Letter to the Editor
Atrioventricular block in dilated cardiomyopathy and mutation in emerin gene
Bloqueo auriculoventricular en miocardiopatía dilatada y mutación en el gen de la emerina
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Santa Cruz de Tenerife, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Bloqueo auriculoventricular en miocardiopatía dilatada y mutación en el gen de la emerina" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Non-ischaemic dilated cardiomyopathy (DCM) is a primary cardiomyopathy with a prevalence of approximately 1/250 and 1/400 people in the general population, with variable penetrance and clinical expression.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The genes involved are mainly autosomal dominant, with the most common being those encoding sarcomeric proteins such as titin (TTN) or the β-myosin heavy chain (MYH7) or encoding nuclear envelope proteins such as lamin A/C.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> However, there is a small group of patients with familial DCM who may have X-linked inheritance,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> as in the case of the missense mutation c.77 T><span class="elsevierStyleSmallCaps">C</span> (p.Val26Ala) in the nuclear envelope protein emerin (EMD) gene, located on chromosome Xq28.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> We report 3 atypical clinical cases of DCM related to the c.77 T > C mutation (p.Val26Ala). The characteristics of the patients are listed in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The first case is a 44-year-old male, with no previous history, who went to the emergency department for cardiogenic syncope with unremarkable physical examination and echocardiography. The electrocardiogram showed complete atrioventricular block (AVB) with wide QRS, so it was decided to implant a permanent dual-chamber pacemaker. At the age of 48, the patient developed heart failure (HF) due to DCM and severe left ventricular dysfunction. One year later a cousin of his received a heart transplant (HT) related to the c.77 T > C (p.Val26Ala) mutation in the EMD gene which was confirmed in our patient. Then, in 2020, he had a decompensation due to HF, receiving implantable cardioverter defibrillator and cardiac resynchronisation therapy (ICD-CRT) in primary prevention. He is currently under follow-up by the Heart Failure Unit at our centre.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Another 48-year-old male also went to the emergency department for cardiogenic syncope with a normal physical examination. He had mild left ventricular hypertrophy with no other relevant echocardiographic findings. Since the electrocardiogram showed sinus rhythm with complete right bundle branch block and left anterior hemiblock, an electrophysiological study was requested, with abnormal values of the HV interval, and a definitive dual-chamber pacemaker was implanted. A cousin of his needed CT scan and the c.77 T > C (p.Val26Ala) mutation in the EMD gene was identified, confirming this genetic suspicion in our patient. Five years after pacemaker implantation, he started with HF due to DCM, and an ICD-CRT was implanted without new decompensations until the present date.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The third case is a 41-year-old male with a history of dyslipidaemia who presented with de novo <span class="elsevierStyleItalic">atrial fibrillation</span> during admission for a stroke. The electrocardiogram showed atrial fibrillation at 40 bpm and complete left bundle branch block. Echocardiography showed mild dysfunction with normal volumes. During admission monitoring, atrioventricular conduction block was observed. A definitive single-chamber pacemaker was implanted. During outpatient follow-up the patient subsequently developed DCM and it was decided to replace the pacemaker with an ICD-CRT for primary prevention at the age of 43 years. At that time, a genetic study was carried out and the c.77 T > C (p.Val26Ala) mutation in the EMD gene was detected. At the age of 50, given that he presented criteria for advanced HF, an elective CT scan was performed.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The clinical presentation of DCM differs depending on the gene affected. Thus, patients with TTN mutation have a better prognosis compared to the lamin A/C mutation, given the superior response to optimal medical treatment. Lamin AC mutation is associated with a high risk of malignant ventricular arrhythmias and sudden death.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a> In addition, clinical presentation as advanced AVB of familial DCM is rare, although it has been reported in other pathogenic variants of nuclear envelope proteins such as lamin A/C.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Histopathology revealed atrophy of the atrioventricular node with fibroadipose degeneration, deformed nuclei with increased lipofuscin and glycogen accumulation around the mitochondria. Our series suggests that the presentation of an advanced atrioventricular conduction disorder may be the first manifestation of familial DCM, in this case due to the c.77 T > C (p.Val26Ala) mutation in the EMD gene, never previously described in the literature.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Therefore, in clinical practice, young patients presenting with a complete AVB in the absence of any other signs should be further assessed. Particular emphasis should be placed on ruling out a family history and a commitment to reasonably rule out an underlying familial DCM.