T波逆転の若いアスリートにおける遺伝子検査の診断結果
Nabeel Sheikh1, Michael Papadakis1, Mathew Wilson2
1St. George's University of London, United Kingdom (N.S., M.P., A.M., T.H., E.R.B., S.S.).
Circulation
|May 17, 2018
まとめ
アスリートにおけるT波逆転 (TWI) の遺伝子検査は,臨床的評価を超えて,いくつかの追加診断をもたらしました. 遺伝子検査の診断成果は臨床評価の半分で 普段の実践ではほとんど使われていません
科学分野:
- 心臓病科
- スポーツ医学
- 遺伝学
背景:
- T波逆転 (TWI) は,心筋病患者および一部のアスリートにおいて一般的であり,しばしば臨床的意義は不明である.
- 黒人アスリートの25%と白人アスリートの5%は,明確な臨床的原因なしにTWIを示しています.
研究 の 目的:
- 標準的な臨床評価を超えて,TWIのスポーツ選手における遺伝子検査の診断効果を評価する.
主な方法:
- 14~35歳の無症状の運動員100人 (黒人50人,白人50人) がTWIと正常なエコーカルジオグラムで調査されました.
- 運動検査,心電図,MRI,心筋病およびイオンチャネル障害の 311 遺伝子パネルを含む包括的な臨床評価を使用しました.
主要な成果:
- アスリートの21%が臨床的に心臓病の診断を受け,そのうち38. 1%が遺伝子陽性であった.
- 臨床的な表型を持たない選手の2. 5%で遺伝子検査で突然変異が確認された.
- 新たに診断された心筋病は,黒人アスリート (12%) よりも白人アスリート (30%) により一般的であった.
結論:
- アスリートにおけるTWIの遺伝子検査は,臨床評価と比較して低い診断結果をもたらします.
- 遺伝子検査は,例の2.5%のみで追加の診断に寄与し,日常的な実践における有用性が限られていることを示唆している.
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