Sepehrkhouy, S;
Gho, JMIH;
van Es, R;
Harakalova, M;
de Jonge, N;
Dooijes, D;
van der Smagt, JJ;
... Vink, A; + view all
(2017)
Distinct fibrosis pattern in desmosomal and phospholamban mutation carriers in hereditary cardiomyopathies.
Heart Rhythm
, 14
(7)
pp. 1024-1032.
10.1016/j.hrthm.2017.03.034.
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Abstract
Background: Desmosomal and phospholamban (PLN) mutations are associated with arrhythmogenic cardiomyopathy. Ultimately, most cardiomyopathic hearts develop significant cardiac fibrosis. // Objective: To compare the fibrosis patterns of desmosomal and p. Arg14del PLN–associated cardiomyopathies with the pattern in hearts with other hereditary cardiomyopathies. // Methods: A midventricular transversal slice was obtained from hearts of 30 patients with a cardiomyopathy with a known underlying mutation and from 8 controls. Fibrosis and fatty changes were quantitatively analyzed using digital microscopy. // Results: Hearts from patients with desmosomal mutations (n = 6) showed fibrosis and fibrofatty replacement in the left ventricular (LV) outer myocardium, mainly in the posterolateral wall, and in the right ventricle. A similar phenotype, but with significantly more severe fibrotic changes in the LV, was found in the PLN mutation group (n = 8). Cardiomyopathies associated with lamin A/C (n = 5), sarcomeric (n = 8), and desmin (n = 3) mutations all showed a different pattern from that of the desmosomal and PLN mutation carriers. The posterolateral LV wall appeared to be the most discriminative area with fibrosis and fatty changes predominantly at the outer compact myocardium in 13 of 14 hearts with desmosomal and PLN mutations (93%), in 0 of 13 hearts with lamin A/C and sarcomeric mutations (0%), and in 1 of 3 desminopathic hearts (33%) (P < .001). // Conclusion: Desmosomal- and PLN-associated cardiomyopathies have a fibrosis pattern distinct from the patterns in other hereditary cardiomyopathies. The posterolateral LV wall appeared to be the most discriminative region between mutation groups. These results may provide a roadmap for cardiac imaging interpretation and may help in further unraveling disease mechanisms.
| Type: | Article |
|---|---|
| Title: | Distinct fibrosis pattern in desmosomal and phospholamban mutation carriers in hereditary cardiomyopathies |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.hrthm.2017.03.034 |
| Publisher version: | https://doi.org/10.1016/j.hrthm.2017.03.034 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | heart, cardiomyopathy, fibrosis, genetics, mutation, histology |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10054467 |
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