TY - JOUR
T1 - SCN5A mutations in 442 neonates and children
T2 - genotype-phenotype correlation and identification of higher-risk subgroups
AU - Baruteau, Alban-Elouen
AU - Kyndt, Florence
AU - Behr, Elijah R
AU - Vink, Arja S
AU - Lachaud, Matthias
AU - Joong, Anna
AU - Schott, Jean-Jacques
AU - Horie, Minoru
AU - Denjoy, Isabelle
AU - Crotti, Lia
AU - Shimizu, Wataru
AU - Bos, Johan M
AU - Stephenson, Elizabeth A
AU - Wong, Leonie
AU - Abrams, Dominic J
AU - Davis, Andrew M
AU - Winbo, Annika
AU - Dubin, Anne M
AU - Sanatani, Shubhayan
AU - Liberman, Leonardo
AU - Kaski, Juan Pablo
AU - Rudic, Boris
AU - Kwok, Sit Yee
AU - Rieubland, Claudine
AU - Tfelt-Hansen, Jacob
AU - Van Hare, George F
AU - Guyomarc'h-Delasalle, Béatrice
AU - Blom, Nico A
AU - Wijeyeratne, Yanushi D
AU - Gourraud, Jean-Baptiste
AU - Le Marec, Hervé
AU - Ozawa, Junichi
AU - Fressart, Véronique
AU - Lupoglazoff, Jean-Marc
AU - Dagradi, Federica
AU - Spazzolini, Carla
AU - Aiba, Takeshi
AU - Tester, David J
AU - Zahavich, Laura A
AU - Beauséjour-Ladouceur, Virginie
AU - Jadhav, Mangesh
AU - Skinner, Jonathan R
AU - Franciosi, Sonia
AU - Krahn, Andrew D
AU - Abdelsayed, Mena
AU - Ruben, Peter C
AU - Yung, Tak-Cheung
AU - Ackerman, Michael J
AU - Wilde, Arthur A
AU - Schwartz, Peter J
AU - Probst, Vincent
PY - 2018/8/14
Y1 - 2018/8/14
N2 - Aims: To clarify the clinical characteristics and outcomes of children with SCN5A-mediated disease and to improve their risk stratification.Methods and results: A multicentre, international, retrospective cohort study was conducted in 25 tertiary hospitals in 13 countries between 1990 and 2015. All patients ≤16 years of age diagnosed with a genetically confirmed SCN5A mutation were included in the analysis. There was no restriction made based on their clinical diagnosis. A total of 442 children {55.7% boys, 40.3% probands, median age: 8.0 [interquartile range (IQR) 9.5] years} from 350 families were included; 67.9% were asymptomatic at diagnosis. Four main phenotypes were identified: isolated progressive cardiac conduction disorders (25.6%), overlap phenotype (15.6%), isolated long QT syndrome type 3 (10.6%), and isolated Brugada syndrome type 1 (1.8%); 44.3% had a negative electrocardiogram phenotype. During a median follow-up of 5.9 (IQR 5.9) years, 272 cardiac events (CEs) occurred in 139 (31.5%) patients. Patients whose mutation localized in the C-terminus had a lower risk. Compound genotype, both gain- and loss-of-function SCN5A mutation, age ≤1 year at diagnosis in probands and age ≤1 year at diagnosis in non-probands were independent predictors of CE.Conclusion: In this large paediatric cohort of SCN5A mutation-positive subjects, cardiac conduction disorders were the most prevalent phenotype; CEs occurred in about one-third of genotype-positive children, and several independent risk factors were identified, including age ≤1 year at diagnosis, compound mutation, and mutation with both gain- and loss-of-function.
AB - Aims: To clarify the clinical characteristics and outcomes of children with SCN5A-mediated disease and to improve their risk stratification.Methods and results: A multicentre, international, retrospective cohort study was conducted in 25 tertiary hospitals in 13 countries between 1990 and 2015. All patients ≤16 years of age diagnosed with a genetically confirmed SCN5A mutation were included in the analysis. There was no restriction made based on their clinical diagnosis. A total of 442 children {55.7% boys, 40.3% probands, median age: 8.0 [interquartile range (IQR) 9.5] years} from 350 families were included; 67.9% were asymptomatic at diagnosis. Four main phenotypes were identified: isolated progressive cardiac conduction disorders (25.6%), overlap phenotype (15.6%), isolated long QT syndrome type 3 (10.6%), and isolated Brugada syndrome type 1 (1.8%); 44.3% had a negative electrocardiogram phenotype. During a median follow-up of 5.9 (IQR 5.9) years, 272 cardiac events (CEs) occurred in 139 (31.5%) patients. Patients whose mutation localized in the C-terminus had a lower risk. Compound genotype, both gain- and loss-of-function SCN5A mutation, age ≤1 year at diagnosis in probands and age ≤1 year at diagnosis in non-probands were independent predictors of CE.Conclusion: In this large paediatric cohort of SCN5A mutation-positive subjects, cardiac conduction disorders were the most prevalent phenotype; CEs occurred in about one-third of genotype-positive children, and several independent risk factors were identified, including age ≤1 year at diagnosis, compound mutation, and mutation with both gain- and loss-of-function.
KW - Brugada syndrome
KW - Genotype-phenotype correlation
KW - Long QT syndrome
KW - Progressive cardiac conduction disorders
KW - SCN5A
KW - Sodium channelopathy
U2 - 10.1093/eurheartj/ehy412
DO - 10.1093/eurheartj/ehy412
M3 - Journal article
C2 - 30059973
SN - 0195-668X
VL - 39
SP - 2879
EP - 2887
JO - European Heart Journal
JF - European Heart Journal
IS - 31
ER -