Hypertrophic cardiomyopathy laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]
Overview
Genetic studies may be used in the diagnosis and screening of patients and families with known hypertrophic cardiomyopathy (HCOM). Laboratory findings consistent with the diagnosis of hypertrophic cardiomyopathy may include but not limited to mutations in the genes involved in Beta-myosin heavy chain, Myosin binding protein C, and Cardiac troponin T. Genes involved in the pathogenesis of hypertrophic cardiomyopathy include MYH7, TNNT2, and TPM1.
Laboratory Findings
Genetic studies may be used in the diagnosis and screening of patients and families with known hypertrophic cardiomyopathy (HCOM). Laboratory findings consistent with the diagnosis of hypertrophic cardiomyopathy may include but not limited to mutations in the genes involved in Beta-myosin heavy chain, Myosin binding protein C, and Cardiac troponin T. Genes involved in the pathogenesis of hypertrophic cardiomyopathy include MYH7, TNNT2, and TPM1. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]
ESC recommendations for genetic counseling and testing
- 1. Genetic counseling by trained professionals working within a multidisciplinary specialist team is recommended for all patients with HCM when their disease cannot be explained solely by a non-genetic cause.
- 2. Genetic testing is recommended in patients fulfilling diagnostic criteria for HCM when it enables cascade genetic screening of their relatives.
- 3. First degree relatives should be provided with information about the consequences of diagnosis for life insurance, pension, occupation, sporting activities, and eligibility for fostering and adoption before they undergo genetic testing or clinical evaluation.
- 4. When a definite causative genetic mutation is identified, relatives should be first genetically tested and then clinically evaluated if they are found to carry the same mutation.
- 5. When genetic testing cannot be performed or fails to identify a definite mutation, first degree relatives should be offered clinical screening with an ECG and echocardiogram which is then repeated every 1-2 years between 10 and 20 years of age and then every 2-5 years thereafter.
- 6. Clinical and genetic testing of children should be guided by the best interests of the child and consider potential benefits and harms such as compromised life insurance prospects.
References
- ↑ Maron BJ, Moller JH, Seidman CE et al. Impact of laboratory molecular diagnosis on contemporary diagnostic criteria for genetically transmitted cardiovascular diseases. Hypertrophic cardiomyopathy, long-QT syndrome, and Marfan syndrome. [A statement for healthcare professionals from the Councils on Clinical Cardiology, Cardiovascular Disease in the Young, and Basic Science, American Heart Association]. Circulation 1998;98:1460–71.
- ↑ Schwartz K, Carrier L, Guicheney P, Komajda M. Molecular basis of familial cardiomyopathies. Circulation 1995;91:532–40.
- ↑ Niimura H, Bachinski LL, Sangwatanaroj S et al. Mutations in the gene for cardiac myosin-binding protein C and late-onset familial hypertrophic cardiomyopathy. N Engl J Med 1998;338:1248–57.
- ↑ Thierfelder L, Watkins H, MacRae C et al. Alpha-tropomyosin and cardiac troponin T mutations cause familial hypertrophic cardiomyopathy. A disease of the sarcomere. Cell 1994;77:701–12.
- ↑ Watkins H, McKenna WJ, Thierfelder L et al. Mutations in the genes for cardiac troponin T and alpha-tropomyosin in hypertrophic cardiomyopathy. N Engl J Med 1995;332:1058–64.
- ↑ Charron P, Dubourg O, Desnos M et al. Clinical features and prognostic implications of familial hypertrophic cardiomyopathy related to the cardiac myosin-binding protein C gene. Circulation 1998;97: 2230–6.
- ↑ Maron BJ, Niimura H, Casey SA et al. Development of left ventricular hypertrophy in adults in hypertrophic cardiomyopathy caused by cardiac myosin-binding protein C gene mutations. J Am Coll Cardiol 2001;38:315–21.
- ↑ Anan R, Greve G, Thierfelder L et al. Prognostic implications of novel beta cardiac myosin heavy chain gene mutations that cause familial hypertrophic cardiomyopathy. J Clin Invest 1994;93:280–5.
- ↑ Coviello DA, Maron BJ, Spirito P et al. Clinical features of hypertrophic cardiomyopathy caused by mutation of a “hot spot” in the alpha-tropomyosin gene. J Am Coll Cardiol 1997;29:635–40.
- ↑ Blair E, Redwood C, Ashrafian H et al. Mutations in the gamma(2) subunit of AMP-activated protein kinase cause familial hypertrophic cardiomyopathy. Evidence for the central role of energy compromise in disease pathogenesis. Hum Mol Genet 2001;10:1215–20.
- ↑ Erdmann J, Raible J, Maki-Abadi J et al. Spectrum of clinical phenotypes and gene variants in cardiac myosin-binding protein C mutation carriers with hypertrophic cardiomyopathy. J Am Coll Cardiol 2001;38:322–30.
- ↑ Gruver EJ, Fatkin D, Dodds GA et al. Familial hypertrophic cardiomyopathy and atrial fibrillation caused by Arg663His beta-cardiac myosin heavy chain mutation. Am J Cardiol 1999;83:13H–8H.
- ↑ Kimura A, Harada H, Park JE et al. Mutations in the cardiac troponin I gene associated with hypertrophic cardiomyopathy. Nat Genet 1997;16:379–82.
- ↑ Marian AJ, Roberts R. Recent advances in the molecular genetics of hypertrophic cardiomyopathy. Circulation 1995;92:1336–47.
- ↑ Niimura H, Patton KK, McKenna WJ et al. Sarcomere protein gene mutations in hypertrophic cardiomyopathy of the elderly. Circulation 2002;105:446–51.