Entry - #613243 - CARDIOMYOPATHY, FAMILIAL HYPERTROPHIC, 13; CMH13 - OMIM
# 613243

CARDIOMYOPATHY, FAMILIAL HYPERTROPHIC, 13; CMH13


Phenotype-Gene Relationships

Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
Gene/Locus Gene/Locus
MIM number
3p21.1 Cardiomyopathy, hypertrophic, 13 613243 AD 3 TNNC1 191040
Clinical Synopsis
 
Phenotypic Series
 

INHERITANCE
- Autosomal dominant
CARDIOVASCULAR
Heart
- Dyspnea on exertion
- Syncope, with or without exertion
- Chest pain
- Left anterior hemiblock (in some patients)
- Right bundle branch block (in some patients)
- Atrial fibrillation (in some patients)
- Ventricular fibrillation (may be associated with physical or emotional stress)
- Increased left ventricular wall thickness
- Concentric hypertrophy of left ventricle (in some patients)
- Asymmetric septal wall hypertrophy (in some patients)
- Left ventricular outflow obstruction
- Significant voltage criteria for biventricular hypertrophy seen on ECG
- ST segment depression in anterior leads seen on ECG
MISCELLANEOUS
- Variable age of onset from first to sixth decade of life
MOLECULAR BASIS
- Caused by mutation in the slow troponin C gene (TNNC1, 191040.0002)
Cardiomyopathy, familial hypertrophic - PS192600 - 37 Entries
Location Phenotype Inheritance Phenotype
mapping key
Phenotype
MIM number
Gene/Locus Gene/Locus
MIM number
1p31.1 Cardiomyopathy, hypertrophic, 20 AD 3 613876 NEXN 613121
1q32.1 Cardiomyopathy, hypertrophic, 2 AD 3 115195 TNNT2 191045
1q43 Cardiomyopathy, dilated, 1AA, with or without LVNC AD 3 612158 ACTN2 102573
1q43 Cardiomyopathy, hypertrophic, 23, with or without LVNC AD 3 612158 ACTN2 102573
2q31.2 Cardiomyopathy, familial hypertrophic, 9 AD 3 613765 TTN 188840
3p25.3 Cardiomyopathy, familial hypertrophic AD, DD 3 192600 CAV3 601253
3p21.31 Cardiomyopathy, hypertrophic, 8 AD, AR 3 608751 MYL3 160790
3p21.1 Cardiomyopathy, hypertrophic, 13 AD 3 613243 TNNC1 191040
3q27.1 Cardiomyopathy, familial hypertrophic, 29, with polyglucosan bodies AR 3 620236 KLHL24 611295
4p12 ?Cardiomyopathy, familial hypertrophic, 30, atrial AR 3 620734 CORIN 605236
4q26 Cardiomyopathy, hypertrophic, 16 AD 3 613838 MYOZ2 605602
6q22.31 Cardiomyopathy, hypertrophic, 18 AD 3 613874 PLN 172405
7p12.1-q21 Cardiomyopathy, hypertrophic, 21 AD 2 614676 CMH21 614676
7q32.1 Cardiomyopathy, familial restrictive 5 AD 3 617047 FLNC 102565
7q32.1 Arrhythmogenic right ventricular dysplasia, familial AD 3 617047 FLNC 102565
7q32.1 Cardiomyopathy, familial hypertrophic, 26 AD 3 617047 FLNC 102565
7q36.1 Cardiomyopathy, hypertrophic 6 AD 3 600858 PRKAG2 602743
10q21.3 Cardiomyopathy, dilated, 1KK AD 3 615248 MYPN 608517
10q21.3 Cardiomyopathy, familial restrictive, 4 AD 3 615248 MYPN 608517
10q21.3 Cardiomyopathy, hypertrophic, 22 AD 3 615248 MYPN 608517
10q22.2 Cardiomyopathy, hypertrophic, 15 AD 3 613255 VCL 193065
10q23.2 Left ventricular noncompaction 3 AD 3 601493 LDB3 605906
10q23.2 Cardiomyopathy, dilated, 1C, with or without LVNC AD 3 601493 LDB3 605906
10q23.2 Cardiomyopathy, hypertrophic, 24 AD 3 601493 LDB3 605906
11p15.1 Cardiomyopathy, hypertrophic, 12 AD 3 612124 CSRP3 600824
11p11.2 Cardiomyopathy, hypertrophic, 4 AD, AR 3 115197 MYBPC3 600958
12q24.11 Cardiomyopathy, hypertrophic, 10 AD 3 608758 MYL2 160781
14q11.2 Cardiomyopathy, hypertrophic, 14 AD 3 613251 MYH6 160710
14q11.2 Cardiomyopathy, hypertrophic, 1 AD, DD 3 192600 MYH7 160760
15q14 Cardiomyopathy, hypertrophic, 11 AD 3 612098 ACTC1 102540
15q22.2 Cardiomyopathy, hypertrophic, 3 AD 3 115196 TPM1 191010
15q25.3 Cardiomyopathy, familial hypertrophic 27 AR 3 618052 ALPK3 617608
17q12 Cardiomyopathy, hypertrophic, 25 AD 3 607487 TCAP 604488
18q12.2 Cardiomyopathy, familial hypertrophic, 28 AD 3 619402 FHOD3 609691
19q13.42 Cardiomyopathy, hypertrophic, 7 AD 3 613690 TNNI3 191044
20q11.21 Cardiomyopathy, hypertrophic, 1, digenic AD, DD 3 192600 MYLK2 606566
20q13.12 Cardiomyopathy, hypertrophic, 17 AD 3 613873 JPH2 605267

