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Published on: August 8, 2022
Prenatal Diagnosis of Isolated Right Ventricular Non-Compaction Cardiomyopathy with an MYH7 Likely Pathogenic Variant
Weiming Yu1,2, Mary Ann Thomas3,2, Lindsay Mills4
1Departments of Pathology & Laboratory Medicine, Cumming School of Medicine, University of Calgary, Alberta, Canada.
Insights
Isolated right ventricular noncompaction, a rare heart condition, was diagnosed in a fetus. This case links the condition to a MYH7 gene mutation, offering new insights into congenital heart defects.
Area of Science:
- Cardiology
- Genetics
- Developmental Biology
Background:
- Noncompaction of ventricular myocardium is a rare cardiomyopathy.
- It primarily affects the left or both ventricles, often linked to sarcomere protein gene mutations.
- Isolated right ventricular noncompaction is poorly understood, with limited case reports.
Observation:
- A 30-year-old woman experienced fetal loss at 19 weeks gestation.
- Ultrasound revealed fetal right ventricular and tricuspid valve abnormalities, ascites, and hydrops.
- Autopsy confirmed isolated right ventricular noncompaction with a dysplastic tricuspid valve.
Findings:
- Histologic examination confirmed isolated right ventricular noncompaction.
- Whole exome sequencing identified a likely pathogenic variant in the MYH7 gene.
- This represents the first reported case of isolated right ventricular noncompaction associated with a gene mutation.
Implications:
- This study presents the first fetal diagnosis of isolated right ventricular noncompaction.
- The findings suggest MYH7 gene variants may play a role in isolated right ventricular noncompaction.
- This case expands the understanding of noncompaction cardiomyopathies and their genetic underpinnings.
Abstract:
Background: Noncompaction of ventricular myocardium is a cardiomyopathy that typically involves the left ventricle or both ventricles; it has often been associated with mutations in genes encoding sarcomere proteins. Little is known about isolated right ventricular noncompaction, as only a few cases have been reported. Case Report: A 30 year old G2P1 woman experienced a spontaneous fetal loss at 19 weeks and 4 days. An ultrasound examination at 19 weeks showed right ventricular and tricuspid valve abnormalities, ascites, and early hydrops. At autopsy, the right ventricular chamber was dilated with numerous prominent trabeculations and deep intrabecular recesses as well as a dysplastic tricuspid valve. Histologic examination confirmed isolated right ventricular noncompaction. Whole exome sequencing showed a likely pathogenic variant in the MYH7 gene. Conclusions: This appears to be the first report of isolated right ventricular noncompaction associated with a gene mutation as well as the first diagnosis in a fetus.
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