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J Am Coll Cardiol, 2003; 42:2014-2027, doi:10.1016/j.jacc.2003.10.021
© 2003 by the American College of Cardiology Foundation
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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{ddagger}, 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*{dagger},*

* Department of Pediatrics (Cardiology), Baylor College of Medicine, Houston, Texas, USA;
{dagger} Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
{ddagger} 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.

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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