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, S Montuoro Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, Pisa; Centre for Paediatric Inherited and Rare Cardiovascular Disease, Institute of Cardiovascular Sciences, University College London , Wc1e 6bt, London Search for other works by this author on: Oxford Academic G Imperatore Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, Pisa; Centre for Paediatric Inherited and Rare Cardiovascular Disease, Institute of Cardiovascular Sciences, University College London , Wc1e 6bt, London Search for other works by this author on: Oxford Academic S Moscatelli Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, Pisa; Centre for Paediatric Inherited and Rare Cardiovascular Disease, Institute of Cardiovascular Sciences, University College London , Wc1e 6bt, London Search for other works by this author on: Oxford Academic E Field Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, Pisa; Centre for Paediatric Inherited and Rare Cardiovascular Disease, Institute of Cardiovascular Sciences, University College London , Wc1e 6bt, London Search for other works by this author on: Oxford Academic J Kaski Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, Pisa; Centre for Paediatric Inherited and Rare Cardiovascular Disease, Institute of Cardiovascular Sciences, University College London , Wc1e 6bt, London Search for other works by this author on: Oxford Academic
European Heart Journal Supplements, Volume 26, Issue Supplement_2, April 2024, Page ii69, https://doi.org/10.1093/eurheartjsupp/suae036.158
Published:
16 May 2024
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S Montuoro, G Imperatore, S Moscatelli, E Field, J Kaski, EXPLORING THE 12 LEAD ECG CHARACTERISTIC OF PAEDIATRIC AND YOUNG ADULT CARRIERS OF DESMOPLAKIN GENE VARIANTS, European Heart Journal Supplements, Volume 26, Issue Supplement_2, April 2024, Page ii69, https://doi.org/10.1093/eurheartjsupp/suae036.158
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Abstract
Background and Aim
The DSP gene (locus. 6p24.3) encodes desmoplakin, a quintessential desmosomal protein for cellular adhesion, particularly within cardiac tissues. DSP gene variants can cause dilated cardiomyopathy, non–dilated left ventricular cardiomyopathy (NDLVC) and arrhythmogenic righ ventricular cardiomyopathy (ARVC), cardiac conditions known to trigger malignant ventricular arrhythmias and cause sudden cardiac death in young individuals. Nevertheless, the electrocardiographic (ECG) patterns in children carrying DSP variants are underexplored.
Methods
A retrospective analysis was conducted involving paediatric DSP gene variant carriers (</=18 years), followed at Great Ormond Street Hospital from 2006 to 2023. Their 12–lead ECGs were characterised and compared with those of an age and gender–matched healthy control group (χ2, p–value<0.05).
Results
25 DSP carriers (64% females; 12.6±4 years) were identified [including 4 (16%) with an overt cardiomyopathy phenotype] and compared to 25 healthy matched controls (12.7±4.3years). Compared to the control group, DSP carriers exhibited a higher prevalence of low QRS voltages (72% vs 44%, p= 0.041), QRS notching (72% vs 26%, p= 0,014) and flattened T waves (72% vs 52%, p= 0,026). All 4 patients with an overt cardiomyopathy phenotype had widespread low QRS voltages and QRS fractionation, as well as flattened/inverted T waves, particularly in the inferior and lateral leads.
Conclusion
Predominant ECG features observed in paediatric patients with DSP gene variants included low QRS voltages, QRS notching, and flat or inverted T waves. Our findings suggest that ECG features may precede the development of an overt cardiomyopathy phenotype in children with DSP variants, but further studies with larger cohorts are needed to confirm this and to determine their prognostic significance.
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© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)
Topic:
- phenotype
- electrocardiogram
- cardiomyopathy, dilated
- arrhythmogenic right ventricular dysplasia
- sudden cardiac death
- cardiomyopathy
- ventricular cardiomyopathy
- t wave feature
- inverted t wave
- heart diseases
- left ventricle
- cell adhesion
- child
- dose fractionation
- genes
- pediatrics
- precipitating factors
- heart
- patient prognosis
- gender
- malignant ventricular arrhythmia
- young adult
- 12 lead ecg
- desmogleins
- desmoplakins
Issue Section:
Abstract > Posters > Arrhythmogenic Right Ventricular Cardiomyopathy
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