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Circ Heart Fail. 2018;11(9):e005191.

Incident Atrial Fibrillation Is Associated With MYH7 Sarcomeric Gene Variation in Hypertrophic Cardiomyopathy.

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제1저자 이승표 · 교신저자 Marco Perez

소속 (12)
  1. Division of Cardiovascular Medicine, Department of Medicine, Stanford University, CA (S.-P.L., E.A.A., M.V.P.).
  2. Department of Internal Medicine, Seoul National University Hospital, South Korea (S.-P.L.).
  3. Stanford Center for Inherited Cardiovascular Disease, Stanford University, CA (E.A.A., C.C., M.V.P.).
  4. Department of Genetics, Stanford University, CA (E.A.A., J.H.).
  5. MyoKardia, South San Francisco, CA (E.M.G.).
  6. Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT (D.J.).
  7. Department of Cardiology, Boston Children's Hospital, MA (S.D.C.).
  8. Laboratory of Genetics and Molecular Cardiology and Cardiomyopathies Unit, Heart Institute (InCor), University of São Paulo, Brazil (E.A.-F.).
  9. Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor (S.M.D.).
  10. Referral Center for Cardiomyopathies, Careggi University Hospital, Florence, Italy (F.G., I.O.).
  11. Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands (M.M.).
  12. Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (C.Y.H.).

Abstract

Background Although atrial fibrillation (AF) is common in hypertrophic cardiomyopathy (HCM) patients, the relationship between genetic variation and AF has been poorly defined. Characterizing genetic subtypes of HCM and their associations with AF may help to improve personalized medical care. We aimed to investigate the link between sarcomeric gene variation and incident AF in HCM patients. Methods and Results Patients from the multinational Sarcomeric Human Cardiomyopathy Registry were followed for incident AF. Those with likely pathogenic or pathogenic variants in sarcomeric genes were included. The AF incidence was ascertained by review of medical records and electrocardiograms at each investigative site. One thousand forty adult HCM patients, without baseline AF and with likely pathogenic or pathogenic variation in either MYH7 (n=296), MYBPC3 (n=659), or thin filament genes (n=85), were included. Compared with patients with variation in other sarcomeric genes, those with MYH7 variants were younger on first clinical encounter at the Sarcomeric Human Cardiomyopathy Registry site and more likely to be probands than the MYBPC3 variants. During an average follow-up of 7.2 years, 198 incident AF events occurred. Patients with likely pathogenic or pathogenic mutations in MYH7 had the highest incidence of AF after adjusting for age, sex, proband status, left atrial size, maximal wall thickness, and peak pressure gradient (hazard ratio, 1.7; 95% CI, 1.1-2.6; P=0.009). Conclusions During a mean follow-up of 7.2 years, new-onset AF developed in 19% of HCM patients with sarcomeric mutations. Compared with other sarcomeric genes, patients with likely pathogenic or pathogenic variation in MYH7 had a higher rate of incident AF independent of clinical and echocardiographic factors.

Keywords

atrial fibrillationcardiomyopathy, hypertrophicgenetic variationincidencemutations

그 밖의 정보
출판 형태
Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't
저널
Circulation. Heart failure · eISSN 1941-3297
MeSH
Adult · Atrial Fibrillation / diagnosis / epidemiology / genetics · Cardiac Myosins / genetics · Cardiomyopathy, Hypertrophic / diagnostic imaging / epidemiology / genetics · Echocardiography · Electrocardiography · Female · Genetic Predisposition to Disease · Genetic Variation* · Humans · Incidence · Male · Middle Aged · Myosin Heavy Chains / genetics · Phenotype · Registries · Risk Assessment · Risk Factors · Sarcomeres / genetics · Time Factors · Young Adult
Substances
MYH7 protein, human · Cardiac Myosins · Myosin Heavy Chains
연구비
Medical Research Council MC_UP_1102/20