[Familial dilated cardiomyopathy in patients transplanted for idiopathic dilated cardiomyopathy].
OBJECTIVE
To evaluate the prevalence, clinical features, and pattern of inheritance of familial dilated cardiomyopathy (DCM) in heart transplant patients.


METHODS
Patients with idiopathic DCM who had undergone heart transplantation were invited to participate. Patients with alcohol abuse were excluded. A clinical evaluation, 12-lead ECG, echocardiogram, blood tests, and DNA extraction were performed in patients and relatives. Familial DCM was defined as the presence of at least one relative with idiopathic DCM. Possible familial DCM was considered when at least one relative had left ventricular enlargement (LVE) (> 112% predicted LVEDD).


RESULTS
One hundred and ninety-nine relatives of 43 families were studied. DCM was familial in 11 probands (25.6%) and possibly familial in 11 (25.6%). Fifteen relatives had DCM (7.5%), 26 (13.1%) LVE, and 5 (2.5%) hypertrophic cardiomyopathy. The pattern of inheritance was autosomal dominant in most families. Five probands (3 with familial DCM) had antecedents of consanguinity and possible recessive inheritance. Six probands (14%, 1 with familial DCM) had relatives with conduction system defects. Creatine kinase was moderately increased in 9 relatives (4.5%), 3 of them with LVE. Fifteen patients had at least moderate alcohol intake. Three of them had familial DCM (relatives without alcohol abuse) and 6 had possible familial DCM.


CONCLUSIONS
The prevalence of familial DCM is high in patients who undergo heart transplant. Left ventricular enlargement, conduction system abnormalities, and elevated creatine kinase may be early markers of familial disease. Hypertrophic cardiomyopathy is present in some relatives of patients with idiopathic DCM. Familial DCM is present in patients with a previous diagnosis of alcoholic DCM.
Servicio de Cardiología del Hospital Juan Canalejo, A Coruña, Spain. Lorenzo_Monserrat@cannalejo.org
Lorenzo
L
Monserrat
Manuel
M
Hermida
Beatriz
B
Bouzas
Ignacio
I
Mosquera
Niall
N
Mahon
Jesús
J
Peteiro
Nemesio
N
Alvarez
Manuel
M
Penas-Lado
Marisa
M
Crespo
Alfonso
A
Castro-Beiras
D015415:Biomarkers; D006332:Cardiomegaly / Q000235:genetics; D002311:Cardiomyopathy, Dilated / Q000453:epidemiology / Q000235:genetics* / Q000601:surgery*; D016009:Chi-Square Distribution; D003241:Consanguinity; D003402:Creatine Kinase / Q000097:blood; D003627:Data Interpretation, Statistical; D005260:Female; D005799:Genes, Dominant; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D010375:Pedigree; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies
D015415:Biomarkers; D003402:Creatine Kinase