Genetics of and pathogenic mechanisms in arrhythmogenic right ventricular cardiomyopathy
Anita Kiran Vimalanathan1, Elisabeth Ehler1,2, Katja Gehmlich3
1Randall Centre for Cell and Molecular Biophysics, School of Basic and Medical Biosciences, London, UK.
Insights
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited heart disease linked to desmosome gene mutations. This review explores ARVC pathology, genetics, and pathogenesis, including non-desmosomal causes.
Area of Science:
- Cardiology
- Genetics
- Molecular Biology
Background:
- Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiac condition.
- It carries a significant risk of sudden cardiac death.
- ARVC is often called a 'disease of the desmosome' due to genetic links.
Purpose of the Study:
- To review the pathology of ARVC.
- To examine the genetic basis of ARVC.
- To elucidate the mechanisms of ARVC pathogenesis.
Main Methods:
- Literature review of ARVC pathology.
- Analysis of genetic studies related to ARVC.
- Examination of molecular mechanisms in ARVC.
Main Results:
- Mutations in desmosomal genes are a common cause of ARVC.
- Desmosomes are crucial for cardiomyocyte adhesion and myocardial integrity.
- Non-desmosomal gene mutations also contribute to ARVC pathogenesis.
Conclusions:
- ARVC results from desmosome dysfunction and other genetic factors.
- Understanding ARVC pathogenesis is key to managing this inherited heart disease.
- Further research into desmosomal and non-desmosomal pathways is warranted.
Abstract:
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited heart disease, associated with a high risk of sudden cardiac death. ARVC has been termed a 'disease of the desmosome' based on the fact that in many cases, it is caused by mutations in genes encoding desmosomal proteins at the specialised intercellular junctions between cardiomyocytes, the intercalated discs. Desmosomes maintain the structural integrity of the ventricular myocardium and are also implicated in signal transduction pathways. Mutated desmosomal proteins are thought to cause detachment of cardiac myocytes by the loss of cellular adhesions and also affect signalling pathways, leading to cell death and substitution by fibrofatty adipocytic tissue. However, mutations in desmosomal proteins are not the sole cause for ARVC as mutations in non-desmosomal genes were also implicated in its pathogenesis. This review will consider the pathology, genetic basis and mechanisms of pathogenesis for ARVC.
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