TY - JOUR
T1 - Clinical presentation of calmodulin mutations
T2 - the International Calmodulinopathy Registry
AU - Crotti, Lia
AU - Spazzolini, Carla
AU - Nyegaard, Mette
AU - Overgaard, Michael T.
AU - Kotta, Maria-Christina
AU - Dagradi, Federica
AU - Sala, Luca
AU - Aiba, Takeshi
AU - Ayers, Mark D.
AU - Baban, Anwar
AU - Barc, Julien
AU - Beach, Cheyenne M.
AU - Behr, Elijah R.
AU - Bos, J. Martijn
AU - Cerrone, Marina
AU - Covi, Peter
AU - Cuneo, Bettina
AU - Denjoy, Isabelle
AU - Donner, Birgit
AU - Elbert, Adrienne
AU - Eliasson, H. kan
AU - Etheridge, Susan P.
AU - Fukuyama, Megumi
AU - Girolami, Francesca
AU - Hamilton, Robert
AU - Horie, Minoru
AU - Iascone, Maria
AU - Jaimez, Juan Jiménez
AU - Jensen, Henrik Kjærulf
AU - Kannankeril, Prince J.
AU - Kaski, Juan P.
AU - Makita, Naomasa
AU - Muñoz-Esparza, Carmen
AU - Odland, Hans H.
AU - Ohno, Seiko
AU - Papagiannis, John
AU - Porretta, Alessandra Pia
AU - Prandstetter, Christopher
AU - Probst, Vincent
AU - Robyns, Tomas
AU - Rosenthal, Eric
AU - Rosés-Noguer, Ferran
AU - Sekarski, Nicole
AU - Singh, Anoop
AU - Spentzou, Georgia
AU - Stute, Fridrike
AU - Tfelt-Hansen, Jacob
AU - Till, Jan
AU - Tobert, Kathryn E.
AU - Vinocur, Jeffrey M.
AU - Webster, Gregory
AU - Wilde, Arthur A. M.
AU - Wolf, Cordula M.
AU - Ackerman, Michael J.
AU - Schwartz, Peter J.
N1 - Funding Information: We thank Pinuccia De Tomasi for expert editorial support and Alice Ghidoni for initial support in genetic variant classification. Special thanks are due to all the families represented in this registry. L.C., P.J.S., C.S., and F.D. are proud members of the European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-Heart). The open access charge was funded by BIBLIOSAN. Funding Information: The ICalmR is one of the registries supported by ERN GUARD-Heart. This research was supported by the Italian Ministry of Health Ricerca Corrente ‘Registro internazionale delle calmodulinopatie’ to L.C., F.D., P.J.S., M.C.K., and C.S.; by the 2019-ATESP-0045 Fondo di Ateneo Quota Competitiva to L.C.; and partially by the Fondation Leducq grant 18CVD05 ‘Towards Precision Medicine with Human iPSCs for Cardiac Channelopathies’ to L.C., M.-C.K., L.S., and P.J.S. J.B., L.C., and P.J.S. were partially supported by the European Joint Programme on Rare Diseases: LQTS-NEXT grant. R.H. was supported by the Canadian Institutes of Health Research, the Heart and Stroke Foundation of Canada, The Labatt Family Heart Centre, the Cartwright Family Fellowship, the Carter Heart Arrhythmia Trainee Fund and the Caitlin Elizabeth Morris fund. J.P.K. was supported by the Medical Research Council (MRC) Clinical Academic Research Partnership (CARP) Award (MR/T024062/1). G.R.W. was supported by an NIH K23HL130554 grant. A.A.M.W. was supported by the Netherlands Cardiovascular Research Initiative (CVON PREDICT-2). M.J.A. was supported in part by the Mayo Clinic Windland Smith Rice Comprehensive Sudden Cardiac Death Program. M.T.O. was supported in part by the Danish Independent Research Council (Grant no. 2032–00333B) and the Lundbeck Foundation (Grant no. R324-2019-1933). H.K.J. was supported by the Novo Nordisk Foundation (Grant NNF 18OC0031258). Publisher Copyright: © 2023 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2023/9/14
Y1 - 2023/9/14
