Hypertrophic remodelling in cardiac regulatory myosin light chain (MYL2) founder mutation carriers.

Abstract:

AIMS:Phenotypic heterogeneity and incomplete penetrance are common in patients with hypertrophic cardiomyopathy (HCM). We aim to improve the understanding in genotype-phenotype correlations in HCM, particularly the contribution of an MYL2 founder mutation and risk factors to left ventricular hypertrophic remodelling. METHODS AND RESULTS:We analysed 14 HCM families of whom 38 family members share the MYL2 c.64G > A [p.(Glu22Lys)] mutation and a common founder haplotype. In this unique cohort, we investigated factors influencing phenotypic outcome in addition to the primary mutation. The mutation alone showed benign disease manifestation with low penetrance. The co-presence of additional risk factors for hypertrophy such as hypertension, obesity, or other sarcomeric gene mutation increased disease penetrance substantially and caused HCM in 89% of MYL2 mutation carriers (P = 0.0005). The most prominent risk factor was hypertension, observed in 71% of mutation carriers with HCM and an additional risk factor. CONCLUSION:The MYL2 mutation c.64G > A on its own is incapable of triggering clinical HCM in most carriers. However, the presence of an additional risk factor for hypertrophy, particularly hypertension, adds to the development of HCM. Early diagnosis of risk factors is important for early treatment of MYL2 mutation carriers and close monitoring should be guaranteed in this case. Our findings also suggest that the presence of hypertension or another risk factor for hypertrophy should not be an exclusion criterion for genetic studies.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Claes GR,van Tienen FH,Lindsey P,Krapels IP,Helderman-van den Enden AT,Hoos MB,Barrois YE,Janssen JW,Paulussen AD,Sels JW,Kuijpers SH,van Tintelen JP,van den Berg MP,Heesen WF,Garcia-Pavia P,Perrot A,Christiaans I,Salem

doi

10.1093/eurheartj/ehv522

subject

Has Abstract

pub_date

2016-06-14 00:00:00

pages

1815-22

issue

23

eissn

0195-668X

issn

1522-9645

pii

ehv522

journal_volume

37

pub_type

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