Functional Epicardial Conduction Disturbances Due to a SCN5A Variant Associated With Brugada Syndrome
In: ISSN: 2405-500X ; EISSN: 2405-5018, 2023
Online
academicJournal
Zugriff:
International audience ; BACKGROUND Brugada syndrome is a significant cause of sudden cardiac death (SCD), but the underlying mechanisms remain hypothetical. OBJECTIVES This study aimed to elucidate this knowledge gap through detailed ex vivo human heart studies. METHODS A heart was obtained from a 15-year-old adolescent boy with normal electrocardiogram who experienced SCD. Postmortem genotyping was performed, and clinical examinations were done on first-degree relatives. The right ventricle was optically mapped, followed by high-field magnetic resonance imaging and histology. Connexin-43 and Na V 1.5 were localized by immunofluorescence, and RNA and protein expression levels were studied. HEK-293 cell surface biotinylation assays were performed to examine Na V 1.5 trafficking. RESULTS A Brugada-related SCD diagnosis was established for the donor because of a SCN5A Brugada-related variant (p.D356N) inherited from his mother, together with a concomitant NKX2.5 variant of unknown significance. Optical mapping demonstrated a localized epicardial region of impaired conduction near the outflow tract, in the absence of repolarization alterations and microstructural defects, leading to conduction blocks and figure-of-8 patterns. Na V 1.5 and connexin-43 localizations were normal in this region, consistent with the finding that the p.D356N variant does not affect the trafficking, nor the expression of Na V 1.5. Trends of decreased Na V 1.5, connexin-43, and desmoglein-2 protein levels were noted; however, the RT-qPCR results suggested that the NKX2-5 variant was unlikely to be involved. CONCLUSIONS This study demonstrates for the first time that SCD associated with a Brugada-SCN5A variant can be caused by localized functionally, not structurally, impaired conduction.
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Functional Epicardial Conduction Disturbances Due to a SCN5A Variant Associated With Brugada Syndrome
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Autor/in / Beteiligte Person: | Renard, Estelle ; Walton, Richard, D ; Benoist, David ; Brette, Fabien ; Bru-Mercier, Gilles ; Chaigne, Sébastien ; Charron, Sabine ; Constantin, Marion ; Douard, Matthieu ; Dubes, Virginie ; Guillot, Bastien ; Hof, Thomas ; Magat, Julie ; Martinez, Marine, E ; Michel, Cindy ; Pallares-Lupon, Néstor ; Pasdois, Philippe ; Récalde, Alice ; Vaillant, Fanny ; Sacher, Frédéric ; Labrousse, Louis ; Rogier, Julien ; Kyndt, Florence ; Baudic, Manon ; Schott, Jean-Jacques ; Barc, Julien ; Probst, Vincent ; Sarlandie, Marine ; Marionneau, Céline ; Ashton, Jesse, L ; Hocini, Mélèze ; Haïssaguerre, Michel ; Bernus, Olivier ; Institut de Chimie et des Matériaux Paris-Est (ICMPE) ; Institut de Chimie - CNRS Chimie (INC-CNRS)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Centre National de la Recherche Scientifique (CNRS) ; Centre de recherche Cardio-Thoracique de Bordeaux Bordeaux (CRCTB) ; Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux-Institut National de la Santé et de la Recherche Médicale (INSERM) ; Bibliothèque nationale de France, Département Son, Vidéo, Multimédia (BnF_AUD) ; Bibliothèque nationale de France (BnF)-Ministère de la Culture et de la Communication (MCC) ; Physiologie & médecine expérimentale du Cœur et des Muscles U 1046 (PhyMedExp) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM) ; Institut de rythmologie et modélisation cardiaque Pessac (IHU Liryc) ; IHU-LIRYC ; Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux ; Centre de résonance magnétique des systèmes biologiques (CRMSB) ; Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS) ; Bordeaux, CHU ; Centre National de la Recherche Scientifique (CNRS) ; Institut du Thorax Nantes ; ITX-lab unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX-lab) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE) ; Nantes Université - pôle Santé ; Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé ; Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ) ; Centre Hospitalier Universitaire de Nantes = Nantes University Hospital (CHU Nantes) ; Auckland Bioengineering Institute ; University of Auckland Auckland ; Centre Hospitalier Universitaire de Bordeaux (CHU de Bordeaux) ; ANR-16-CE92-0013,Progress DHF,Mécanismes de la progression de la dysfonction diastolique vers l'insuffisance cardiaque(2016) |
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Zeitschrift: | ISSN: 2405-500X ; EISSN: 2405-5018, 2023 |
Veröffentlichung: | HAL CCSD ; Elsevier, 2023 |
Medientyp: | academicJournal |
DOI: | 10.1016/j.jacep.2023.03.009 |
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