Powered by OpenAIRE graph
Found an issue? Give us feedback
image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Revista Portuguesa d...arrow_drop_down
image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
Revista Portuguesa de Cardiologia
Article . 2015 . Peer-reviewed
License: CC BY NC ND
Data sources: Crossref
image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
Revista Portuguesa de Cardiologia
Article
License: CC BY NC ND
Data sources: UnpayWall
image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
Revista Portuguesa de Cardiologia
Article . 2015
Data sources: DOAJ
versions View all 2 versions
addClaim

Laminopatias: uma caixa de Pandora com insuficiência cardíaca, bradiarritmias e morte súbita

Authors: Nuno Cabanelas; Vítor Paulo Martins;

Laminopatias: uma caixa de Pandora com insuficiência cardíaca, bradiarritmias e morte súbita

Abstract

Resumo: Introdução: O gene LMNA codifica proteínas que têm um papel estrutural e funcional importante a nível do núcleo celular. As suas mutações foram encontradas em 6% de todas as formas de miocardiopatia dilatada (MCD) e em 33% das formas que cursam com perturbações no sistema de condução. Objetivos e métodos: Partindo da descrição de um caso clínico, é feita uma revisão da evidência existente acerca dos mecanismos fisiopatológicos, manifestações, estratificação de risco e tratamento das laminopatias com atingimento cardíaco. Caso clínico: É apresentado o caso clínico de um homem de 46 anos com critérios de voltagem bizarros para hipertrofia ventricular esquerda no ECG, dilatação e ligeira depressão da função sistólica ventricular esquerda e bloqueio auriculoventricular de 1.° grau, arritmias ventriculares não mantidas polimórficas em Holter e história de morte súbita familiar. O teste genético foi positivo para mutação no gene LMNA. Foi submetido a estudo eletrofisiológico no qual não se induziram arritmias ventriculares. O doente foi mantido sob vigilância clínica e ecocardiográfica e implantado detetor de eventos. Discussão: Fenotipicamente, o atingimento miocárdico é indistinguível do das outras formas de MCD idiopática. As arritmias ventriculares são frequentes e a forma de melhor estratificar o risco de morte súbita está ainda por definir. Estão disponíveis resultados de poucos estudos e com um número muito limitado de doentes, sendo que os fatores de mau prognóstico identificados por estes foram: fração de ejeção < 45%, TV não mantidas, sexo masculino e presença de qualquer forma de bloqueio auriculoventricular. Dada a fraca evidência disponível, as indicações formais para implantação de CDI em prevenção primária neste contexto não são ainda diferentes das indicações convencionais noutras formas de MCD idiopática. Conclusão: O atingimento cardíaco como consequência da mutação no gene LMNA apresenta uma história natural geralmente mais agressiva do que a maior parte das demais formas de MCD não isquémica. Um índice de suspeição elevado e o pedido atempado do teste genético são essenciais para a estratégia terapêutica. Abstract: Introduction: The LMNA gene encodes a group of proteins that have an important structural and functional role in the cell nucleus. Mutations in this gene have been found in 6% of all forms of dilated cardiomyopathy and in up to 33% of those with conduction system disturbances. Aims and Methods: Using a case report as an example, we performed a review of the literature on the pathophysiological mechanisms, clinical manifestations, risk stratification and treatment options of cardiac involvement in laminopathies. Case report: We present the case of a 46‐year‐old man, whose ECG showed bizarre voltage criteria for left ventricular hypertrophy and first‐degree atrioventricular block, a dilated left ventricle with mildly impaired global systolic function and non‐sustained ventricular tachycardia on Holter monitoring, and with a family history of sudden death. Genetic testing identified an LMNA mutation. No ventricular arrhythmias were induced during electrophysiological study. The patient is under close clinical and echocardiographic monitoring and an event loop recorder has been implanted. Discussion: Phenotypically, myocardial involvement in laminopathies is indistinguishable from other forms of idiopathic dilated cardiomyopathy. Ventricular arrhythmias are common, but the best method for sudden death risk stratification has yet to be established. The few studies that have been performed, with a very limited number of patients, show that factors associated with an unfavorable prognosis are ejection fraction <45%, non‐sustained ventricular tachycardia, male gender and any form of atrioventricular block. Given the lack of evidence, indications for an implantable cardioverter‐defibrillator for primary prevention in this context are the same as conventional indications for other forms of idiopathic dilated cardiomyopathy. Conclusions: Cardiac involvement as a consequence of LMNA mutations generally has a more aggressive natural history than other forms of non‐ischemic dilated cardiomyopathy. A high index of suspicion and prompt referral for genetic testing are essential for appropriate therapeutic management. Palavras‐chave: Laminopatia, Mutações no gene LMNA, Miocardiopatia dilatada, Keywords: Laminopathy, LMNA gene mutations, Dilated cardiomiopathy

Keywords

RC666-701, Diseases of the circulatory (Cardiovascular) system

  • BIP!
    Impact byBIP!
    selected citations
    These citations are derived from selected sources.
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    5
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Average
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Average
Powered by OpenAIRE graph
Found an issue? Give us feedback
selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
5
Average
Average
Average
gold