Skip to main content

Geographical distribution of plakophilin-2 mutation prevalence in patients with arrhythmogenic cardiomyopathy

Abstract

Arrhythmogenic cardiomyopathy (AC) is characterised by myocardial fibrofatty tissue infiltration and presents with palpitations, ventricular arrhythmias, syncope and sudden cardiac death. AC is associated with mutations in genes encoding the desmosomal proteins plakophilin-2 (PKP2), desmoplakin (DSP), desmoglein-2 (DSG2), desmocollin-2 (DSC2) and junctional plakoglobin (JUP). In the present study we compared 28 studies (2004–2011) on the prevalence of mutations in desmosomal protein encoding genes in relation to geographic distribution of the study population. In most populations, mutations in PKP2 showed the highest prevalence. Mutation prevalence in DSP, DSG2 and DSC2 varied among the different geographic regions. Mutations in JUP were rarely found, except in Denmark and the Greece/Cyprus region.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

References

  1. Basso C, Corrado D, Marcus FI, et al. Arrhythmogenic right ventricular cardiomyopathy. Lancet. 2009;373:1289–9.

    PubMed  Article  Google Scholar 

  2. Herren T, Gerber PA, Duru F. Arrhythmogenic right ventricular cardiomyopathy/dysplasia: a not so rare ‘disease of the desmosome’ with multiple clinical presentations. Clin Res Cardiol. 2009;98:141–58.

    PubMed  Article  Google Scholar 

  3. Priori SG, Aliot E, Blomstrom-Lundqvist C, et al. Task Force on sudden cardiac death of the European Society of Cardiology. Eur Heart J. 2001;22:1374–450.

    PubMed  Article  CAS  Google Scholar 

  4. Noorman M, Van der Heyden MAG, Van Veen TA, et al. Cardiac cell-cell junctions in health and disease: Electrical versus mechanical coupling. J Mol Cell Cardiol. 2009;47:23–31.

    PubMed  Article  CAS  Google Scholar 

  5. Cheng L, Yung A, Covarrubias M, et al. Cortactin is required for N-cadherin regulation of Kv1.5 channel function. J Biol Chem. 2011;286:20478–89.

    PubMed  Article  CAS  Google Scholar 

  6. Gerull B, Heuser A, Wichter T, et al. Mutations in the desmosomal protein plakophilin-2 are common in arrhythmogenic right ventricular cardiomyopathy. Nat Genet. 2004;36:62–1164.

    Article  Google Scholar 

  7. Watkins DA, Hendricks N, Shaboodien G, et al. ARVC Registry of the Cardiac Arrhythmia Society of Southern Africa (CASSA). Clinical features, survival experience, and profile of plakophylin-2 gene mutations in participants of the arrhythmogenic right ventricular cardiomyopathy registry of South Africa. Hear Rhythm. 2009;6(11 Suppl):S10–7.

    Article  Google Scholar 

  8. Lahtinen AM, Lehtonen E, Marjamaa A, et al. Population-prevalent desmosomal mutations predisposing to arrhythmogenic right ventricular cardiomyopathy. Hear Rhythm. 2011;8:1214–21.

    Article  Google Scholar 

  9. Van der Zwaag PA, Cox MGPJ, Van der Werf C, et al. Recurrent and founder mutations in the Netherlands. Neth Heart J. 2010;18:583–91.

    Article  Google Scholar 

  10. Marcus FI, McKenna WJ, Sherrill D, et al. Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the Task Force Criteria. Eur Heart J. 2010;31:806–14.

    PubMed  Article  Google Scholar 

  11. McKenna WJ, Thiene G, Nava A, et al. Diagnosis of arrhythmogenic right ventricular dysplasia/cardiomyopathy. Task Force of the Working Group Myocardial and Pericardial Disease of the European Society of Cardiology and of the Scientific Council on Cardiomyopathies of the International Society and Federation of Cardiology. Br Heart J. 1994;71:215–8.

    PubMed  Article  CAS  Google Scholar 

  12. Kapplinger JD, Landstrom AP, Salisbury BA, et al. Distinguishing Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia-associated mutations from background genetic noise. J Am Coll Cardiol. 2011;57:2317–27.

    PubMed  Article  CAS  Google Scholar 

  13. Beffagna G, Occhi G, Nava A, et al. Regulatory mutations in transforming growth factor-beta3 gene cause arrhythmogenic right ventricular cardiomyopathy type 1. Cardiovasc Res. 2005;65:366–73.

