Journal
JOURNAL OF NEUROLOGY
Volume 266, Issue 6, Pages 1367-1375Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00415-019-09267-3
Keywords
Congenital myopathies; Arrhythmia; Echocardiography; Heart failure
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Funding
- Research Foundation of Rigshospitalet
- Danish Heart Foundation
- Lundbeck Foundation
- Stibo Foundation
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BackgroundTo evaluate the prevalence of cardiac involvement in patients with congenital myopathies and the association to specific genotypes.MethodsWe evaluated patients with physical examination, electrocardiogram, echocardiography, and 48-h Holter monitoring. Follow-up was performed for major events.ResultsWe included 130 patients, 55 men (42%), with a mean age of 3417years. A genetic diagnosis was established in 97 patients (75%). Right bundle branch block was observed in three patients: 2/34 patients with a ryanodine receptor 1 (RYR1) and 1/6 with a tropomyosin two gene (TPM2) gene mutation. Echocardiography showed left-ventricular hypertrophy in five patients: 2/17 and 3/34 patients with a Dynamin 2 (DNM2) and a RYR1 mutation, respectively. One patient with a myosin heavy-chain (MYH7) mutation had dilated cardiomyopathy and heart failure. On Holter monitoring, frequent ventricular premature contractions were observed in one patient with a DNM2 mutation. Two patients with a TPM2 and a RYR1 mutation, respectively, had a single short run of non-sustained ventricular tachycardia. Atrioventricular nodal re-entry tachycardia was observed in a 20-year-old man with an actin 1 gene mutation. During follow-up (median 8.4years), four patients died, all of non-cardiac causes.Conclusion p id=Par4 Congenital myopathies are generally associated with a mild cardiac phenotype. Our findings substantiate the literature and indicate that, except for patients with specific genotypes, such as MYH7 and TTN mutations, repeated cardiac assessments can be minimized, given a normal initial cardiac screening at time of diagnosis.
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