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Natural History of MYH7-Related Dilated Cardiomyopathy

de Frutos, F; Ochoa, JP; Navarro-Peñalver, M; Baas, A; Bjerre, JV; Zorio, E; Méndez, I; ... Negreira-Caamaño, M; + view all (2022) Natural History of MYH7-Related Dilated Cardiomyopathy. Journal of the American College of Cardiology , 80 (15) pp. 1447-1461. 10.1016/j.jacc.2022.07.023. Green open access

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Abstract

BACKGROUND: Variants in myosin heavy chain 7 (MYH7) are responsible for disease in 1% to 5% of patients with dilated cardiomyopathy (DCM); however, the clinical characteristics and natural history of MYH7-related DCM are poorly described. OBJECTIVE: We sought to determine the phenotype and prognosis of MYH7-related DCM. We also evaluated the influence of variant location on phenotypic expression. METHODS: We studied clinical data from 147 individuals with DCM-causing MYH7 variants (47.6% female; 35.6 ± 19.2 years) recruited from 29 international centers. RESULTS: At initial evaluation, 106 (72.1%) patients had DCM (left ventricular ejection fraction: 34.5% ± 11.7%). Median follow-up was 4.5 years (IQR: 1.7-8.0 years), and 23.7% of carriers who were initially phenotype-negative developed DCM. Phenotypic expression by 40 and 60 years was 46% and 88%, respectively, with 18 patients (16%) first diagnosed at <18 years of age. Thirty-six percent of patients with DCM met imaging criteria for LV noncompaction. During follow-up, 28% showed left ventricular reverse remodeling. Incidence of adverse cardiac events among patients with DCM at 5 years was 11.6%, with 5 (4.6%) deaths caused by end-stage heart failure (ESHF) and 5 patients (4.6%) requiring heart transplantation. The major ventricular arrhythmia rate was low (1.0% and 2.1% at 5 years in patients with DCM and in those with LVEF of ≤35%, respectively). ESHF and major ventricular arrhythmia were significantly lower compared with LMNA-related DCM and similar to DCM caused by TTN truncating variants. CONCLUSIONS: MYH7-related DCM is characterized by early age of onset, high phenotypic expression, low left ventricular reverse remodeling, and frequent progression to ESHF. Heart failure complications predominate over ventricular arrhythmias, which are rare.

Type: Article
Title: Natural History of MYH7-Related Dilated Cardiomyopathy
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jacc.2022.07.023
Publisher version: https://doi.org/10.1016/j.jacc.2022.07.023
Language: English
Additional information: © 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation under a Creative Commons license (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: MYH7, dilated cardiomyopathy, genetics
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10157413
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