    PubMed  Article  CAS  Google Scholar 

  14. Tiso N, Stephan DA, Nava A, et al. Identification of mutations in the cardiac ryanodine receptor gene in families affected with arrhythmogenic right ventricular cardiomyopathy type 2 (ARVD2). Hum Mol Genet. 2001;10:189–94.

    PubMed  Article  CAS  Google Scholar 

  15. Merner ND, Hodgkinson KA, Haywood AF, et al. Arrhythmogenic right ventricular cardiomyopathy type 5 is a fully penetrant, lethal arrhythmic disorder caused by a missense mutation in the TMEM43 gene. Am J Hum Genet. 2008;82:809–21.

    PubMed  Article  CAS  Google Scholar 

  16. Groeneweg JA, Van der Zwaag PA, Van der Werf C, et al. Revised 2010 Task Force Criteria for ARVD/C diagnosis promote inclusion of non-desmosomal mutation carriers. Circulation. 2011;124:A12326.

    Google Scholar 

  17. Christensen AH, Benn M, Tybjærg-Hansen A, et al. Screening of three novel candidate genes in arrhythmogenic right ventricular cardiomyopathy. Genet Test Mol Biomarkers. 2011;15:267–71.

    PubMed  Article  CAS  Google Scholar 

  18. Fressart V, Duthoit G, Donal E, et al. Desmosomal gene analysis in arrhythmogenic right ventricular dysplasia/cardiomyopathy: spectrum of mutations and clinical impact in practice. Europace. 2010;12:861–8.

    PubMed  Article  Google Scholar 

  19. Sen-Chowdhry S, Syrris P, Ward D, et al. Clinical and genetic characterization of families with arrhythmogenic right ventricular dysplasia/cardiomyopathy provides novel insights into patterns of disease expression. Circulation. 2007;115:1710–20.

    PubMed  Article  Google Scholar 

  20. Pilichou K, Nava A, Basso C, et al. Mutations in desmoglein-2 gene are associated with arrhythmogenic right ventricular cardiomyopathy. Circulation. 2006;113:1171–9.

    PubMed  Article  CAS  Google Scholar 

  21. Awad MM, Dalal D, Cho E, et al. DSG2 mutations contribute to arrhythmogenic right ventricular dysplasia/cardiomyopathy. Am J Hum Genet. 2006;79:136–42.

    PubMed  Article  CAS  Google Scholar 

  22. Den Haan AD, Tan BY, Zikusoka MN, et al. Comprehensive desmosome mutation analysis in North Americans with Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy. Circ Cardiovasc Genet. 2009;2:428–35.

    Article  Google Scholar 

  23. Barahona-Dussault C, Benito B, Campuzano O, et al. Role of genetic testing in arrhythmogenic right ventricular cardiomyopathy/dysplasia. Clin Genet. 2010;77:37–48.

    PubMed  Article  CAS  Google Scholar 

  24. Sen-Chowdhry S, Syrris P, McKenna WJ. Role of genetic analysis in the management of patients with Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy. J Am Coll Cardiol. 2007;50:1813–21.

    PubMed  Article  CAS  Google Scholar 

  25. Cox MGPJ, Van der Zwaag PA, Van der Werf C, et al. Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy. Pathogenic desmosome mutations in index-patients predict outcome of family screening: Dutch Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy genotype-phenotype follow-up study. Circulation. 2011;123:2690–700.

    PubMed  Article  Google Scholar 

  26. Bauce B, Nava A, Beffagna G, et al. Multiple mutations in desmosomal proteins encoding genes in arrhythmogenic right ventricular cardiomyopathy/dysplasia. Hear Rhythm. 2010;7:22–9.

    Article  Google Scholar 

  27. Christensen AH, Benn M, Bundgaard H, et al. Wide spectrum of desmosomal mutations in Danish patients with arrhythmogenic right ventricular cardiomyopathy. J Med Genet. 2010;47:736–44.

    PubMed  Article  CAS  Google Scholar 

  28. Dalal D, Molin LH, Piccini J, et al. Clinical features of arrhythmogenic right ventricular dysplasia/cardiomyopathy associated with mutations in plakophilin-2. Circulation. 2006;113:1634–7.

    Article  Google Scholar 

  29. Yang Z, Bowles NE, Scherer SE, et al. Desmosomal dysfunction due to mutations in desmoplakin causes arrhythmogenic right ventricular dysplasia/cardiomyopathy. Circ Res. 2006;99:646–55.

