Pompe Disease: From a Cardiovascular Lens

Abdullah Ali1, Dinushan Thirumavalavan1, John Nicholas Catanzaro1

  • 1From the Department of Medicine, Northwell Health, New Hyde Park, NY.

Cardiology in Review
|August 14, 2026
PubMed

Insights

Pompe disease, a genetic disorder causing glycogen buildup, is now treatable with enzyme replacement therapy (ERT). However, long-term ERT requires ongoing cardiac monitoring due to persistent cardiovascular issues in patients.

Area of Science:

  • Biochemistry
  • Genetics
  • Pediatrics

Background:

  • Pompe disease is a rare, progressive, autosomal recessive lysosomal storage disorder.
  • It stems from a deficiency in the acid α-glucosidase enzyme, leading to glycogen accumulation in lysosomes, particularly in muscles.
  • Cardiovascular complications are a significant feature of Pompe disease.

Purpose of the Study:

  • To review the impact of enzyme replacement therapy (ERT) on infantile-onset Pompe disease.
  • To highlight persistent cardiac issues in patients undergoing long-term ERT.
  • To emphasize the necessity of continued cardiovascular surveillance in Pompe disease patients.

Main Methods:

  • Literature review of studies on Pompe disease and its treatment.
  • Analysis of long-term follow-up data for patients receiving alglucosidase alfa.
  • Evaluation of cardiovascular outcomes in treated individuals.

Main Results:

  • Enzyme replacement therapy (alglucosidase alfa) has transformed infantile-onset Pompe disease from fatal to treatable.
  • Long-term ERT is associated with ongoing cardiac problems, including conduction defects and arrhythmias.
  • Residual myocardial fibrosis remains a concern in patients on long-term therapy.

Conclusions:

  • While ERT has improved outcomes, Pompe disease management requires sustained attention to cardiac health.
  • Continued cardiovascular monitoring is crucial for patients with Pompe disease on enzyme replacement therapy.
  • Further research may be needed to address residual cardiac manifestations.

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