N2 - AIMS: Calmodulinopathy due to mutations in any of the three CALM genes (CALM1-3) causes life-threatening arrhythmia syndromes, especially in young individuals. The International Calmodulinopathy Registry (ICalmR) aims to define and link the increasing complexity of the clinical presentation to the underlying molecular mechanisms. METHODS AND RESULTS: The ICalmR is an international, collaborative, observational study, assembling and analysing clinical and genetic data on CALM-positive patients. The ICalmR has enrolled 140 subjects (median age 10.8 years [interquartile range 5-19]), 97 index cases and 43 family members. CALM-LQTS and CALM-CPVT are the prevalent phenotypes. Primary neurological manifestations, unrelated to post-anoxic sequelae, manifested in 20 patients. Calmodulinopathy remains associated with a high arrhythmic event rate (symptomatic patients, n = 103, 74%). However, compared with the original 2019 cohort, there was a reduced frequency and severity of all cardiac events (61% vs. 85%; P = .001) and sudden death (9% vs. 27%; P = .008). Data on therapy do not allow definitive recommendations. Cardiac structural abnormalities, either cardiomyopathy or congenital heart defects, are present in 30% of patients, mainly CALM-LQTS, and lethal cases of heart failure have occurred. The number of familial cases and of families with strikingly different phenotypes is increasing. CONCLUSION: Calmodulinopathy has pleiotropic presentations, from channelopathy to syndromic forms. Clinical severity ranges from the early onset of life-threatening arrhythmias to the absence of symptoms, and the percentage of milder and familial forms is increasing. There are no hard data to guide therapy, and current management includes pharmacological and surgical antiadrenergic interventions with sodium channel blockers often accompanied by an implantable cardioverter-defibrillator.
AB - AIMS: Calmodulinopathy due to mutations in any of the three CALM genes (CALM1-3) causes life-threatening arrhythmia syndromes, especially in young individuals. The International Calmodulinopathy Registry (ICalmR) aims to define and link the increasing complexity of the clinical presentation to the underlying molecular mechanisms. METHODS AND RESULTS: The ICalmR is an international, collaborative, observational study, assembling and analysing clinical and genetic data on CALM-positive patients. The ICalmR has enrolled 140 subjects (median age 10.8 years [interquartile range 5-19]), 97 index cases and 43 family members. CALM-LQTS and CALM-CPVT are the prevalent phenotypes. Primary neurological manifestations, unrelated to post-anoxic sequelae, manifested in 20 patients. Calmodulinopathy remains associated with a high arrhythmic event rate (symptomatic patients, n = 103, 74%). However, compared with the original 2019 cohort, there was a reduced frequency and severity of all cardiac events (61% vs. 85%; P = .001) and sudden death (9% vs. 27%; P = .008). Data on therapy do not allow definitive recommendations. Cardiac structural abnormalities, either cardiomyopathy or congenital heart defects, are present in 30% of patients, mainly CALM-LQTS, and lethal cases of heart failure have occurred. The number of familial cases and of families with strikingly different phenotypes is increasing. CONCLUSION: Calmodulinopathy has pleiotropic presentations, from channelopathy to syndromic forms. Clinical severity ranges from the early onset of life-threatening arrhythmias to the absence of symptoms, and the percentage of milder and familial forms is increasing. There are no hard data to guide therapy, and current management includes pharmacological and surgical antiadrenergic interventions with sodium channel blockers often accompanied by an implantable cardioverter-defibrillator.
KW - Calmodulin
KW - Cardiomyopathies
KW - Catecholaminergic polymorphic ventricular tachycardia
KW - Idiopathic ventricular fibrillation
KW - Long QT syndrome
KW - Neurological disorders
KW - Sudden death
UR - http://www.scopus.com/inward/record.url?scp=85170699059&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/eurheartj/ehad418
DO - https://doi.org/10.1093/eurheartj/ehad418
M3 - Article
C2 - 37528649
SN - 0195-668X
VL - 44
SP - 3357
EP - 3370
JO - European Heart journal
JF - European Heart journal
IS - 35
ER -