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Prevalence of Fabry disease in a predominantly hypertensive population with left ventricular hypertrophy.

Abstract：

BACKGROUND:Patients with Fabry disease (FD) develop progressive left ventricular hypertrophy (LVH). In screening studies in patients with LVH, the prevalence of FD ranges from 0 to 12%. This variability is attributable to different factors like diverging inclusion and exclusion criteria, the evaluation of selected populations and suboptimal screening methods. In this study, we aimed to determine the prevalence of FD in an unselected population of everyday clinical practice presenting LVH, defined as a maximal end-diastolic septal or posterior wall thickness ≥ 13 mm, without exclusion of patients with arterial hypertension or valvular pathology, and using optimal screening methods. METHODS:In adult males, a two-tier approach was used; α-Galactosidase A (aGAL A) activity was measured using a dried bloodspot test (DBS) and diagnosis was confirmed by mutation analysis of the GLA gene. In females, mutation analysis was the primary screening tool. RESULTS:362 men and 178 women were screened. Six patients were diagnosed with a genetic sequence alteration of the GLA gene. One man had a novel mutation, GLA p.Ala5Glu (c.44C>A), presenting as classical FD. Another man and three women had the previously described GLA p.Ala143Thr (c.427G>A) mutation, which generally presents as an attenuated phenotype. One woman had a novel sequence alteration c.639+6A>C, which appeared to be a polymorphism. All true Fabry patients had arterial hypertension (AHT), and one had hypertrophic obstructive cardiomyopathy (HOCM). CONCLUSIONS:In a group of unselected patients with LVH, we found a prevalence of Fabry disease of 0.9%. AHT or type of hypertrophy should not be an exclusion criterion for screening for FD.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Terryn W,Deschoenmakere G,De Keyser J,Meersseman W,Van Biesen W,Wuyts B,Hemelsoet D,Pascale H,De Backer J,De Paepe A,Poppe B,Vanholder R

doi

10.1016/j.ijcard.2012.06.069

subject

Has Abstract

pub_date

2013-09-10 00:00:00

pages

2555-60

issue

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(12)00860-1

journal_volume

167

pub_type

临床试验,杂志文章,多中心研究

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Prevalence of Fabry disease in a predominantly hypertensive population with left ventricular hypertrophy.