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Long QT syndrome 9(LQT9)

MedGen UID:
395635
Concept ID:
C2678485
Disease or Syndrome
Synonym: LQT9
 
Gene (location): CAV3 (3p25.3)
 
Monarch Initiative: MONDO:0012736
OMIM®: 611818

Authors:
Alexander J Groffen  |  Hennie Bikker  |  Imke Christiaans   view full author information

Additional descriptions

From GeneReviews Overview
Long QT syndrome (LQTS) is a cardiac electrophysiologic disorder, characterized by QT prolongation and T-wave abnormalities on the EKG that are associated with tachyarrhythmias, typically the ventricular tachycardia torsade de pointes (TdP). TdP is usually self-terminating, thus causing a syncopal event, the most common symptom in individuals with LQTS. Such cardiac events typically occur during exercise and emotional stress, less frequently during sleep, and usually without warning. In some instances, TdP degenerates to ventricular fibrillation and causes aborted cardiac arrest (if the individual is defibrillated) or sudden death. Approximately 50% of untreated individuals with a pathogenic variant in one of the genes associated with LQTS have symptoms, usually one to a few syncopal events. While cardiac events may occur from infancy through middle age, they are most common from the preteen years through the 20s. Some types of LQTS are associated with a phenotype extending beyond cardiac arrhythmia. In addition to the prolonged QT interval, associations include muscle weakness and facial dysmorphism in Andersen-Tawil syndrome (LQTS type 7); hand/foot, facial, and neurodevelopmental features in Timothy syndrome (LQTS type 8); and profound sensorineural hearing loss in Jervell and Lange-Nielson syndrome.
From OMIM
Congenital long QT syndrome is electrocardiographically characterized by a prolonged QT interval and polymorphic ventricular arrhythmias (torsade de pointes). These cardiac arrhythmias may result in recurrent syncope, seizure, or sudden death (Jongbloed et al., 1999). For a discussion of genetic heterogeneity of long QT syndrome, see LQT1 (192500).  http://www.omim.org/entry/611818

Clinical features

From HPO
Chest pain
MedGen UID:
2992
Concept ID:
C0008031
Sign or Symptom
An unpleasant sensation characterized by physical discomfort (such as pricking, throbbing, or aching) localized to the chest.
Cardiac arrest
MedGen UID:
5456
Concept ID:
C0018790
Finding
An abrupt loss of heart function.
Syncope
MedGen UID:
21443
Concept ID:
C0039070
Sign or Symptom
Syncope is a syndrome in which loss of consciousness is of relatively sudden onset, temporary (usually less than 1 to 2 minutes), self-terminating, and of usually rapid recovery. Syncope leads to a generalized weakness of muscles with loss of postural tone, inability to stand upright, and loss of consciousness. Once the patient is in a horizontal position, blood flow to the brain is no longer hindered by gravitation and consciousness is regained. Unconsciousness usually lasts for seconds to minutes. Headache and drowsiness (which usually follow seizures) do not follow a syncopal attack. Syncope results from a sudden impairment of brain metabolism usually due to a reduction in cerebral blood flow.
Sinus bradycardia
MedGen UID:
39316
Concept ID:
C0085610
Pathologic Function
Bradycardia related to a mean resting sinus rate of less than 50 beats per minute.
Ventricular arrhythmia
MedGen UID:
39082
Concept ID:
C0085612
Disease or Syndrome
A disorder characterized by an electrocardiographic finding of an atypical cardiac rhythm resulting from a pathologic process in the cardiac ventricles.
Prolonged QT interval
MedGen UID:
57494
Concept ID:
C0151878
Finding
Increased time between the start of the Q wave and the end of the T wave as measured by the electrocardiogram (EKG).
Abnormal U wave
MedGen UID:
820422
Concept ID:
C3827674
Finding
An anomaly of the U wave of the electrocardiogram (EKG). The U wave is a small (0.5 mm) deflection immediately following the T wave, usually in the same direction as the T wave. It is best seen in leads V2 and V3.

