Accelerated cardiomyopathy in maternally inherited diabetes and deafness.

TitleAccelerated cardiomyopathy in maternally inherited diabetes and deafness.
Publication TypeJournal Article
Year of Publication2004
AuthorsMangiafico, RA, Zeviani, M, Bartoloni, G, Fiore, CE
JournalInt J Clin Pharmacol Res
Volume24
Issue1
Pagination15-21
Date Published2004
ISSN0251-1649
KeywordsAdolescent, Adult, Deafness, Diabetes Mellitus, DNA, Mitochondrial, Echocardiography, Electrocardiography, Fatal Outcome, Female, Heart Failure, Humans, Middle Aged, Pedigree, Point Mutation, Polymorphism, Restriction Fragment Length, RNA, Transfer, Leu
Abstract

The clinical features and course of cardiac involvement in a patient with maternally inherited diabetes and deafness associated with the mitochondrial DNA 3243 mutation are reported. A 45-year-old woman with maternally transmitted diabetes mellitus and deafness presented with congestive heart failure. The patient showed a short P-R interval on electrocardiogram (ECG) and had developed progression from left ventricular hypertrophy to a hypokinetic cardiomyopathy pattern over the course of 10 months. Rapid cardiac change was accompanied by left ventricular remodeling, as shown by wall thinning on echocardiogram and decrease in QRS voltages on ECG. Coronary arteriography revealed no significant stenosis. In the endomyocardial biopsy specimens, light microscopy showed nonspecific cardiomyopathic changes. Genetic testing for mitochondrial DNA mutations in peripheral blood lymphocytes revealed an adenine (A)-to-guanine (G) substitution at nucleotide 3243 in the mitochondrial DNA encoding the transfer RNA for leucine (tRNA Leu (UUR)). The proportion of mutant mitochondrial DNA was 25%. Two of the patient's daughters, aged 13 and 21 years, who were symptom free, were found to carry the same point mutation. A short P-R interval on ECG in the younger of them was the sole manifestation of the mutation. Unfortunately, 6 months after diagnosis, the patient died suddenly at home. Accelerated cardiomyopathy can occur as a mitochondria-related complication in patients with maternally inherited diabetes and deafness associated with the 3243 mutation.

Alternate JournalInt J Clin Pharmacol Res
Citation Key1331
PubMed ID15575173