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Lookup NU author(s): Dr Matthew Bates, Dr Kieren Hollingsworth, Jane Newman, Professor Djordje JakovljevicORCiD, Professor Andrew BlamireORCiD, Dr Guy MacGowanORCiD, Professor Bernard Keavney, Professor Patrick Chinnery, Emeritus Professor Doug Turnbull, Professor Robert Taylor, Professor Mike TrenellORCiD, Professor Grainne Gorman
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Aims: Hypertrophic remodelling and systolic dysfunction are common in patients with mitochondrial disease and independent predictors of morbidity and early mortality. Screening strategies for cardiac disease are unclear. We investigated whether myocardial abnormalities could be identified in mitochondrial DNA mutation carriers without clinical cardiac involvement. Methods and results: Cardiac magnetic resonance imaging was performed in 22 adult patients with mitochondrial disease due to the m.3243A.G mutation, but no known cardiac involvement, and 22 age- and gender-matched control subjects: (i) Phosphorus-31- magnetic resonance spectroscopy, (ii) cine imaging (iii), cardiac tagging and (iv) late gadolinium enhancement (LGE) imaging. Disease burden was determined using the Newcastle Mitochondrial Disease Adult Scale (NMDAS) and urinary mutation load. Compared with control subjects, patients had an increased left ventricular mass index (LVMI), LV mass to end-diastolic volume (M/V) ratio, wall thicknesses (all P , 0.01), torsion and torsion to endocardial strain ratio (both P , 0.05). Longitudinal shortening was decreased in patients (P, 0.0001) and correlated with an increased LVMI (r ¼ 20.52, P , 0.03), but there were no differences in the diastolic function. Among patients there was no correlation of LVMI or the M/V ratio with diabetic or hypertensive status, but the mutation load and NMDAS correlated with the LVMI (r ¼ 0.71 and r ¼ 0.79, respectively, both P , 0.001). The phosphocreatine/adenosine triphosphate ratio was decreased in patients (P , 0.001) but did not correlate with other parameters. No patients displayed focal LGE. Conclusion: Concentric remodelling and subendocardial dysfunction occur in patients carrying m.3243A.G mutation without clinical cardiac disease. Patients with higher mutation loads and disease burden may be at increased risk of cardiac involvement.
Author(s): Bates MG, Hollingsworth KG, Newman J, Jakovljevic DG, Blamire AM, MacGowan GA, Keavney BD, Chinnery PF, Turnbull DM, Taylor RW, Trenell MI, Gorman GS
Publication type: Article
Publication status: Published
Journal: European Heart Journal - Cardiovascular Imaging
Year: 2013
Volume: 14
Issue: 7
Pages: 650-658
Print publication date: 01/07/2013
Online publication date: 04/11/2012
Acceptance date: 05/10/2012
ISSN (print): 2047-2404
ISSN (electronic): 2047-2412
Publisher: Oxford University Press
URL: http://dx.doi.org/10.1093/ehjci/jes226
DOI: 10.1093/ehjci/jes226
PubMed id: 23129433
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