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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....
Language English Country England, Great Britain
Document type Journal Article, Multicenter Study
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- MeSH
- Cardiomyopathy, Dilated * genetics physiopathology diagnosis MeSH
- Child MeSH
- Phenotype MeSH
- Ventricular Function, Left MeSH
- Genetic Predisposition to Disease MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Mutation MeSH
- Infant, Newborn MeSH
- Child, Preschool MeSH
- Prognosis MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- Cardiac Myosins * genetics MeSH
- Heart Failure genetics physiopathology diagnosis MeSH
- Myosin Heavy Chains * genetics MeSH
- Heart Transplantation * MeSH
- Check Tag
- Child MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Infant, Newborn MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
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.
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 Genetics University Medical Centre Utrecht Utrecht University Utrecht the Netherlands
Department of Pediatrics School of Medicine and Health Sciences Universitat de Barcelona Spain
Facultad de Medicina Universidad Complutense Madrid Spain
Faculté de Médecine Paris Université Paris Cité Paris France
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
References provided by Crossref.org
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