1. Mutation location and I-Ks requlation in the arrhythmic risk of long QT syndrome type 1
- Author
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Carla Spazzolini, Isabelle Denjoy, Roel L.H.M.G. Spätjens, Peter J. Schwartz, Maria Christina Kotta, Paul A. Brink, Cristina Moreno, Kristina H. Haugaa, Sandrine R.M. Seyen, Maria Shkolnikova, Federica Dagradi, Lia Crotti, Marshall Heradien, Paul G.A. Volders, Silvia Castelletti, Matteo Pedrazzini, Schwartz, P, Moreno, C, Kotta, M, Pedrazzini, M, Crotti, L, Dagradi, F, Castelletti, S, Haugaa, K, Denjoy, I, Shkolnikova, M, Brink, P, Heradien, M, Seyen, S, Spatjens, R, Spazzolini, C, Volders, P, RS: Carim - H04 Arrhythmogenesis and cardiogenetics, Cardiologie, and MUMC+: MA Med Staf Spec Cardiologie (9)
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medicine.medical_specialty ,Long QT syndrome ,Romano-Ward Syndrome ,Mutation, Missense ,Fast Track Clinical Research ,REQUIREMENT ,Stimulation ,VARIANTS ,medicine.disease_cause ,PHENOTYPE ,QT interval ,Sudden cardiac death ,MECHANISMS ,chemistry.chemical_compound ,Genetic ,CHANNEL ,Internal medicine ,medicine ,Clinical endpoint ,Genetics ,Missense mutation ,Humans ,Cyclic adenosine monophosphate ,Mutation ,business.industry ,KVLQT1 ,medicine.disease ,GENOTYPE ,DOMINANT-NEGATIVE SUPPRESSION ,chemistry ,KCNQ1 Potassium Channel ,Cardiology ,GENETIC MODIFIER ,Cardiology and Cardiovascular Medicine ,business ,LANGE-NIELSEN-SYNDROME - Abstract
Aims Mutation type, location, dominant-negative I Ks reduction, and possibly loss of cyclic adenosine monophosphate (cAMP)-dependent I Ks stimulation via protein kinase A (PKA) influence the clinical severity of long QT syndrome type 1 (LQT1). Given the malignancy of KCNQ1-p.A341V, we assessed whether mutations neighbouring p.A341V in the S6 channel segment could also increase arrhythmic risk. Methods and results Clinical and genetic data were obtained from 1316 LQT1 patients [450 families, 166 unique KCNQ1 mutations, including 277 p.A341V-positive subjects, 139 patients with p.A341-neighbouring mutations (91 missense, 48 non-missense), and 900 other LQT1 subjects]. A first cardiac event represented the primary endpoint. S6 segment missense variant characteristics, particularly cAMP stimulation responses, were analysed by cellular electrophysiology. p.A341-neighbouring mutation carriers had a QTc shorter than p.A341V carriers (477 ± 33 vs. 490 ± 44 ms) but longer than the remaining LQT1 patient population (467 ± 41 ms) (P Conclusion KCNQ1 S6 segment mutations surrounding p.A341 increase arrhythmic risk. p.A341V-specific loss of PKA-dependent I Ks enhancement correlates with its phenotypic severity. Cellular studies providing further insights into I Ks-channel regulation and knowledge of structure-function relationships could improve risk stratification. These findings impact on clinical management.
- Published
- 2021
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