Long-term follow-up of R403W MYH7 and R92W TNNT2 HCM families : mutations determine left ventricular dimensions but not wall thickness during disease progression

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dc.contributor.author Revera, Miriam
dc.contributor.author Van Der Merwe, Lize
dc.contributor.author Heradien, Marshall
dc.contributor.author Goosen, Althea
dc.contributor.author Corfield, Valerie A.
dc.contributor.author Brink, Paul A.
dc.contributor.author Moolman-Smook, Johanna C.
dc.date.accessioned 2012-01-18T10:21:17Z
dc.date.available 2012-01-18T10:21:17Z
dc.date.issued 2007-06
dc.identifier.citation Revera, M. et al. 2007. Long-term follow-up of R403WMYH7 and R92WTNNT2 HCM families: mutations determine left ventricular dimensions but not wall thickness during disease progression. Cardiovascular Journal of Africa, 18(3), 146-153. en_ZA
dc.identifier.issn 1680-0745 (online)
dc.identifier.issn 1995-1892 (print)
dc.identifier.uri http://hdl.handle.net/10019.1/19311
dc.description The original publication is available at http://www.cvja.co.za/ en_ZA
dc.description CVJA holds the copyright
dc.description.abstract The clinical profile and prognosis of patients with hypertrophic cardiomyopathy, a primary cardiac muscle disease caused mostly by mutations in sarcomeric protein-encoding genes, have been linked to particular disease-causing mutations in the past. However, such associations are often based on cross-sectional observations, as longitudinal studies of the progression of the disease in genotypically defined patients are sparse. Most importantly, the relative contribution of age, gender and genetic cause to disease profile and progression has not yet been reported, and the question remains whether one or more of these factors could mask the effect of the other(s). Methods: We previously described cross-sectional family studies of two hypertrophic cardiomyopathy (HCM)-causing mutations, R92WTNNT2 and R403WMYH7, both associated with minimal hypertrophy, but with widely different life expectancies. We re-investigated 22 and 26 R92WTNNT2 and R403WMYH7 mutation carriers in these and additional South African R92WTNNT2 families after a mean 11.08 ± 2.79 years, and compared the influence of the two mutations, in the context of age and gender, on disease progression. Results: We demonstrated a positive correlation between age and interventricular septal thickness for both mutations, with more than a third of all mutation carriers developing clinically recognised hypertrophy only after the age of 35 years. This period of hypertrophically silent HCM also coincided with the years in which most sudden cardiac deaths occurred, particularly in male R92WTNNT2 carriers. Statistical analyses indicated that the particular mutation was the strongest determinant of left ventricular remodelling; particularly, LVESD increased and EF reduction was noted in the majority of R403WMYH7 carriers, which may require clinical follow-up over the longer term. Conclusions: Statistical modelling of follow-up data suggests that an interplay between unidentified, possibly genderassociated factors, and the causal mutation are the determinants of eventual cardiac function and survival, but not of the extent of hypertrophy, and emphasises the need for long-term follow-up even in individuals with apparently mild disease. en_ZA
dc.format.extent p. 146-153 : ill.
dc.language.iso en_ZA en_ZA
dc.publisher Clinics Cardiv Publishing en_ZA
dc.subject Hypertrophic cardiomyopathy en_ZA
dc.subject Heart muscles -- Diseases en_ZA
dc.subject Cardiac arrest en_ZA
dc.subject Heart attack en_ZA
dc.title Long-term follow-up of R403W MYH7 and R92W TNNT2 HCM families : mutations determine left ventricular dimensions but not wall thickness during disease progression en_ZA
dc.type Article en_ZA
dc.description.version Publishers' Version en_ZA
dc.rights.holder Clinics Cardiv Publishing en_ZA


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