5型长QT综合征的国际多中心评估:低透性初级失律性疾病
Jason D Roberts1, S Yukiko Asaki2, Andrea Mazzanti3,4
1Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, Ontario, Canada (J.D.R., I.E.H., M.D.Y., L.J.G., P.L.-S.).
Circulation
|January 17, 2020
概括
与长QT综合征5型 (LQT5) 相关的罕见KCNE1变异显示出低ECG透率,这意味着大多数这些变异的个体不会出现临床症状. 这表明KCNE1变异会导致QT延长,但并不总是导致明显的LQT5疾病.
科学领域:
- 心血管遗传学
- 离子通道病变
- 电生理学
背景情况:
- 对长QT综合征5型 (LQT5) 的临床和遗传特征的了解有限.
- 以前的见解主要来自案例报告和小型家庭研究.
- 在LQT5中需要对罕见的KCNE1变体进行全面分析.
研究的目的:
- 在LQT5中研究罕见的KCNE1变异的临床表型和遗传特征.
- 在LQT5中评估心电图透率和基因型-表型相关性.
- 在LQT5试验者和家庭成员之间比较心律失常事件的风险.
主要方法:
- 国际多中心合作,包括229名LQT5和19名Jervell和Lange-Nielsen综合征患者.
- 对32种不同的KCNE1变体进行心电图穿透和分离的评估.
- 多变量考克斯回归分析用于心律失常事件风险评估.
主要成果:
- 在89名LQT5试验者和140名家族成员中发现了32种不同的KCNE1变异.
- 异体LQT5家族成员显示出20. 7%的心电图穿透率 (QTc> 460毫秒).
- 与家族成员相比,LQT5试验对心律失常事件的风险显著增加 (aHR 11. 6).
结论:
- 假定功能丧失的KCNE1变体会导致QT延长.
- 低心电图透率表明变异通常不会在临床上表现出来.
- 这些发现与在2型Jervell和Lange- Nielsen综合征患者中观察到的较温和的表型一致.
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