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Late gadolinium enhanced cardiovascular magnetic resonance of lamin A/C gene mutation related dilated cardiomyopathy.

AbstractBACKGROUND:
The purpose of this study was to identify early features of lamin A/C gene mutation related dilated cardiomyopathy (DCM) with cardiovascular magnetic resonance (CMR). We characterise myocardial and functional findings in carriers of lamin A/C mutation to facilitate the recognition of these patients using this method. We also investigated the connection between myocardial fibrosis and conduction abnormalities.
METHODS:
Seventeen lamin A/C mutation carriers underwent CMR. Late gadolinium enhancement (LGE) and cine images were performed to evaluate myocardial fibrosis, regional wall motion, longitudinal myocardial function, global function and volumetry of both ventricles. The location, pattern and extent of enhancement in the left ventricle (LV) myocardium were visually estimated.
RESULTS:
Patients had LV myocardial fibrosis in 88% of cases. Segmental wall motion abnormalities correlated strongly with the degree of enhancement. Myocardial enhancement was associated with conduction abnormalities. Sixty-nine percent of our asymptomatic or mildly symptomatic patients showed mild ventricular dilatation, systolic failure or both in global ventricular analysis. Decreased longitudinal systolic LV function was observed in 53% of patients.
CONCLUSIONS:
Cardiac conduction abnormalities, mildly dilated LV and depressed systolic dysfunction are common in DCM caused by a lamin A/C gene mutation. However, other cardiac diseases may produce similar symptoms. CMR is an accurate tool to determine the typical cardiac involvement in lamin A/C cardiomyopathy and may help to initiate early treatment in this malignant familiar form of DCM.
AuthorsMiia Holmström, Sari Kivistö, Tiina Heliö, Raija Jurkko, Maija Kaartinen, Margareta Antila, Eeva Reissell, Johanna Kuusisto, Satu Kärkkäinen, Keijo Peuhkurinen, Juha Koikkalainen, Jyrki Lötjönen, Kirsi Lauerma
JournalJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance (J Cardiovasc Magn Reson) Vol. 13 Pg. 30 (Jun 20 2011) ISSN: 1532-429X [Electronic] England
PMID21689390 (Publication Type: Journal Article, Multicenter Study)
Chemical References
  • Contrast Media
  • LMNA protein, human
  • Lamin Type A
  • Organometallic Compounds
  • Meglumine
  • gadoterate meglumine
Topics
  • Adolescent
  • Adult
  • Cardiomyopathy, Dilated (diagnosis, genetics, physiopathology)
  • Chi-Square Distribution
  • Contrast Media
  • Electrocardiography
  • Female
  • Fibrosis
  • Finland
  • Genetic Predisposition to Disease
  • Humans
  • Hypertrophy, Left Ventricular (diagnosis, genetics)
  • Lamin Type A (genetics)
  • Magnetic Resonance Imaging, Cine
  • Male
  • Meglumine
  • Middle Aged
  • Mutation
  • Myocardium (pathology)
  • Organometallic Compounds
  • Phenotype
  • Predictive Value of Tests
  • Severity of Illness Index
  • Ventricular Dysfunction, Left (diagnosis, genetics)
  • Ventricular Function, Left
  • Ventricular Function, Right

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