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Clinical Features and Outcomes of Pediatric MYH7-Related Dilated Cardiomyopathy

F. de Frutos, JP. Ochoa, G. Webster, M. Jansen, P. Remior, TB. Rasmussen, M. Sabater-Molina, R. Barriales-Villa, F. Girolami, S. Cesar, ME. Fuentes-Cañamero, R. Alvarez García-Rovés, K. Wahbi, J. Limeres, M. Kubanek, MG. Slieker, G....

. 2024 ; 13 (21) : e036208. [pub] 20241104

Language English Country England, Great Britain

Document type Journal Article, Multicenter Study

BACKGROUND: Although genetic variants in MYH7 are the most frequent cause of pediatric genetic dilated cardiomyopathy (DCM), there are no studies available describing this entity. We sought to describe clinical features, analyze variant location, and explore predictors of bad prognosis in pediatric MYH7-related DCM. METHODS AND RESULTS: We evaluated clinical records from 44 patients (24 men; median age at diagnosis, 0.54 [interquartile range, 0.01-10.8] years) with pathogenic/likely pathogenic variants in MYH7 diagnosed with DCM at pediatric age (<18 years) followed at 13 international centers. We also explored risk factors associated with a composite end point of end-stage heart failure defined as heart transplantation or heart failure-related death. Twenty-two patients (50%) were diagnosed at age <6 months, including 7 (16%) at birth. Left ventricular (LV) hypertrabeculation features were present in 15 (38%), particularly among patients with genetic variants in the head domain. After a median follow-up of 6.1 years (interquartile range, 1.9-13.4), 15 patients (36%) required a heart transplant (n=14) or died due to end-stage heart failure (n=1), 15 patients (36%) persisted with systolic dysfunction despite treatment, 12 (29%) had a significant increase in LV ejection fraction, and 2 were lost to follow-up. Overall, end-stage heart failure event rate was 25% at 5 years. New York Heart Association class III to IV (hazard ratio [HR], 7.67 [95% CI, 2.16-27.2]; P=0.002) and LV ejection fraction ≤35% (HR, 4.00 [95% CI, 1.11-14.4]; P=0.03) were the best predictors of bad prognosis. CONCLUSIONS: Pediatric MYH7-related DCM is characterized by early onset, frequent LV hypertrabeculation, and poor prognosis. Advanced New York Heart Association class and low LV ejection fraction emerged as predictors of end-stage heart failure.

Ann and Robert H Lurie Children's Hospital of Chicago Division of Cardiology Northwestern University Feinberg School of Medicine Chicago IL USA

Arrhythmia Inherited Cardiac Diseases and Sudden Death Unit Hospital Sant Joan de Déu Esplugues de Llobregat Barcelona Spain

Arrítmies pediàtriques cardiologia genètica i mort sobtada Malalties Cardiovasculars en el desenvolupament Institut de Recerca Sant Joan de Déu Esplugues de Llobregat Barcelona Spain

Cardiology Department AP HP Cochin Hospital Paris Cedex 14 France

Cardiology Unit Meyer Children's Hospital IRCCS Florence Italy

Centro Nacional de Investigaciones Cardiovasculares Madrid Spain

CIBER Cardiovascular Instituto de Salud Carlos 3 Madrid Spain

Complejo Hospitalario Universitario de Badajoz Spain

Department of Cardiology Aarhus University Hospital Aarhus Denmark

Department of Cardiology Boston Children's Hospital Harvard Medical School Boston MA USA

Department of Cardiology Institute for Clinical and Experimental Medicine Prague Czech Republic

Department of Cardiology University Medical Centre Utrecht Utrecht University Utrecht the Netherlands

Department of Genetics University Medical Centre Utrecht Utrecht University Utrecht the Netherlands

Department of Pediatric Cardiology University Medical Centre Utrecht Utrecht University Utrecht the Netherlands

Department of Pediatrics School of Medicine and Health Sciences Universitat de Barcelona Spain

European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart ERN GUARD Heart Amsterdam the Netherlands

Facultad de Medicina Universidad Complutense Madrid Spain

Faculté de Médecine Paris Université Paris Cité Paris France

Heart Failure and Inherited Cardiac Diseases Unit Department of Cardiology Hospital Universitario Puerta de Hierro IDIPHISA Madrid Spain

Inheritance Cardiovascular Disease Unit Pediatric Cardiology Hospital Materno Infantil Gregorio Marañón Madrid Spain

Inherited Cardiac Diseases Unit Cardiology Department Vall Hebron Hospital Barcelona Spain

Instituto de Investigación Sanitaria Gregorio Marañón Madrid Spain

Laboratorio de Cardiogenética IMIB Arrixaca Universidad de Murcia Spain

Medical Science Department School of Medicine Universitat de Girona Spain

Unidad de Cardiopatías Familiares Complexo Hospitalario Universitario A Coruña INIBIC A Coruña Spain

Universidad Francisco de Vitoria Pozuelo de Alarcón Spain

Vall Hebron Research Unit Barcelona Spain

References provided by Crossref.org

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