Meta-analysis of clinical characteristics of 299 carriers of LMNA gene mutations: do lamin A/C mutations portend a high risk of sudden death?

JH Van Berlo, WG De Voogt, AJ Van Der Kooi… - Journal of molecular …, 2005 - Springer
JH Van Berlo, WG De Voogt, AJ Van Der Kooi, JP Van Tintelen, G Bonne, RB Yaou…
Journal of molecular medicine, 2005Springer
This study evaluated common clinical characteristics of patients with lamin A/C gene
mutations that cause either isolated dilated cardiomyopathy or dilated cardiomyopathy in
association with skeletal muscular dystrophy. We pooled clinical data of all published
carriers of lamin A/C gene mutations as cause of skeletal and/or cardiac muscle disease and
reviewed ECG findings. Cardiac dysrhythmias were reported in 92% of patients after the age
of 30 years; heart failure was reported in 64% after the age of 50. Sudden death was the …
Abstract
This study evaluated common clinical characteristics of patients with lamin A/C gene mutations that cause either isolated dilated cardiomyopathy or dilated cardiomyopathy in association with skeletal muscular dystrophy. We pooled clinical data of all published carriers of lamin A/C gene mutations as cause of skeletal and/or cardiac muscle disease and reviewed ECG findings. Cardiac dysrhythmias were reported in 92% of patients after the age of 30 years; heart failure was reported in 64% after the age of 50. Sudden death was the most frequently reported mode of death (46%) in both the cardiac and the neuromuscular phenotype. Carriers of lamin A/C gene mutations often received a pacemaker (28%). However, this intervention did not alter the rate of sudden death. Review of the ECG findings typically showed a low amplitude P wave and prolongation of the PR interval with a narrow QRS complex. This meta-analysis suggests that cardiomyopathy due to lamin A/C gene mutations portends a high risk of sudden death, and that this risk does not differ between subjects with predominantly cardiac or neuromuscular disease. This implies then that all carriers of a lamin A/C gene mutation need to be carefully screened with particular emphasis also on tachyarrhythmias. Prospective studies are needed to evaluate risk stratification and proper treatment strategies.
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