Heart Failure with Recovered Ejection Fraction in Patients with Vinculin Loss-of-function Variants

Laura Zahavich1,2,3, Rajadurai Akilen4, Kristen George3, Seema Mital3,4,5,6
1Department of Genetic Counselling, Hospital for Sick Children, University of Toronto, Toronto, Canada
2Department of Molecular Genetics, University of Toronto, Toronto, Canada
3Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Canada
4Genetics and Genome Biology Program, Hospital for Sick Children, Toronto, Canada
5Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Canada
6Ted Rogers Centre for Heart Research, Toronto, Canada

Tóm tắt

Predictors of myocardial recovery in heart failure (HF) are poorly understood. We explored if vinculin (VCL) variants are associated with myocardial recovery in dilated cardiomyopathy (DCM). Six infants with DCM with a VCL loss-of-function (LOF) variant were identified. Median age at diagnosis was 2 months, median LV ejection fraction was 24%, and median LV end-diastolic diameter z-score was 10.8. All patients received HF medications. Five patients (83%) showed normalization of LV function at a median age of 2.7 years. One patient progressed to end-stage HF requiring heart transplant. This case series identified a unique phenotype of HF with reduced ejection fraction at presentation that evolved to HF with recovered EF in over 80% of infant DCM cases with LOF VCL variants. These findings have prognostic implications for counseling and management of VCL-associated DCM and highlight a possible genetic basis for HF with recovered ejection fraction.

Tài liệu tham khảo

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