儿童非紧凑心肌病基因验证的相关性:临床病例

Наталия Андреевна Сдвигова, Елена Николаевна Басаргина, Д В Рябцев, К. В. Савостьянов, А. А. Пушков, Н. В. Журкова, Григорий Валерьевич Ревуненков, О. П. Жарова
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引用次数: 1

摘要

背景。非压实性心肌病是一组遗传异质性的、研究较少的心肌疾病,具有多种临床表现(从无症状到进行性收缩功能障碍,伴有慢性心力衰竭、心律失常和血栓栓塞并发症)。考虑到与非压实性心肌病发展相关的各种遗传疾病,诊断的遗传验证对于确定预后和对患有该疾病的家庭进行遗传咨询非常重要。临床病例描述。本文介绍了两个临床观察严重的非压实性心肌病与重构的心腔根据扩张表型。为了明确疾病的病因,采用直接自动测序的方法,对404个在心脏和血管遗传性疾病中描述突变的基因进行了分子遗传学研究。在验证突变(ACTC1和MYBPC3基因)后,我们在父母静脉血样本和胎儿DNA样本中搜索检测到的核苷酸替代。继承方式已经确定;该疾病在兄弟姐妹随后怀孕中复发的概率已被估计。结论。临床病例的描述显示了非压实性心肌病患者诊断的遗传验证对于确定疾病预后和开发先证亲属监测算法的重要性。
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АКТУАЛЬНОСТЬ ГЕНЕТИЧЕСКОЙ ВЕРИФИКАЦИИ НЕКОМПАКТНОЙ КАРДИОМИОПАТИИ У ДЕТЕЙ: КЛИНИЧЕСКИЕ СЛУЧАИ
Background. Non-compaction cardiomyopathy is a group of genetically heterogeneous, poorly studied myocardial diseases with a variety of clinical manifestations (from asymptomatic course to progressive systolic dysfunction with symptoms of chronic heart failure, arrhythmias, and thromboembolic complications). Considering the variety of genetic disorders associated with the development of noncompaction cardiomyopathy, genetic verification of the diagnosis is important for determining the prognosis and conducting genetic counselling of families with cases of the disease. Description of the Clinical Case. The article presents two clinical observations of a severe course of non-compaction cardiomyopathy with remodeling of the heart cavities according to the dilated phenotype. In order to clarify the disease etiology, a molecular genetic study was conducted using the method of direct automatic sequencing with the analysis of targeted regions of 404 genes which mutations are described in hereditary diseases of the heart and blood vessels. After verifying the mutation (in the ACTC1 and MYBPC3 genes), we performed a search for the detected nucleotide substitution in the venous blood samples of parents and in one case — in the fetal DNA sample. The mode of inheritance has been determined; the probability of recurrence of the disease in siblings in subsequent pregnancies has been estimated. Conclusion. The description of clinical cases shows the importance of genetic verification of the diagnosis in patients with non-compaction cardiomyopathy for determining the disease prognosis and developing an algorithm for monitoring relatives of a proband.
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