EXPEDITED REVIEW
Mutations in Cypher/ZASP in patients with dilated cardiomyopathy and left ventricular non-compaction
Matteo Vatta, PhD*,
Bhagyalaxmi Mohapatra, PhD*,
Shinawe Jimenez, MD*,
Ximena Sanchez, PhD*,
Georgine Faulkner, PhD ,
Zeev Perles, MD*,
Gianfranco Sinagra, MD ,
Jiuann-Huey Lin, MD*,
Thuy M. Vu, BS*,
Qiang Zhou, PhD||,
Karla R. Bowles, PhD*,
Andrea Di Lenarda, MD ,
Lisa Schimmenti, MD¶,
Michelle Fox, MS||,
Michelle A. Chrisco, BS*,
Ross T. Murphy, MD#,
William McKenna, MD#,
Perry Elliott, MD#,
Neil E. Bowles, PhD*,
Ju Chen, PhD||,
Giorgio Valle, PhD** and
Jeffrey A. Towbin, MD, FACC* ,*
* Department of Pediatrics (Cardiology), Baylor College of Medicine, Houston, Texas, USA;
Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
International Centre for Genetic Engineering and Biotechnology, Trieste, Italy
Department of Cardiology, Ospedale Maggiore, Trieste, Italy
|| Institute of Molecular Medicine and Department of Medicine, University of California at San Diego, School of Medicine, La Jolla, California, USA
¶ Department of Pediatrics (Genetics), University of California at Los Angeles, Los Angeles, California, USA
# Department of Cardiological Sciences, St. George's Hospital Medical School, London, United Kingdom
** CRIBI Biotechnology Centre, Universita degli Studi di Padova, Padova, Italy
Manuscript received July 15, 2003;
revised manuscript received October 6, 2003,
accepted October 9, 2003.
* Reprint requests and correspondence: Dr. Jeffrey A. Towbin, Pediatric Cardiology, Texas Children's Hospital, 6621 Fannin Street, F.C. 430.09, Houston, Texas 77030, USA. jtowbin{at}bcm.tmc.edu
OBJECTIVES: We evaluated the role of Cypher/ZASP in the pathogenesis of dilated cardiomyopathy (DCM) with or without isolated non-compaction of the left ventricular myocardium (INLVM).
BACKGROUND: Dilated cardiomyopathy, characterized by left ventricular dilation and systolic dysfunction with signs of heart failure, is genetically transmitted in 30% to 40% of cases. Genetic heterogeneity has been identified with mutations in multiple cytoskeletal and sarcomeric genes causing the phenotype. In addition, INLVM with a hypertrophic dilated left ventricle, ventricular dysfunction, and deep trabeculations, is also inherited, and the genes identified to date differ from those causing DCM. Cypher/ZASP is a newly identified gene encoding a protein that is a component of the Z-line in both skeletal and cardiac muscle.
METHODS: Diagnosis of DCM was performed by echocardiogram, electrocardiogram, and physical examination. In addition, levels of the muscular isoform of creatine kinase were measured to evaluate for skeletal muscle involvement. Cypher/ZASP was screened by denaturing high performance liquid chromatography (DHPLC) and direct deoxyribonucleic acid sequencing.
RESULTS: We identified and screened 100 probands with left ventricular dysfunction. Five mutations in six probands (6% of cases) were identified in patients with familial or sporadic DCM or INLVM. In vitro studies showed cytoskeleton disarray in cells transfected with mutated Cypher/ZASP.
CONCLUSIONS: These data suggest that mutated Cypher/ZASP can cause DCM and INLVM and identify a mechanistic basis.
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Abbreviations and Acronyms
| | BAC | = bacterial artificial chromosome | | DCM | = dilated cardiomyopathy | | DNA | = deoxyribonucleic acid | | DHPLC | = denaturing high performance liquid chromatography | | GFP | = green fluorescence protein | | INLVM | = isolated non-compaction of the left ventricular myocardium | | LVNC | = left ventricular non-compaction | | MRI | = magnetic resonance imaging | | mRNA | = messenger ribonucleic acid | | NYHA | = New York Heart Association | | PCR | = polymerase chain reaction | | RNA | = ribonucleic acid | | RT | = reverse transcription | | SDS | = sodium dodecylsulfate |
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