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Clinical Profile of Cardiac Involvement in Danon Disease: A Multicenter European Registry

Lotan, D; Salazar-Mendiguchia, J; Mogensen, J; Rathore, F; Anastasakis, A; Kaski, J; Garcia-Pavia, P; ... Arad, M; + view all (2020) Clinical Profile of Cardiac Involvement in Danon Disease: A Multicenter European Registry. Circulation: Genomic and Precision Medicine , 13 (6) pp. 660-670. 10.1161/CIRCGEN.120.003117. Green open access

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Abstract

Background: The X-linked Danon disease manifests by severe cardiomyopathy, myopathy, and neuropsychiatric problems. We designed this registry to generate a comprehensive picture of clinical presentations and outcome of patients with Danon disease in cardiomyopathy centers throughout Europe. Methods: Clinical and genetic data were collected in 16 cardiology centers from 8 European countries. Results: The cohort comprised 30 male and 27 female patients. The age at diagnosis was birth to 42 years in men and 2 to 65 in women. Cardiac involvement was observed in 96%. Extracardiac manifestations were prominent in men but not in women. Left ventricular (LV) hypertrophy was reported in 73% of male and 74% of female patients. LV systolic dysfunction was reported in 40% of men (who had LV ejection fraction, 34±11%) and 59% of women (LV ejection fraction, 28±13%). The risk of arrhythmia and heart failure was comparable among sexes. The age of first heart failure hospitalization was lower in men (18±6 versus 28±17 years; P<0.003). Heart failure was the leading cause of death (10 of 17; 59%), and LV systolic dysfunction predicted an adverse outcome. Eight men and 8 women (28%) underwent heart transplantation or received an LV assist device. Our cohort suggests better prognosis of female compared with male heart transplant recipients. Conclusions: Danon disease presents earlier in men than in women and runs a malignant course in both sexes, due to cardiac complications. Cardiomyopathy features, heart failure and arrhythmia, are similar among the sexes. Clinical diagnosis and management is extremely challenging in women due to phenotypic diversity and the absence of extracardiac manifestations.

Type: Article
Title: Clinical Profile of Cardiac Involvement in Danon Disease: A Multicenter European Registry
Open access status: An open access version is available from UCL Discovery
DOI: 10.1161/CIRCGEN.120.003117
Publisher version: https://doi.org/10.1161/CIRCGEN.120.003117
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10120215
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