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A Novel Mutation Of The EMD Gene In A Family With Cardiac Conduction Abnormalities And A High Incidence Of Sudden Cardiac Death

Authors Kong D, Zhan Y, Liu C, Hu Y, Zhou Y, Luo J, Gu L, Zhou X, Zhang Z

Received 1 July 2019

Accepted for publication 27 September 2019

Published 31 October 2019 Volume 2019:12 Pages 319—327

DOI https://doi.org/10.2147/PGPM.S221444

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Ms Rachel Predeepa

Peer reviewer comments 2

Editor who approved publication: Dr Martin H. Bluth


Demiao Kong,1,2,* Yi Zhan,3,* Canzhao Liu,4 Yerong Hu,1 Yangzhao Zhou,1,4 Jiawen Luo,1 Lu Gu,1 Xinmin Zhou,1 Zhiwei Zhang1,4

1Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; 2Department of Thoracic Surgery, Guizhou Provincial People’s Hospital, Guiyang, Guizhou 550002, China; 3Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; 4Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA

*These authors contributed equally to this work

Correspondence: Zhiwei Zhang
Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, No. 139 Middle Renmin Road, Changsha, Hunan 410011, People’s Republic of China
Tel +86 13787083210 Email somebody_zhang@csu.edu.cn

Background: Emery-Dreifuss muscular dystrophy, caused by mutations in genes such as emerin (EMD) or lamin A/C (LMNA), is a disorder affecting the joints, muscles, and heart, with a wide spectrum of patient phenotypes including muscle wasting and cardiac conduction defects.
Methods and results: Here we report a multi-generation family from the Hunan Province of China. Affected family members displayed an uncommon clinical presentation of serious cardiac conduction abnormalities at an early age and a high incidence of sudden cardiac death along with mild skeletal muscular atrophy and joint contracture. Clinical analysis of affected members provided evidence of X-linked recessive inheritance. Consequently, using Sanger sequencing of X chromosome exomes, we identified a novel duplication mutation (c.405dup/p.Asp136X) in the EMD gene as the cause for the disease in this family. This variant is a novel mutation that has not been previously reported in Pubmed, Clinvar or other cases reported in the Human Gene Mutation Database.
Conclusion: Our finding expands the mutation spectrum of Emery-Dreifuss muscular dystrophy and provides a rationale for EMD mutation testing in cases of X-linked inherited cardiac conduction disease and sudden cardiac death, even in those lacking pathognomonic neuromuscular features.

Keywords: Emery-Dreifuss muscular dystrophy, emerin, sudden cardiac death, cardiac conduction abnormalities, mutation


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