Reversed pulmonary artery flow in isolated noncompaction of the ventricular myocardium.
OBJECTIVE
To investigate the morphology and genetics of a fetus at 22 weeks. This fetus demonstrated progressive fetal hydrops and cardiomegaly with retrograde flow in the pulmonary artery and progressive myocardial deterioration and heart failure.


METHODS
Postmortem examination, light and electron microscopy of the myocardium, karyotyping, fetal DNA analysis, screening for mutations in the G4.5 gene, alpha-dystrobrevin gene, FKBP 12 gene, Desmin, Syntrophin and Cypher/ZASP genes, which have been described as being associated with noncompaction ventricular myocardium, using single-strand DNA conformation polymorphism analysis and DNA sequencing.


RESULTS
The morphological diagnosis was compatible with noncompaction ventricular myocardium or spongyforme myopathy. The karyotype was normal. Mutation analysis in exons and introns of all six genes did not show any known mutation.


CONCLUSIONS
Noncompaction ventricular myocardium or spongyforme myopathy may be associated with mutations in genes which have previously not been thought to be associated with this phenotype. Alternatively, this disease could be the result of abnormal cardiac hemodynamics.
Grebe
Sandra
S
Department of Obstetrics and Gynecology, University of Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Ichida
Fukiko
F
Grabitz
Ralph
R
Bültmann
Burkhard
B
Heideman
Simone
S
von Kaisenberg
Constantin S
CS
D000328:Adult; D006332:Cardiomegaly / Q000473:pathology; D004252:DNA Mutational Analysis; D005260:Female; D006330:Heart Defects, Congenital / Q000235:genetics / Q000473:pathology* / Q000503:physiopathology; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D015160:Hydrops Fetalis / Q000473:pathology; D009206:Myocardium / Q000473:pathology*; D011247:Pregnancy; D011651:Pulmonary Artery / Q000503:physiopathology*