TEXT

A number sign (#) is used with this entry because familial hypertrophic cardiomyopathy-13 (CMH13) is caused by heterozygous mutation in the TNNC1 gene (191040) on chromosome 3p21.

For a phenotypic description and a discussion of genetic heterogeneity of familial hypertrophic cardiomyopathy, see 192600.


Clinical Features

Parvatiyar et al. (2012) studied a 5-year-old boy who at 3.75 years of age survived an episode of ventricular fibrillation, then underwent implantation of an intracardioverter defibrillator (ICD) and was maintained on beta-blockers. He subsequently had 5 episodes of breakthrough ventricular fibrillation, generally when emotionally excited and physically active, with a single ICD shock restoring normal sinus rhythm in each case. Echocardiography showed asymmetric septal wall hypertrophy with a mean left ventricular wall thickness of 20 mm (normal, 6-8 mm) with reverse curve morphology, ejection fraction of 65%, diastolic dysfunction, with no left ventricular outflow obstruction. He had moderate left atrial enlargement, and ECG demonstrated significant voltage criteria for biventricular hypertrophy, ST segment depression in anterior leads, and borderline QT prolongation with a QTc of 460 ms. Family history was negative for CMH or sudden cardiac death, and both parents were negative for CMH by echocardiography.


Molecular Genetics

In a 60-year-old German man who presented with dyspnea on exertion and was found to have concentric hypertrophic cardiomyopathy (CMH) of the left ventricle, with 15-mm thick septal and posterior walls, Hoffmann et al. (2001) identified a heterozygous mutation in the TNNC1 gene (L29Q; 191040.0002). No family members were available for study. The mutation was not found in 96 controls, but the authors stated that they could not determine whether this was a disease-causing variant. Schmidtmann et al. (2005) studied the structural and functional consequences of the L29Q substitution and demonstrated alteration of the dynamics of the actin-myosin interaction as well as impairment of PKA (see 601639)-dependent signaling from cardiac TnI (191044) to cardiac TnC, resulting in an increased sensitivity to Ca(2+) when cardiac TnI is phosphorylated.

In 108 consecutive CMH patients diagnosed by echocardiography, angiography, or findings after myectomy, Erdmann et al. (2003) screened for mutations in 6 sarcomeric genes, but did not identify any disease-causing mutations in the TNNC1 gene.

Landstrom et al. (2008) analyzed the TNNC1 gene in 1,025 unrelated patients who met the clinical criteria for CMH, with maximum left ventricular wall thickness of greater than 13 mm in the absence of other confounding diagnoses, and identified 4 heterozygous missense mutations in 4 Caucasian patients (see, e.g., 191040.0003-191040.0005) who were negative for mutation in 15 known CMH-susceptibility genes. The mutations were not found in 400 Caucasian or 100 African American controls with normal screening ECGs and echocardiograms. Landstrom et al. (2008) noted that the prevalence of TNNC1 mutations in their cohort was approximately 0.4%, comparable in frequency to those previously reported by Van Driest et al. (2003) for both alpha-tropomyosin (CMH3; 115196) and actin (CMH11; 612098) mutations in a cohort of 388 CMH patients.

In a 5-year-old boy with CMH and a history of ventricular fibrillation, Parvatiyar et al. (2012) analyzed 12 CMH-associated genes and identified heterozygosity for a missense mutation in the TNNC1 gene (A31S; 191040.0006). Functional analysis suggested that the A31S mutation has a direct effect on the Ca(2+) sensitivity of the myofilament, which may alter Ca(2+) handling and contribute to the arrhythmogenesis observed in the proband.