Recent clinical studies

Etiology

Adler A, Sadek MM, Chan AY, Dell E, Rutberg J, Davis D, Green MS, Spears DA, Gollob MH
Circ Arrhythm Electrophysiol 2016 Jan;9(1):e003440. doi: 10.1161/CIRCEP.115.003440. PMID: 26743238
Hofferberth SC, Cecchin F, Loberman D, Fynn-Thompson F
J Thorac Cardiovasc Surg 2014 Jan;147(1):404-9. Epub 2013 Oct 24 doi: 10.1016/j.jtcvs.2013.07.064. PMID: 24268954
Gow RM, Borghese MM, Honeywell CR, Colley RC
Circ Arrhythm Electrophysiol 2013 Oct;6(5):939-45. Epub 2013 Aug 30 doi: 10.1161/CIRCEP.113.000514. PMID: 23994883
Stefanelli CB, Bradley DJ, Leroy S, Dick M 2nd, Serwer GA, Fischbach PS
J Interv Card Electrophysiol 2002 Jul;6(3):235-44. doi: 10.1023/a:1019509803992. PMID: 12154326
Love BA, Barrett KS, Alexander ME, Bevilacqua LM, Epstein MR, Triedman JK, Walsh EP, Berul CI
J Cardiovasc Electrophysiol 2001 Oct;12(10):1097-101. doi: 10.1046/j.1540-8167.2001.01097.x. PMID: 11699514

Diagnosis

Adler A, Sadek MM, Chan AY, Dell E, Rutberg J, Davis D, Green MS, Spears DA, Gollob MH
Circ Arrhythm Electrophysiol 2016 Jan;9(1):e003440. doi: 10.1161/CIRCEP.115.003440. PMID: 26743238
Hofferberth SC, Cecchin F, Loberman D, Fynn-Thompson F
J Thorac Cardiovasc Surg 2014 Jan;147(1):404-9. Epub 2013 Oct 24 doi: 10.1016/j.jtcvs.2013.07.064. PMID: 24268954
Stefanelli CB, Bradley DJ, Leroy S, Dick M 2nd, Serwer GA, Fischbach PS
J Interv Card Electrophysiol 2002 Jul;6(3):235-44. doi: 10.1023/a:1019509803992. PMID: 12154326
Love BA, Barrett KS, Alexander ME, Bevilacqua LM, Epstein MR, Triedman JK, Walsh EP, Berul CI
J Cardiovasc Electrophysiol 2001 Oct;12(10):1097-101. doi: 10.1046/j.1540-8167.2001.01097.x. PMID: 11699514

Therapy

Hofferberth SC, Cecchin F, Loberman D, Fynn-Thompson F
J Thorac Cardiovasc Surg 2014 Jan;147(1):404-9. Epub 2013 Oct 24 doi: 10.1016/j.jtcvs.2013.07.064. PMID: 24268954
Love BA, Barrett KS, Alexander ME, Bevilacqua LM, Epstein MR, Triedman JK, Walsh EP, Berul CI
J Cardiovasc Electrophysiol 2001 Oct;12(10):1097-101. doi: 10.1046/j.1540-8167.2001.01097.x. PMID: 11699514

Prognosis

Vaidyanathan R, Van Ert H, Haq KT, Morotti S, Esch S, McCune EC, Grandi E, Eckhardt LL
Circ Arrhythm Electrophysiol 2018 Jan;11(1):e005800. doi: 10.1161/CIRCEP.117.005800. PMID: 29326130Free PMC Article
Stefanelli CB, Bradley DJ, Leroy S, Dick M 2nd, Serwer GA, Fischbach PS
J Interv Card Electrophysiol 2002 Jul;6(3):235-44. doi: 10.1023/a:1019509803992. PMID: 12154326
Love BA, Barrett KS, Alexander ME, Bevilacqua LM, Epstein MR, Triedman JK, Walsh EP, Berul CI
J Cardiovasc Electrophysiol 2001 Oct;12(10):1097-101. doi: 10.1046/j.1540-8167.2001.01097.x. PMID: 11699514

Clinical prediction guides

Vaidyanathan R, Van Ert H, Haq KT, Morotti S, Esch S, McCune EC, Grandi E, Eckhardt LL
Circ Arrhythm Electrophysiol 2018 Jan;11(1):e005800. doi: 10.1161/CIRCEP.117.005800. PMID: 29326130Free PMC Article

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