title: Anderson-Fabry cardiomyopathy: prevalence, pathophysiology, diagnosis and treatment.
abstract: Anderson-Fabry disease (AFD) is a lysosomal storage disease caused by the inappropriate accumulation of globotriaosylceramide in tissues due to a deficiency in the enzyme α-galactosidase A (α-Gal A). Anderson-Fabry cardiomyopathy is characterized by structural, valvular, vascular and conduction abnormalities, and is now the most common cause of mortality in patients with AFD. Large-scale metabolic and genetic screening studies have revealed AFD to be prevalent in populations of diverse ethnic origins, and the variant form of AFD represents an unrecognized health burden. Anderson-Fabry disease is an X-linked disorder, and genetic testing is critical for the diagnosis of AFD in women. Echocardiography with strain imaging and cardiac magnetic resonance imaging using late enhancement and T1 mapping are important imaging tools. The current therapy for AFD is enzyme replacement therapy (ERT), which can reverse or prevent AFD progression, while gene therapy and the use of molecular chaperones represent promising novel therapies for AFD. Anderson-Fabry cardiomyopathy is an important and potentially reversible cause of heart failure that involves LVH, increased susceptibility to arrhythmias and valvular regurgitation. Genetic testing and cardiac MRI are important diagnostic tools, and AFD cardiomyopathy is treatable if ERT is introduced early.
authors.affiliation: Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, T6G 2S2, AB, Canada.
authors.forename: Brendan N
authors.initials: BN
authors.lastname: Putko
authors.forename: Kevin
authors.initials: K
authors.lastname: Wen
authors.forename: Richard B
authors.initials: RB
authors.lastname: Thompson
authors.forename: John
authors.initials: J
authors.lastname: Mullen
authors.forename: Miriam
authors.initials: M
authors.lastname: Shanks
authors.forename: Haran
authors.initials: H
authors.lastname: Yogasundaram
authors.forename: Consolato
authors.initials: C
authors.lastname: Sergi
authors.forename: Gavin Y
authors.initials: GY
authors.lastname: Oudit
mesh_terms: D000328:Adult; D009202:Cardiomyopathies / Q000628:therapy*; D019468:Disease Management; D004452:Echocardiography; D056947:Enzyme Replacement Therapy; D000795:Fabry Disease / Q000150:complications / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy*; D005260:Female; D005820:Genetic Testing; D015316:Genetic Therapy; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D014281:Trihexosylceramides / Q000378:metabolism; D000519:alpha-Galactosidase / Q000378:metabolism*
chemical_list: D014281:Trihexosylceramides; C018549:globotriaosylceramide; D000519:alpha-Galactosidase