Ethnic differences in patients with Brugada syndrome and arrhythmic events: New insights from Survey on Arrhythmic Events in Brugada Syndrome
Por:
Milman A, Andorin A, Postema PG, Gourraud JB, Sacher F, Mabo P, Kim SH, Maeda S, Takahashi Y, Kamakura T, Aiba T, Conte G, Juang JJ, Leshem E, Michowitz Y, Fogelman R, Hochstadt A, Mizusawa Y, Giustetto C, Arbelo E, Huang Z, Corrado D, Delise P, Allocca G, Takagi M, Wijeyeratne YD, Mazzanti A, Brugada R, Casado-Arroyo R, Champagne J, Calo L, Sarquella-Brugada G, Jespersen CH, Tfelt-Hansen J, Veltmann C, Priori SG, Behr ER, Yan GX, Brugada-Terradellas J, Gaita F, Wilde AAM, Brugada P, Kusano KF, Hirao K, Nam GB, Probst V and Belhassen B
Publicada:
1 oct 2019
Ahead of Print:
5 jul 2019
Resumen:
BACKGROUND There is limited information on ethnic differences between patients with Brugada syndrome (BrS) and arrhythmic events (AEs).
OBJECTIVE The purpose of this study was to compare clinical, electrocardiographic (ECG), electrophysiological, and genetic characteristics between white and Asian patients with BrS and AEs.
METHODS The Survey on Arrhythmic Events in Brugada Syndrome is a multicenter survey from Western and Asian countries, gathering 678 patients with BrS and first documented AE. After excluding patients with other (n = 14 [2.1%]) or unknown (n = 30 [4.4%]) ethnicity, 364 (53.7%) whites and 270 (39.8%) Asians comprised the study group.
RESULTS There was no difference in AE age onset (41.3 +/- 16.1 years in whites vs 43.3 +/- 12.3 years in Asians; P = .285). Higher proportions of whites were observed in pediatric and elderly populations. Asians were predominantly men (98.1% vs 85.7% in whites; P < .001) and frequently presented with aborted cardiac arrest (71.1% vs 56%; P < .001). Asians tended to display more spontaneous type 1 BrS-ECG pattern (71.5% vs 64.3%; P = .068). A family history of sudden cardiac death was noted more in whites (29.1% vs 11.5 0 /0; P < .001), with a higher rate of SCN5A mutation carriers (40.1% vs 13.2% in Asians; P < .001), as well as more fever-related AEs (8.5% vs 2.9 0 /0; P = .011). No difference was observed between the 2 groups regarding history of syncope and ventricular arrhythmia inducibility.
CONCLUSION There are important differences between Asian and white patients with BrS. Asian patients present almost exclusively as male adults, more often with aborted cardiac arrest and spontaneous type 1 BrS-ECG. However, they have less family history of sudden cardiac death and markedly lower SCN5A mutation rates. The striking difference in SCN5A mutation rates should be tested in future studies.
Filiaciones:
Milman A:
Leviev Heart Institute, The Chaim Sheba Medical Center, Tel Hashomer, Israel
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Andorin A:
Service de Cardiologie, CHU de Nantes, Nantes, France
European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
Postema PG:
European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
Department of Clinical and Experimental Cardiology, AMC, University of Amsterdam, Amsterdam, Netherlands
Gourraud JB:
Service de Cardiologie, CHU de Nantes, Nantes, France
European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
Sacher F:
Hôpital Cardiologique du Haut-Lévêque Université Bordeaux, LIRYC Institute, Bordeaux, France
Mabo P:
Cardiology and Vascular Disease Division, Rennes University Health Centre, Rennes, France
Kim SH:
Division of Cardiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
Maeda S:
Heart Rhythm Center, Tokyo Medical and Dental University, Tokyo, Japan
Takahashi Y:
Heart Rhythm Center, Tokyo Medical and Dental University, Tokyo, Japan
Kamakura T:
Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Aiba T:
Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Conte G:
Heart Rhythm Management Centre, UZ-VUB, Brussels, Belgium
Juang JJ:
Cardiovascular Center and Division of Cardiology, National Taiwan University Hospital and University College of Medicine, Taipei, Taiwan
Leshem E:
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
Michowitz Y:
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
Fogelman R:
Department of Pediatric Cardiology, Schneider Children's Medical Center, Petach Tikva, Israel
Hochstadt A:
Department of Internal Medicine J, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
Mizusawa Y:
European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
Department of Clinical and Experimental Cardiology, AMC, University of Amsterdam, Amsterdam, Netherlands
Giustetto C:
Division of Cardiology, University of Torino, Department of Medical Sciences, Città della Salute e della Scienza Hospital, Torino, Italy
Arbelo E:
Cardiovascular Institute, Hospital Clinic and IDIBAPS, Barcelona, Catalonia, Spain
Huang Z:
Department of Cardiology, the First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China
Corrado D:
European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
Department of Cardiac, Thoracic and Vascular Sciences University of Padova, Padova, Italy
Delise P:
Division of Cardiology, Hospital of Peschiera del Garda, Veneto, Italy
Allocca G:
Division of Cardiology, Hospital of Peschiera del Garda, Veneto, Italy
Takagi M:
Division of Cardiac Arrhythmia, Kansai Medical University Medical Center, Moriguchi, Japan
Wijeyeratne YD:
European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
Cardiovascular Sciences and Cardiology Clinical Academic Group St. George's University Hospitals NHS Foundation Trust, London, UK
Mazzanti A:
European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
Molecular Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
Brugada R:
Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona, Spain
Medical Science Department, School of Medicine, University of Girona, Girona, Spain
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
Casado-Arroyo R:
Department of Cardiology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
Champagne J:
Quebec Heart and Lung Institute, Quebec City, Canada
Calo L:
Division of Cardiology, Policlinico Casilino, Roma, Italy
Sarquella-Brugada G:
Pediatric Arrhythmias, Electrophysiology and Sudden Death Unit Cardiology, Department Hospital Sant Joan de Déu, Barcelona - Universitat de Barcelona, Spain
Jespersen CH:
European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark
Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Tfelt-Hansen J:
European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark
Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Veltmann C:
Rhythmology and Electrophysiology, Hannover Medical School, Hannover, Germany
Priori SG:
European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
Molecular Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
Behr ER:
European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
Cardiovascular Sciences and Cardiology Clinical Academic Group St. George's University Hospitals NHS Foundation Trust, London, UK
Yan GX:
Lankenau Medical Center, Wynnewood, Pennsylvania, USA
Brugada-Terradellas J:
Cardiovascular Institute, Hospital Clinic and IDIBAPS, Barcelona, Catalonia, Spain
Gaita F:
Division of Cardiology, University of Torino, Department of Medical Sciences, Città della Salute e della Scienza Hospital, Torino, Italy
Wilde AAM:
European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
Department of Clinical and Experimental Cardiology, AMC, University of Amsterdam, Amsterdam, Netherlands
Brugada P:
Heart Rhythm Management Centre, UZ-VUB, Brussels, Belgium
Kusano KF:
Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan
Hirao K:
Heart Rhythm Center, Tokyo Medical and Dental University, Tokyo, Japan
Nam GB:
Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Probst V:
Service de Cardiologie, CHU de Nantes, Nantes, France
European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
Belhassen B:
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Heart Institute, Hadassah University Hospital, Jerusalem, Israel
Green Accepted
|