IndraLab
Statements
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"For example, despite carrying the mutation since birth, patients with BrS do not typically develop an arrhythmic phenotype until aged approximately 34–53 years. xref Interestingly, the male predominance of an arrhythmic phenotype is not observed in children with BrS. xref Age-dependent hormonal changes have been proposed to explain the increased risk of spontaneous arrhythmias in men after puberty. xref , xref Moreover, within an individual patient with an SCN5A mutation associated with BrS, phenotypic variability exists in the ECG manifestations of the disease as a function of time."
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"Loss-of-function mutations in Scn5a have been associated with BrS (Chen et al., xref ), sick sinus syndrome (SSS; Benson et al., xref ), progressive cardiac conduction defect (PCCD, or Lenègre disease; Schott et al., xref ; Tan et al., xref ; Probst et al., xref ) and overlap disorders between these conditions (Remme et al., xref )."
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"It is reported to be more common in Asia than in Western countries, with the estimated prevalence ranging from 1:1000 to 1:10000. xref There are 20 genes associated with BrS, and SCN5A is the major causative one. xref Implantable cardioverter-defibrillator (ICD) is the most effective therapy to prevent SCD, and quinidine, isoproterenol, and catheter ablation are also recommended to reduce the incidence rate of arrhythmic events. xref WPW syndrome is the most common cause of preexcitation, and usually it is presented with supraventricular tachycardia and AF."
sparser
"SCN5A mutations associated with BrS are loss-of-function, decreasing Na V 1.5 channel availability or surface expression. xref Loss-of-function mutations have also been found in the CACNA1C -encoded pore-forming subunit of the cardiac Ca V 1.2 L-type Ca 2+ channel. xref , xref In addition, genes associated with BrS include those encoding channel modulators, such as Na + and Ca 2+ channel β subunits and proteins responsible for channel trafficking and targeting within the cardiomyocyte."
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"These results may help to improve prognosis assessment, establish accurate risk stratification, and prevent SCD in children with BrS-SCN5A. Future studies in large cohorts of different ethnicities are crucial to strengthen our risk factors in paediatric cohorts at high risk of malignant arrhythmias."
| PMC
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"Several commonly recognized predisposing factors, including increased body temperature, drugs, and electrolyte disturbances, play a crucial role in unmasking the dynamic ECG changes of BrS. xref , xref In 1999, Dumaine et al. provided evidence that some loss-of-function of SCN5A mutations associated with BrS may be temperature-dependent, suggesting that this may underlie the ability of a febrile state to unmask the BrS phenotype. xref However, fever-induced BrS is a clinically heterogeneous disease without a mutation-specific cause. xref Recent studies have shown that a BrS pattern is much more prevalent (2–4%) in patients presenting in the emergency department with fever than in afebrile group of patients. xref , xref In the present study, we present the largest cohort to date of fever-induced BrS and report the clinical characteristics and outcomes of this cohort."
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"Loss-of-function mutations in the cardiac sodium channel gene SCN5A are associated with BrS (Kapplinger et al , xref ), PCCD (3), DCM in combination with atrial and ventricular arrhythmias and conduction disease (McNair et al , xref ), sick sinus syndrome (SSS) (Benson et al , xref ), familial atrial fibrillation (AF) (Darbar et al , xref ), and sudden cardiac infant death syndrome (SIDS) (Klaver et al , xref )."
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"Further analysis demonstrated that peak I Na density was reduced by 80% in BrS-SCN5A and 70% in BrS-SCN1B compared to their control counterparts ( P <0.001 for both, xref ), which was in line with the downregulation in relevant gene expression ( P <0.001 for both, xref and xref )."
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"SCN5A mutations are associated with both BrS and familial atrial fibrillation, progressive cardiac conduction defect, sick sinus syndrome, early repolarization syndrome, dilated cardiomyopathy, and sudden infant death syndrome. xref Furthermore, BrS has been linked to mutations in 18 other genes, but they are rarer."
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"In addition, compared to the control group, both BrS groups displayed a higher incidence of arrhythmic events at baseline, including early afterdepolarizations (EADs) or delayed afterdepolarizations (DADs) (0 out of 10 for control, 3 out of 10 for BrS-SCN5A, 2 out of 9 for BrS-SCN1B)."