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- Title
High Prevalence of Late-Onset Fabry Cardiomyopathy in a Cohort of 499 Non-Selective Patients with Left Ventricular Hypertrophy: The Asian Fabry Cardiomyopathy High-Risk Screening Study (ASIAN-FAME).
- Authors
Fan, Yiting; Chan, Tsz-Ngai; Chow, Josie T. Y.; Kam, Kevin K. H.; Chi, Wai-Kin; Chan, Joseph Y. S.; Fung, Erik; Tong, Mabel M. P.; Wong, Jeffery K. T.; Choi, Paul C. L.; Chan, David K. H.; Sheng, Bun; Lee, Alex Pui-Wai; Bursi, Francesca; Banach, Maciej
- Abstract
Left ventricular hypertrophy (LVH) caused by cardiac variant Fabry disease (FD) is typically late-onset and may mimic LVH caused by abnormal loading conditions. We aimed to determine the prevalence of FD in a non-selective patient population of everyday practice presenting with LVH, including those with hypertension and valve disease. We measured plasma alpha-galactosidase A activity using dried blood spot tests in 499 (age = 66 ± 13 years; 336 men) Hong Kong Chinese patients with LVH defined as maximal LV septal/posterior wall thickness ≥13 mm on echocardiography. Patients with low enzyme activity underwent mutation analysis of the GLA gene. Eight (age = 53−74 years; all men) unrelated patients (1.6%) had low plasma alpha-galactosidase A activity (0.57 ± 0.27 μmol/L wb/hr) and all were confirmed to have the GLA IVS4 + 919G > A mutation. FD patients presented with heart failure (n = 5), heart block (n = 2), ventricular tachycardia (n = 1), chest pain (n = 3), and/or murmur (n = 1). Uncontrolled hypertension (n = 4) and/or severe mitral/aortic valve pathology (n = 2) were frequent. Ethnic subgroups included Teochew (n = 5), Canton (n = 2), and Wenzhou (n = 1). Endomyocardial biopsy (n = 6) revealed hypertrophic myocytes with vacuolization and dense lamellar bodies. Late-onset IVS4 + 919G > A FD is prevalent among Chinese LVH patients, and should be considered as a cause of LVH in adult patients even when hypertension and/or valve pathology are present.
- Subjects
GUANGZHOU (China); HONG Kong (China); LEFT ventricular hypertrophy; DRIED blood spot testing; HEART failure patients; HEART block; CARDIOMYOPATHIES; ANGIOKERATOMA corporis diffusum
- Publication
Journal of Clinical Medicine, 2021, Vol 10, Issue 10, p2160
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm10102160