Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-23T00:31:46.923Z Has data issue: false hasContentIssue false

RYR2 p.R169L mutation and left ventricular hypertrophy in a child with emotion-triggered sudden death

Published online by Cambridge University Press:  09 June 2020

Utkarsh Kohli*
Affiliation:
Section of Pediatric Cardiology, Department of Pediatrics, Comer Children’s Hospital and Pritzker School of Medicine of the University of Chicago, Chicago, IL, USA
Lisa Kuntz
Affiliation:
Divisions of Pediatric Critical Care, Cardiology and Cardiac Surgery, Department of Pediatrics, Pritzker School of Medicine of the University of Chicago, Chicago, IL, USA
Hemal M. Nayak
Affiliation:
Center for Arrhythmia Care, Heart & Vascular Center, Pritzker School of Medicine of the University of Chicago, Chicago, IL, USA
*
Author for correspondence: Utkarsh Kohli, Assistant Professor of Pediatrics, Section of Pediatric Cardiology, Department of Pediatrics, University of Chicago, 5481 S Maryland Ave., RM-C104E, MC 4051, Chicago, IL60637, USA. Tel: +1 773-702-6172; Fax: +1 773 702 2319. E-mail: [email protected]

Abstract

Catecholaminergic polymorphic ventricular tachycardia is a rare (prevalence: 1/10,000) channelopathy characterised by exercise-induced or emotion-triggered ventricular arrhythmias. There is an overall paucity of genotype-phenotype correlation studies in patients with catecholaminergic polymorphic ventricular tachycardia, and in vitro and in vivo effects of individual mutations have not been well characterised. We report an 8-year-old child who carried a mutation in the coding exon 8 of RYR2 (p.R169L) and presented with emotion-triggered sudden cardiac death. He was also found to have left ventricular hypertrophy, a combination which has not been reported before. We discuss the association between genetic variation in RYR2, particularly mutations causing replacement of arginine at position 169 of RYR2 and structural cardiac abnormalities.

Type
Brief Report
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Murthy, M, Xu, S, Massimo, G, et al.Role for germline mutations and a rare coding single nucleotide polymorphism within the KCNJ5 potassium channel in a large cohort of sporadic cases of primary aldosteronism. Hypertension 2014; 63: 783789. doi: 10.1161/HYPERTENSIONAHA.113.02234.CrossRefGoogle Scholar
Foster, BJ, Mackie, AS, Mitsnefes, M, Ali, H, Mamber, S, Colan, SD.A novel method of expressing left ventricular mass relative to body size in children. Circulation 2008; 117: 27692775. doi: 10.1161/CIRCULATIONCrossRefGoogle ScholarPubMed
Kohli, U, Aziz, Z, Beaser, AD, Nayak, H.A large deletion in RYR2 Exon 3 is associated with nadolol and flecainide refractory catecholaminergic polymorphic ventricular tachycardia. Pacing Clin Electrophysiol 2019; 42: 11461154. doi: 10.1111/pace.13668.CrossRefGoogle ScholarPubMed
van der Werf, C, Nederend, I, Hofman, N, et al.Familial evaluation in catecholaminergic polymorphic ventricular tachycardia: disease penetrance and expression in cardiac ryanodine receptor mutation carrying relatives. Circ Arrhythm Electrophysiol 2012; 5: 748756. doi: 10.1161/CIRCEP.112.970517.CrossRefGoogle ScholarPubMed
Roston, TM, Yuchi, Z, Kannankeril, PJ, et al.The clinical and genetic spectrum of catecholaminergic polymorphic ventricular tachycardia: findings from an international multicentre registry. Europace 2018; 20: 541547. doi: 10.1093/europace/euw389.CrossRefGoogle ScholarPubMed
Fujino, N, Ino, H, Hayashi, K, et al.A novel missense mutation in cardiac ryanodine receptor gene as a possible cause of hypertrophic cardiomyopathy: evidence from familial analysis. Circulation 2006; 114: 165.Google Scholar
Tang, Y, Tian, X, Wang, R, Fill, M, Chen, SR.Abnormal termination of Ca2+ release is a common defect of RyR2 mutations associated with cardiomyopathies. Circ Res 2012; 110: 968977. doi: 10.1161/CIRCRESAHA.111.256560.CrossRefGoogle ScholarPubMed
Ohno, S, Hasegawa, K, Horie, M.Gender differences in the inheritance mode of RYR2 mutations in catecholaminergic polymorphic ventricular tachycardia patients. PLoS One 2015; 10: e0131517. doi: 10.1371/journal.pone.0131517.CrossRefGoogle ScholarPubMed
Hsueh, CH, Weng, YC, Chen, CY, et al.A novel mutation (Arg169Gln) of the cardiac ryanodine receptor gene causing exercise-induced bidirectional ventricular tachycardia. Int J Cardiol 2006; 108: 276278.CrossRefGoogle ScholarPubMed
Nozaki, Y, Kato, Y, Uike, K, et al.Co-phenotype of left ventricular non-compaction cardiomyopathy and atypical catecholaminergic polymorphic ventricular tachycardia in association with R169Q, a ryanodine receptor type 2 missense mutation. Circ J 2020; 84: 226234. doi: 10.1253/circj.CJ-19-0720.CrossRefGoogle ScholarPubMed
Oechslin, E, Jenni, R.Left ventricular non-compaction revisited: a distinct phenotype with genetic heterogeneity? Eur Heart J 2011; 32: 14461456. doi: 10.1093/eurheartj/ehq508.CrossRefGoogle ScholarPubMed
Bauce, B, Rampazzo, A, Basso, C, et al.Screening for ryanodine receptor type 2 mutations in families with effort-induced polymorphic ventricular arrhythmias and sudden death: early diagnosis of asymptomatic carriers. J Am Coll Cardiol 2002; 40: 341349.CrossRefGoogle ScholarPubMed
Hayashi, M, Denjoy, I, Extramiana, F, et al.Incidence and risk factors of arrhythmic events in catecholaminergic polymorphic ventricular tachycardia. Circulation 2009; 119: 24262434. doi: 10.1161/CIRCULATIONAHA.108.829267.CrossRefGoogle ScholarPubMed
Amador, FJ, Kimlicka, L, Stathopulos, PB, et al.Type 2 ryanodine receptor domain A contains a unique and dynamic α-helix that transitions to a β-strand in a mutant linked with a heritable cardiomyopathy. J Mol Biol 2013; 425: 40344046. doi: 10.1016/j.jmb.2013.08.015.CrossRefGoogle Scholar
Amador, FJ, Kimlicka, L, Stathopulos, PB, et al.Type 2 ryanodine receptor domain A contains a unique and dynamic alpha-helix that transitions to a beta-strand in a mutant linked with a heritable cardiomyopathy. J Mol Biol 2013; 425: 40344046.CrossRefGoogle Scholar
Borko, L, Bauerová-Hlinková, V, Hostinová, E, et al.Structural insights into the human RyR2 N-terminal region involved in cardiac arrhythmias. Acta Crystallogr D Biol Crystallogr 2014; 70: 28972912.CrossRefGoogle ScholarPubMed
Kohli, U, Aziz, Z, Beaser, AD, Nayak, HM.Ventricular arrhythmia suppression with ivabradine in a patient with catecholaminergic polymorphic ventricular tachycardia refractory to nadolol, flecainide, and sympathectomy. Pacing Clin Electrophysiol 2020 Apr 7. doi: 10.1111/pace.13913.Google Scholar