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Article: Clinical and genetic profile of congenital long QT syndrome in Hong Kong: a 20-year experience in paediatrics

TitleClinical and genetic profile of congenital long QT syndrome in Hong Kong: a 20-year experience in paediatrics
Authors
Issue Date2018
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/
Citation
Hong Kong Medical Journal, 2018, v. 24 n. 6, p. 561-570 How to Cite?
AbstractIntroduction: Congenital long QT syndrome (LQTS) is a genetically transmitted cardiac channelopathy that can lead to sudden cardiac death. This study aimed to report the clinical and genetic characteristics of all young patients diagnosed with LQTS in the only tertiary paediatric cardiology centre in Hong Kong. Methods: This is a retrospective review of all paediatric and young adult patients diagnosed at our centre with LQTS from January 1997 to December 2016. The diagnosis of LQTS was established with a corrected QT interval (QTc) ≥480 ms, Schwartz score of >3 points, or the presence of a pathogenic mutation. Results: Fifty-nine patients (33 males) from 52 families were included, with a mean age of 8.17 years (range, 0.00-16.95 years) at presentation. Five patients had concomitant congenital heart diseases. The mean follow-up duration was 5.33 ± 4.65 years. The mean QTc in the cohort was 504 ± 47 ms. They presented with syncope and convulsion (49%), cardiac arrest (10%), bradycardia and neonatal atrioventricular block (12%). Fifteen (25%) patients were asymptomatic at diagnosis. Thirty-eight (64.4%) patients were confirmed to have a pathogenic mutation for LQTS genes. Forty-five (76.3%) patients received beta blocker therapy. Thirteen (22.0%) patients required implantable cardioverter defibrillator. There was no mortality in the study period. The 1-, 5-, and 10-year breakthrough cardiac event–free rates were 93.0%, 80.7%, and 72.6%, respectively. Conclusion: Identification of the disorder, administration of beta blockers, and lifestyle modification can prevent subsequent cardiac events in LQTS. Genotyping in patients with LQTS is essential in guiding medical therapy and improving prognosis.
Persistent Identifierhttp://hdl.handle.net/10722/266023
ISSN
2017 Impact Factor: 1.226
2015 SCImago Journal Rankings: 0.279
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorKwok, SY-
dc.contributor.authorLiu, APY-
dc.contributor.authorChan, CYY-
dc.contributor.authorLun, KS-
dc.contributor.authorFung, LF-
dc.contributor.authorMak, CCY-
dc.contributor.authorChung, BHY-
dc.contributor.authorYung, TC-
dc.date.accessioned2018-12-17T02:16:34Z-
dc.date.available2018-12-17T02:16:34Z-
dc.date.issued2018-
dc.identifier.citationHong Kong Medical Journal, 2018, v. 24 n. 6, p. 561-570-
dc.identifier.issn1024-2708-
dc.identifier.urihttp://hdl.handle.net/10722/266023-
dc.description.abstractIntroduction: Congenital long QT syndrome (LQTS) is a genetically transmitted cardiac channelopathy that can lead to sudden cardiac death. This study aimed to report the clinical and genetic characteristics of all young patients diagnosed with LQTS in the only tertiary paediatric cardiology centre in Hong Kong. Methods: This is a retrospective review of all paediatric and young adult patients diagnosed at our centre with LQTS from January 1997 to December 2016. The diagnosis of LQTS was established with a corrected QT interval (QTc) ≥480 ms, Schwartz score of >3 points, or the presence of a pathogenic mutation. Results: Fifty-nine patients (33 males) from 52 families were included, with a mean age of 8.17 years (range, 0.00-16.95 years) at presentation. Five patients had concomitant congenital heart diseases. The mean follow-up duration was 5.33 ± 4.65 years. The mean QTc in the cohort was 504 ± 47 ms. They presented with syncope and convulsion (49%), cardiac arrest (10%), bradycardia and neonatal atrioventricular block (12%). Fifteen (25%) patients were asymptomatic at diagnosis. Thirty-eight (64.4%) patients were confirmed to have a pathogenic mutation for LQTS genes. Forty-five (76.3%) patients received beta blocker therapy. Thirteen (22.0%) patients required implantable cardioverter defibrillator. There was no mortality in the study period. The 1-, 5-, and 10-year breakthrough cardiac event–free rates were 93.0%, 80.7%, and 72.6%, respectively. Conclusion: Identification of the disorder, administration of beta blockers, and lifestyle modification can prevent subsequent cardiac events in LQTS. Genotyping in patients with LQTS is essential in guiding medical therapy and improving prognosis.-
dc.languageeng-
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/-
dc.relation.ispartofHong Kong Medical Journal-
dc.rightsHong Kong Medical Journal. Copyright © Hong Kong Academy of Medicine Press.-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.titleClinical and genetic profile of congenital long QT syndrome in Hong Kong: a 20-year experience in paediatrics-
dc.typeArticle-
dc.identifier.emailKwok, SY: ksy464@hku.hk-
dc.identifier.emailLiu, APY: apyliu@hku.hk-
dc.identifier.emailLun, KS: lunks@hkucc.hku.hk-
dc.identifier.emailFung, LF: jasflf@connect.hku.hk-
dc.identifier.emailChung, BHY: bhychung@hku.hk-
dc.identifier.emailYung, TC: tcyung@hkusua.hku.hk-
dc.identifier.authorityLiu, APY=rp01357-
dc.identifier.authorityChung, BHY=rp00473-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.12809/hkmj187487-
dc.identifier.pmid30530868-
dc.identifier.scopuseid_2-s2.0-85058461935-
dc.identifier.hkuros296421-
dc.identifier.volume24-
dc.identifier.issue6-
dc.identifier.spage561-
dc.identifier.epage570-
dc.identifier.isiWOS:000452729900003-
dc.publisher.placeHong Kong-

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