac causes.
Conclusion
Congenital myopathies are generally associated with a mild cardiac phenotype. Our findings substantiate the literature and indicate that, except for patients with specific genotypes, such as MYH7 and TTN mutations, repeated cardiac assessments can be minimized, given a normal initial cardiac screening at time of diagnosis.