    PubMed  Article  CAS  Google Scholar 

  30. Marcus FI, Zareba W, Calkins H, et al. Arrhythmogenic right ventricular cardiomyopathy/dysplasia clinical presentation and diagnostic evaluation: results from the North American Multidisciplinary Study. Hear Rhythm. 2009;6:984–92.

    Article  Google Scholar 

  31. Heuser A, Plovie ER, Ellinor PT, et al. Mutant desmocollin-2 causes arrhythmogenic right ventricular cardiomyopathy. Am J Hum Genet. 2006;79:1081–8.

    PubMed  Article  CAS  Google Scholar 

  32. Syrris P, Ward D, Evans A, et al. Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy associated with mutations in the desmosomal gene desmocollin-2. Am J Hum Genet. 2006;79:978–84.

    PubMed  Article  CAS  Google Scholar 

  33. Syrris P, Ward D, Asimaki A, et al. Clinical expression of plakophilin-2 mutations in familial Arrhythmogenic Right Ventricular Cardiomyopathy. Circulation. 2006;113:356–64.

    PubMed  Article  CAS  Google Scholar 

  34. Syrris P, Ward D, Asimaki A, et al. Desmoglein-2 mutations in arrhythmogenic right ventricular cardiomyopathy: a genotype-phenotype characterization of familial disease. Eur Heart J. 2007;28:581–8.

    PubMed  Article  CAS  Google Scholar 

  35. Van Tintelen JP, Entius MM, Bhuiyan ZA, et al. Plakophilin-2 mutations are the major determinant of familial arrhythmogenic right ventricular dysplasia/cardiomyopathy. Circulation. 2006;113:1650–8.

    PubMed  Article  Google Scholar 

  36. Bhuiyan ZA, Jongbloed JD, van der Smagt J, et al. Desmoglein-2 and desmocollin-2 mutations in Dutch arrhythmogenic right ventricular dysplasia/cardiomypathy patients: results from a multicenter study. Circ Cardiovasc Genet. 2009;2:418–27.

    PubMed  Article  CAS  Google Scholar 

  37. Basso C, Czarnowska E, Della Barbera M, et al. Ultrastructural evidence of intercalated disc remodelling in arrhythmogenic right ventricular cardiomyopathy: an electron microscopy investigation on endomyocardial biopsies. Eur Heart J. 2006;27:1847–54.

    PubMed  Article  Google Scholar 

  38. Antoniades L, Tsatsopoulou A, Anastasakis A, et al. Arrhythmogenic right ventricular cardiomyopathy caused by deletions in plakophilin-2 and plakoglobin (Naxos disease) in families from Greece and Cyprus: genotype-phenotype relations, diagnostic features and prognosis. Eur Heart J. 2006;27:2208–16.

    PubMed  Article  CAS  Google Scholar 

  39. Christensen AH, Benn M, Tybjaerg-Hansen A, et al. Missense variants in plakophilin-2 in arrhythmogenic right ventricular cardiomyopathy patients–disease-causing or innocent bystanders? Cardiology. 2010;115:148–54.

    PubMed  Article  CAS  Google Scholar 

  40. Lahtinen AM, Lehtonen A, Kaartinen M, et al. Plakophilin-2 missense mutations in arrhythmogenic right ventricular cardiomyopathy. Int J Cardiol. 2008;126:92–100.

    PubMed  Article  Google Scholar 

  41. Qiu X, Liu W, Hu D, et al. Mutations of plakophilin-2 in Chinese with arrhythmogenic right ventricular dysplasia/cardiomyopathy. Am J Cardiol. 2009;103:1439–44.

    PubMed  Article  CAS  Google Scholar 

Download references

Acknowledgements

KAJ is a medical student participating in the Honours program of the Faculty of Medicine, UMC Utrecht. This work is financially supported by the Netherlands Heart Foundation grant 2007B139 and the Interuniversity Cardiology Institute of the Netherlands (ICIN) project # 06901.

Author information

Affiliations

Authors

Corresponding author

Correspondence to M. A. G. van der Heyden.

Additional information

Kirolos A. Jacob and Maartje Noorman contributed equally to this study.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Jacob, K.A., Noorman, M., Cox, M.G.P.J. et al. Geographical distribution of plakophilin-2 mutation prevalence in patients with arrhythmogenic cardiomyopathy. Neth Heart J 20, 234–239 (2012). https://doi.org/10.1007/s12471-012-0274-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12471-012-0274-x

Keywords

  • Cardiomyopathy
  • Plakophilin-2
  • Mutation
  • Desmosome
  • Prevalence
  • Geography