Haploinsufficiency in combination with aging causes SCN5A-linked hereditary lenègre disease

Vincent Probst, Florence Kyndt, Franck Potet, Jean Noel Trochu, Guy Mialet, Sophie Demolombe, Jean Jacques Schott, Isabelle Baró, Denis Escande*, Hervé Le Marec

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

142 Scopus citations

Abstract

OBJECTIVES: The goal of this study was to investigate the genotype-to-phenotype relationship between SCN5A gene mutation and progressive cardiac conduction defect in order to gain insights into the pathophysiologic mechanisms of the disease. BACKGROUND: Progressive cardiac conduction defect is a frequent disease commonly attributed to degeneration and fibrosis of the His bundle and its branches. In a French family, we have identified a splicing mutation in the SCN5A gene leading to hereditary progressive cardiac conduction defect. METHODS: We have extended the size of the pedigree and phenotyped and genotyped all family members, and also investigated in vitro the functional consequences of the mutation. RESULTS: Among 65 potentially affected members, 25 individuals were carriers of the IVS.22+2 T→C SCN5A mutation. In relation to aging, gene carriers exhibit various types of conduction defects. P-wave, PR, and QRS duration increased progressively with age in gene carriers and in noncarriers. Whatever the age, conduction parameters were longer in gene carriers. The widening in the QRS complex with aging was more pronounced in gene carriers older than 40 years. Functional studies show that the IVS.22+2 T→C SCN5A mutation lead to exon 22 skipping and to a complete loss of function of the affected allele, but to a normal trafficking of the mutated gene product. CONCLUSIONS: Our findings demonstrate that hereditary Lenègre disease is caused by a haploinsufficiency mechanism, which in combination with aging leads to progressive alteration in conduction velocity.

Original languageEnglish (US)
Pages (from-to)643-652
Number of pages10
JournalJournal of the American College of Cardiology
Volume41
Issue number4
DOIs
StatePublished - Feb 19 2003

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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