Literature DB >> 22281253

Risk factors for malignant ventricular arrhythmias in lamin a/c mutation carriers a European cohort study.

Ingrid A W van Rijsingen1, Eloisa Arbustini, Perry M Elliott, Jens Mogensen, Johanna F Hermans-van Ast, Anneke J van der Kooi, J Peter van Tintelen, Maarten P van den Berg, Andrea Pilotto, Michele Pasotti, Sharon Jenkins, Camilla Rowland, Uzma Aslam, Arthur A M Wilde, Andreas Perrot, Sabine Pankuweit, Aeilko H Zwinderman, Philippe Charron, Yigal M Pinto.   

Abstract

OBJECTIVES: The purpose of this study was to determine risk factors that predict malignant ventricular arrhythmias (MVA) in Lamin A/C (LMNA) mutation carriers.
BACKGROUND: LMNA mutations cause a variety of clinical phenotypes, including dilated cardiomyopathy and conduction disease. Many LMNA mutation carriers have a poor prognosis, because of a high frequency of MVA and progression to end-stage heart failure. However, it is unclear how to identify mutation carriers that are at risk for MVA.
METHODS: In this multicenter cohort of 269 LMNA mutation carriers, we evaluated risk factors for MVA, defined as sudden cardiac death, resuscitation, and appropriate implantable cardioverter-defibrillator (ICD) treatment.
RESULTS: In a median follow-up period of 43 months (interquartile range: 17 to 101 months), 48 (18%) persons experienced a first episode of MVA: 11 persons received successful cardiopulmonary resuscitation, 25 received appropriate ICD treatment, and 12 persons died suddenly. Independent risk factors for MVA were nonsustained ventricular tachycardia, left ventricular ejection fraction <45% at the first clinical contact, male sex, and non-missense mutations (ins-del/truncating or mutations affecting splicing). MVA occurred only in persons with at least 2 of these risk factors. There was a cumulative risk for MVA per additional risk factor.
CONCLUSIONS: Carriers of LMNA mutations with a high risk of MVA can be identified using these risk factors. This facilitates selection of LMNA mutation carriers who are most likely to benefit from an ICD.
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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Year:  2012        PMID: 22281253     DOI: 10.1016/j.jacc.2011.08.078

Source DB:  PubMed          Journal:  J Am Coll Cardiol        ISSN: 0735-1097            Impact factor:   24.094


  117 in total

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