Pediatric Cardiology

, Volume 25, Issue 5, pp 443–450 | Cite as

Clinical Presentations of Mitochondrial Cardiomyopathies

  • D. Lev
  • A. Nissenkorn
  • E. Leshinsky-Silver
  • M. Sadeh
  • A. Zeharia
  • B. -Z. Garty
  • L. Blieden
  • V. Barash
  • T. Lerman-Sagie
Article

Abstract

To determine the clinical manifestations and interfamilial variability of patients diagnosed with a mitochondrial cardiomyopathy, we reviewed the charts of 14 patients with cardiomyopathy out of 59 patients with mitochondrial disorders who attended the mitochondrial disease clinic at Wolfson Medical Center from 1996 to 2001. All patients underwent a metabolic evaluation including blood lactate, pyruvate, carnitine, and amino acids and urine organic acids. Respiratory chain enzymes were assessed in 10 patients. The mitochondrial DNA (mtDNA) was assessed for mutations.

The age at presentation ranged between 6 months and 24 years. Six of the patients died, 5 from heart failure. The cardiomyopathy was hypertrophic in 10 and dilated in 4. Conduction and rhythm abnormalities were present in 6. Eleven patients had family members with mitochondrial disorders. All the patients had additional involvement of one or more systems. Seven patients exhibited a deficiency of a respiratory chain enzyme in the muscle. The MELAS mtDNA point mutation (3243) was found in one patient. Blood lactic acid levels were increased in 5. Brain MRI abnormalities were observed in 4.

Conclusions

Mitochondrial dysfunction frequently affects the heart and may cause both hypertrophic and dilated cardiomyopathy. The cardiomyopathy is usually a part of a multisystem involvement and may rarely be isolated. The course may be stable for many years, but rapid deterioration may occur. Understanding the biochemical and genetic features of these diseases will enable us to comprehend the clinical heterogeneity of these disorders.

Keywords

Hypertrophic cardiomyopathy Dilated cardiomyopathy Mitochondrial DNA 

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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • D. Lev
    • 1
  • A. Nissenkorn
    • 1
  • E. Leshinsky-Silver
    • 2
    • 3
  • M. Sadeh
    • 4
  • A. Zeharia
    • 5
  • B. -Z. Garty
    • 6
  • L. Blieden
    • 7
  • V. Barash
    • 8
  • T. Lerman-Sagie
    • 1
  1. 1.Mitochondrial Disease Clinic, Metabolic Neurogenetic ServiceWolfson Medical CenterHolonIsrael
  2. 2.Molecular Genetics LaboratoryWolfson Medical CenterHolonIsrael
  3. 3.Institute for Physical HygieneWolfson Medical CenterHolonIsrael
  4. 4.Neurology DepartmentWolfson Medical CenterHolonIsrael
  5. 5.Department of Pediatrics DSchneider’s Children’s Medical Center of Israel, Petah-Tikva, Sackler School of MedicineTel- AvivIsrael
  6. 6.Department of Pediatrics BSchneider’s Children’s Medical Center of Israel, Petah-Tikva, Sackler School of MedicineTel- AvivIsrael
  7. 7.Pediatric Cardiology UnitSchneider’s Children’s Medical Center of Israel, Petah-Tikva, Sackler School of MedicineTel- AvivIsrael
  8. 8.Biochemistry DepartmentHadassah Medical Center, The Hebrew UniversityJerusalemIsrael

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