REFERENCES

  1. Erdmann, J., Daehmlow, S., Wischke, S., Senyuva, M., Werner, U., Raible, J., Tanis, N., Dyachenko, S., Hummel, M., Hetzer, R., Regitz-Zagrosek, V. Mutation spectrum in a large cohort of unrelated consecutive patients with hypertrophic cardiomyopathy. Clin. Genet. 64: 339-349, 2003. [PubMed: 12974739, related citations] [Full Text]

  2. Hoffmann, B., Schmidt-Traub, H., Perrot, A., Osterziel, K. J., Gessner, R. First mutation in cardiac troponin C, L29Q, in a patient with hypertrophic cardiomyopathy. Hum. Mutat. 17: 524 only, 2001. [PubMed: 11385718, related citations] [Full Text]

  3. Landstrom, A. P., Parvatiyar, M. S., Pinto, J. R., Marquardt, M. L., Bos, J. M., Tester, D. J., Ommen, S. R., Potter, J. D., Ackerman, M. J. Molecular and functional characterization of novel hypertrophic cardiomyopathy susceptibility mutations in TNNC1-encoded troponin C. J. Molec. Cell. Cardiol. 45: 281-288, 2008. [PubMed: 18572189, images, related citations] [Full Text]

  4. Parvatiyar, M. S., Landstrom, A. P., Figueiredo-Freitas, C., Potter, J. D., Ackerman, M. J., Pinto, J. R. A mutation in TNNC1-encoded cardiac troponin C, TNNC1-A31S, predisposes to hypertrophic cardiomyopathy and ventricular fibrillation. J. Biol. Chem. 287: 31845-31855, 2012. [PubMed: 22815480, images, related citations] [Full Text]

  5. Schmidtmann, A., Lindow, C., Villard, S., Heuser, A., Mugge, A., Gessner, R., Granier, C., Jaquet, K. Cardiac troponin C-L29Q, related to hypertrophic cardiomyopathy, hinders the transduction of the protein kinase A dependent phosphorylation signal from cardiac troponin I to C. FEBS J. 272: 6087-6097, 2005. [PubMed: 16302972, related citations] [Full Text]

  6. Van Driest, S. L., Ellsworth, E. G., Ommen, S. R., Tajik, A. J., Gersh, B. J., Ackerman, M. J. Prevalence and spectrum of thin filament mutations in an outpatient referral population with hypertrophic cardiomyopathy. Circulation 108: 445-451, 2003. [PubMed: 12860912, related citations] [Full Text]


Contributors:
Marla J. F. O'Neill - updated : 11/30/2012
Creation Date:
Marla J. F. O'Neill : 2/3/2010
carol : 12/04/2012
terry : 11/30/2012
terry : 4/1/2010
wwang : 2/3/2010

# 613243

CARDIOMYOPATHY, FAMILIAL HYPERTROPHIC, 13; CMH13


DO: 0110319;  


Phenotype-Gene Relationships

Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
Gene/Locus Gene/Locus
MIM number
3p21.1 Cardiomyopathy, hypertrophic, 13 613243 Autosomal dominant 3 TNNC1 191040

TEXT

A number sign (#) is used with this entry because familial hypertrophic cardiomyopathy-13 (CMH13) is caused by heterozygous mutation in the TNNC1 gene (191040) on chromosome 3p21.

For a phenotypic description and a discussion of genetic heterogeneity of familial hypertrophic cardiomyopathy, see 192600.


Clinical Features

Parvatiyar et al. (2012) studied a 5-year-old boy who at 3.75 years of age survived an episode of ventricular fibrillation, then underwent implantation of an intracardioverter defibrillator (ICD) and was maintained on beta-blockers. He subsequently had 5 episodes of breakthrough ventricular fibrillation, generally when emotionally excited and physically active, with a single ICD shock restoring normal sinus rhythm in each case. Echocardiography showed asymmetric septal wall hypertrophy with a mean left ventricular wall thickness of 20 mm (normal, 6-8 mm) with reverse curve morphology, ejection fraction of 65%, diastolic dysfunction, with no left ventricular outflow obstruction. He had moderate left atrial enlargement, and ECG demonstrated significant voltage criteria for biventricular hypertrophy, ST segment depression in anterior leads, and borderline QT prolongation with a QTc of 460 ms. Family history was negative for CMH or sudden cardiac death, and both parents were negative for CMH by echocardiography.


Molecular Genetics

In a 60-year-old German man who presented with dyspnea on exertion and was found to have concentric hypertrophic cardiomyopathy (CMH) of the left ventricle, with 15-mm thick septal and posterior walls, Hoffmann et al. (2001) identified a heterozygous mutation in the TNNC1 gene (L29Q; 191040.0002). No family members were available for study. The mutation was not found in 96 controls, but the authors stated that they could not determine whether this was a disease-causing variant. Schmidtmann et al. (2005) studied the structural and functional consequences of the L29Q substitution and demonstrated alteration of the dynamics of the actin-myosin interaction as well as impairment of PKA (see 601639)-dependent signaling from cardiac TnI (191044) to cardiac TnC, resulting in an increased sensitivity to Ca(2+) when cardiac TnI is phosphorylated.

