Increased ventilatory response to exercise in symptomatic and asymptomatic LMNA mutation carriers: a follow-up study.

LMNA mutations are an important cause of cardiomyopathy often leading to cardiac arrhythmias, heart failure and even heart transplantation. An increasing number of asymptomatic mutation carriers are identified, as family members of the index patients are screened. Our aim was to study the disease progression in asymptomatic LMNA mutation carriers and in patients with symptomatic cardiolaminopathy by repeated spiroergometric testing in a prospective clinical follow-up study. We studied 26 LMNA mutation carriers once a year during 5 years up to 6 times by spiroergometry, clinical assessment, laboratory tests and echocardiography. The 23 control subjects underwent clinical assessment and spiroergometry once. Twelve of the mutation carriers were asymptomatic, and 14 had some clinical manifestations of the mutation ranging from clinically relevant rhythm disturbances to DCM and heart failure. Compared to controls, the symptomatic carriers showed a higher slope of the ventilatory equivalent for CO2 (V˙E/V˙CO2 slope) and a lower fraction of end-tidal CO2 (FetCO2 ). The asymptomatic mutation carriers also showed an increased ventilatory response to exercise during the follow-up as indicated by increased V˙E/V˙CO2 slope and decreased FetCO2 . The study suggests that an increased ventilatory response during exercise might reveal a preclinical manifestation of DCM in LMNA mutation carriers. © 2015 The Authors. Clinical Physiology and Functional Imaging published by John Wiley & Sons Ltd on behalf of Scandinavian Society of Clinical Physiology and Nuclear Medicine.

Citation

Laura Ollila, Tiina Heliö, Anssi Sovijärvi, Mikko Jalanko, Maija Kaartinen, Johanna Kuusisto, Satu Kärkkäinen, Raija Jurkko, Eeva Reissell, Eeva Palojoki, Päivi Piirilä. Increased ventilatory response to exercise in symptomatic and asymptomatic LMNA mutation carriers: a follow-up study. Clinical physiology and functional imaging. 2017 Jan;37(1):8-16

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PMID: 27966284

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