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Emery-Dreifuss muscular dystrophy Type 1 is associated with a high risk of malignant ventricular arrhythmias and end-stage heart failure

Lookup NU author(s): Professor Chiara Marini Bettolo, Dr John Bourke

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).

Abstract

© 2023 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology.Background and Aims: Emery-Dreifuss muscular dystrophy (EDMD) is caused by variants in EMD (EDMD1) and LMNA (EDMD2). Cardiac conduction defects and atrial arrhythmia are common to both, but LMNA variants also cause end-stage heart failure (ESHF) and malignant ventricular arrhythmia (MVA). This study aimed to better characterize the cardiac complications of EMD variants. Methods: Consecutively referred EMD variant-carriers were retrospectively recruited from 12 international cardiomyopathy units. MVA and ESHF incidences in male and female variant-carriers were determined. Male EMD variant-carriers with a cardiac phenotype at baseline (EMDCARDIAC) were compared with consecutively recruited male LMNA variant-carriers with a cardiac phenotype at baseline (LMNACARDIAC). Results: Longitudinal follow-up data were available for 38 male and 21 female EMD variant-carriers [mean (SD) ages 33.4 (13.3) and 43.3 (16.8) years, respectively]. Nine (23.7%) males developed MVA and five (13.2%) developed ESHF during a median (inter-quartile range) follow-up of 65.0 (24.3-109.5) months. No female EMD variant-carrier had MVA or ESHF, but nine (42.8%) developed a cardiac phenotype at a median (inter-quartile range) age of 58.6 (53.2-60.4) years. Incidence rates for MVA were similar for EMDCARDIAC and LMNACARDIAC (4.8 and 6.6 per 100 person-years, respectively; log-rank P =. 49). Incidence rates for ESHF were 2.4 and 5.9 per 100 person-years for EMDCARDIAC and LMNACARDIAC, respectively (log-rank P =. 09). Conclusions: Male EMD variant-carriers have a risk of progressive heart failure and ventricular arrhythmias similar to that of male LMNA variant-carriers. Early implantable cardioverter defibrillator implantation and heart failure drug therapy should be considered in male EMD variant-carriers with cardiac disease.

Publication metadata

Author(s): Cannie DE, Syrris P, Protonotarios A, Bakalakos A, Pruny J-F, Ditaranto R, Martinez-Veira C, Larranaga-Moreira JM, Medo K, Bermudez-Jiménez FJ, Ben Yaou R, Leturcq F, Mezcua AR, Marini-Bettolo C, Cabrera E, Reuter C, Limeres Freire J, Rodriguez-Palomares JF, Mestroni L, Taylor MRG, Parikh VN, Ashley EA, Barriales-Villa R, Jiménez-Jaimez J, Garcia-Pavia P, Charron P, Biagini E, Garcia Pinilla JM, Bourke J, Savvatis K, Wahbi K, Elliott PM

Publication type: Article

Publication status: Published

Journal: European Heart Journal

Year: 2023

Volume: 44

Issue: 48

Pages: 5064-5073

Print publication date: 21/12/2023

Online publication date: 28/08/2023

Acceptance date: 21/08/2023

Date deposited: 15/01/2024

ISSN (print): 0195-668X

ISSN (electronic): 1522-9645

Publisher: Oxford University Press

URL: https://doi.org/10.1093/eurheartj/ehad561

DOI: 10.1093/eurheartj/ehad561

Data Access Statement: Patient-level data will not be made available as consent was not sought for public dissemination, and due to concerns, that information could be used to identify individuals.

PubMed id: 37639473

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