In 108 consecutive CMH patients diagnosed by echocardiography, angiography, or findings after myectomy, Erdmann et al. (2003) screened for mutations in 6 sarcomeric genes, but did not identify any disease-causing mutations in the TNNC1 gene.

Landstrom et al. (2008) analyzed the TNNC1 gene in 1,025 unrelated patients who met the clinical criteria for CMH, with maximum left ventricular wall thickness of greater than 13 mm in the absence of other confounding diagnoses, and identified 4 heterozygous missense mutations in 4 Caucasian patients (see, e.g., 191040.0003-191040.0005) who were negative for mutation in 15 known CMH-susceptibility genes. The mutations were not found in 400 Caucasian or 100 African American controls with normal screening ECGs and echocardiograms. Landstrom et al. (2008) noted that the prevalence of TNNC1 mutations in their cohort was approximately 0.4%, comparable in frequency to those previously reported by Van Driest et al. (2003) for both alpha-tropomyosin (CMH3; 115196) and actin (CMH11; 612098) mutations in a cohort of 388 CMH patients.

In a 5-year-old boy with CMH and a history of ventricular fibrillation, Parvatiyar et al. (2012) analyzed 12 CMH-associated genes and identified heterozygosity for a missense mutation in the TNNC1 gene (A31S; 191040.0006). Functional analysis suggested that the A31S mutation has a direct effect on the Ca(2+) sensitivity of the myofilament, which may alter Ca(2+) handling and contribute to the arrhythmogenesis observed in the proband.


REFERENCES

  1. Erdmann, J., Daehmlow, S., Wischke, S., Senyuva, M., Werner, U., Raible, J., Tanis, N., Dyachenko, S., Hummel, M., Hetzer, R., Regitz-Zagrosek, V. Mutation spectrum in a large cohort of unrelated consecutive patients with hypertrophic cardiomyopathy. Clin. Genet. 64: 339-349, 2003. [PubMed: 12974739] [Full Text: https://doi.org/10.1034/j.1399-0004.2003.00151.x]

  2. Hoffmann, B., Schmidt-Traub, H., Perrot, A., Osterziel, K. J., Gessner, R. First mutation in cardiac troponin C, L29Q, in a patient with hypertrophic cardiomyopathy. Hum. Mutat. 17: 524 only, 2001. [PubMed: 11385718] [Full Text: https://doi.org/10.1002/humu.1143]

  3. Landstrom, A. P., Parvatiyar, M. S., Pinto, J. R., Marquardt, M. L., Bos, J. M., Tester, D. J., Ommen, S. R., Potter, J. D., Ackerman, M. J. Molecular and functional characterization of novel hypertrophic cardiomyopathy susceptibility mutations in TNNC1-encoded troponin C. J. Molec. Cell. Cardiol. 45: 281-288, 2008. [PubMed: 18572189] [Full Text: https://doi.org/10.1016/j.yjmcc.2008.05.003]

  4. Parvatiyar, M. S., Landstrom, A. P., Figueiredo-Freitas, C., Potter, J. D., Ackerman, M. J., Pinto, J. R. A mutation in TNNC1-encoded cardiac troponin C, TNNC1-A31S, predisposes to hypertrophic cardiomyopathy and ventricular fibrillation. J. Biol. Chem. 287: 31845-31855, 2012. [PubMed: 22815480] [Full Text: https://doi.org/10.1074/jbc.M112.377713]

  5. Schmidtmann, A., Lindow, C., Villard, S., Heuser, A., Mugge, A., Gessner, R., Granier, C., Jaquet, K. Cardiac troponin C-L29Q, related to hypertrophic cardiomyopathy, hinders the transduction of the protein kinase A dependent phosphorylation signal from cardiac troponin I to C. FEBS J. 272: 6087-6097, 2005. [PubMed: 16302972] [Full Text: https://doi.org/10.1111/j.1742-4658.2005.05001.x]

  6. Van Driest, S. L., Ellsworth, E. G., Ommen, S. R., Tajik, A. J., Gersh, B. J., Ackerman, M. J. Prevalence and spectrum of thin filament mutations in an outpatient referral population with hypertrophic cardiomyopathy. Circulation 108: 445-451, 2003. [PubMed: 12860912] [Full Text: https://doi.org/10.1161/01.CIR.0000080896.52003.DF]


Contributors:
Marla J. F. O'Neill - updated : 11/30/2012

Creation Date:
Marla J. F. O'Neill : 2/3/2010

Edit History:
carol : 12/04/2012
terry : 11/30/2012
terry : 4/1/2010
wwang : 2/3/2010