Cardiac involvement in genotype-positive Fabry disease patients assessed by cardiovascular MR

Kozor, Rebecca, Grieve, Stuart M., Tchan, Michel C., Callaghan, Fraser, Hamilton-Craig, Christian, Denaro, Charles, Moon, James C. and Figtree, Gemma A. (2016) Cardiac involvement in genotype-positive Fabry disease patients assessed by cardiovascular MR. Heart, 102 4: 298-302. doi:10.1136/heartjnl-2015-308494

Author Kozor, Rebecca
Grieve, Stuart M.
Tchan, Michel C.
Callaghan, Fraser
Hamilton-Craig, Christian
Denaro, Charles
Moon, James C.
Figtree, Gemma A.
Title Cardiac involvement in genotype-positive Fabry disease patients assessed by cardiovascular MR
Journal name Heart   Check publisher's open access policy
ISSN 1355-6037
Publication date 2016-02-01
Year available 2016
Sub-type Article (original research)
DOI 10.1136/heartjnl-2015-308494
Open Access Status Not Open Access
Volume 102
Issue 4
Start page 298
End page 302
Total pages 5
Place of publication London, United Kingdom
Publisher BMJ Group
Language eng
Formatted abstract
Objective Cardiac magnetic resonance (CMR) has the potential to provide early detection of cardiac involvement in Fabry disease. We aimed to gain further insight into this by assessing a cohort of Fabry patients using CMR.

Methods/results Fifty genotype-positive Fabry subjects (age 45±2 years; 50% male) referred for CMR and 39 matched controls (age 40±2 years; 59% male) were recruited. Patients had a mean Mainz severity score index of 15±2 (range 0–46), reflecting an overall mild degree of disease severity. Compared with controls, Fabry subjects had a 34% greater left ventricular mass (LVM) index (82±5 vs 61±2 g/m2, p=0.001) and had a significantly greater papillary muscle contribution to total LVM (13±1 vs 6±0.5%, p<0.001), even in the absence of left ventricular hypertrophy (LVH). Late gadolinium enhancement (LGE) was present in 15 Fabry subjects (9/21 males and 6/23 females). The most common site for LGE was the basal inferolateral wall (93%, 14/15). There was a positive association between LVM index and LGE. Despite this, there were two males and three females with no LVH that displayed LGE. Of Fabry subjects who were not on enzyme replacement therapy at enrolment (n=28), six were reclassified as having cardiac involvement (four LVH-negative/LGE-positive, one LVH-positive/LGE-positive and one LVH-positive/LGE-negative).

Conclusions CMR was able to detect cardiac involvement in 48% of this Fabry cohort, despite the overall mild disease phenotype of the cohort. Of those not on ERT, 21% were reclassified as having cardiac involvement allowing improved risk stratification and targeting of therapy.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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