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical considerations</span><p id="par0035" class="elsevierStylePara elsevierViewall">Informed consents were obtained from the patients in order to publish the work.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Funding</span><p id="par0040" class="elsevierStylePara elsevierViewall">This study did not receive any funding.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflict of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Ethical considerations" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Funding" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflict of interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">AVB: atrioventricular block; DCM: dilated cardiomyopathy; EMD: emerin; HFU: Heart Failure Unit; ICD-CRT: implantable cardioverter-defibrillator and cardiac resynchronisation therapy; LV: left ventricle.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Patients \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age of AVB \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Baseline echocardiography during AVB \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Family history of DCM \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age of DCM onset \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age of ICD-CRT implantation \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age of heart transplantation \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48 years old \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52 years old \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Follow-up at HFU \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mild LV hypertrophy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53 years old \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53 years old \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Follow-up at HFU \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mild LV systolic dysfunction \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42 years old \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 years \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3444905.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Baseline characteristics of patients and milestones in the natural history of their DCM for the c.77 T > C (p.Val26Ala) mutation in the EMD gene.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology of the inherited cardiomyopathies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "W.J. McKenna" 1 => "D.P. Judge" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/s41569-020-0428-2" "Revista" => array:6 [ "tituloSerie" => "Nat Rev Cardiol" "fecha" => "2021" "volumen" => "18" "paginaInicial" => "22" "paginaFinal" => "36" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32895535" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Genetic testing as a guide for treatment in dilated cardiomyopathies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. García-Hernández" 1 => "L.M. Iglesias" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11886-022-01772-8" "Revista" => array:6 [ "tituloSerie" => "Curr Cardiol Rep" "fecha" => "2022" "volumen" => "24" "paginaInicial" => "1537" "paginaFinal" => "1546" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35994197" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Genetic basis of familial dilated cardiomyopathy patients undergoing heart transplantation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Cuenca" 1 => "M.J. Ruiz-Cano" 2 => "J.R. Gimeno-Blanes" 3 => "A. Jurado" 4 => "C. Salas" 5 => "I. Gómez-Díaz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Hear Lung Transplant" "fecha" => "2016" "volumen" => "35" "paginaInicial" => "625" "paginaFinal" => "635" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk predictors in a Spanish cohort with cardiac laminopathies. The REDLAMINA registry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Barriales-Villa" 1 => "J.P. Ochoa" 2 => "J.M. Larrañaga-Moreira" 3 => "J. Salazar-Mendiguchía" 4 => "C. Díez-López" 5 => "M.A. Restrepo-Córdoba" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Española Cardiol (English Ed.)" "fecha" => "2021" "volumen" => "74" "numero" => "3" "paginaInicial" => "216" "paginaFinal" => "224" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Electrophysiological and histopathological characteristics of progressive atrioventricular block accompanied by familial dilated cardiomyopathy caused by a novel mutation of lamin A/C gene" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Otomo" 1 => "S. Kure" 2 => "T. Shiba" 3 => "A. Karibe" 4 => "T. Shinozaki" 5 => "T. Yagi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1540-8167.2004.40096.x" "Revista" => array:6 [ "tituloSerie" => "J Cardiovasc Electrophysiol" "fecha" => "2005" "volumen" => "16" "paginaInicial" => "137" "paginaFinal" => "145" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15720451" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000016100000012/v2_202401260944/S2387020623004953/v2_202401260944/en/main.assets" "Apartado" => array:4 [ "identificador" => "43309" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000016100000012/v2_202401260944/S2387020623004953/v2_202401260944/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623004953?idApp=UINPBA00004N" ]
