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  2. Keyword: PRKAG2 Syndrome/genetics
Echocardiographic Findings in Children of Patients Diagnosed with PRKAG2 Syndrome
ABC
Original Article

Echocardiographic Findings in Children of Patients Diagnosed with PRKAG2 Syndrome

Dinamar Amador dos Santos Neto et al. Igor de Souza Neto Alice Pinheiro Barbosa Eduardo Back Sternick José Luiz Barros Pena

Abstract

Background:

PRKAG2 syndrome typically manifests in adolescence and early adulthood, progressing with left ventricular hypertrophy, arrhythmias, and risk of sudden death. Findings of echocardiographic markers before clinical manifestation in children of patients affected by the disease can facilitate prevention strategies and therapeutic planning for this patient group.

Objective:

To identify the existence of echocardiographic findings that manifest early in children of parents affected by PRKAG2 syndrome, while they are still asymptomatic.

Methods:

In this cross-sectional observational study, 7 participants who were children of parents with established diagnosis of PRKAG2 syndrome, between the ages of 9 months and 12 years, with proven genetic diagnosis, underwent conventional and advanced echocardiography. Their findings were compared to those of a control group composed of 7 age- and sex-matched volunteers who were healthy from a cardiovascular point of view. P values < 0.05 were considered significant.

Results:

Conventional echocardiography showed statistically significantly higher values in the case group for left atrium, interventricular septum, left ventricular posterior wall, indexed ventricular mass, and relative wall thickness (p < 0.05). Global longitudinal systolic strain on 2-dimensional echocardiography did not show statistical significance between the case and control groups. None of the parameters on 3-dimensional echocardiography showed statistical significance between groups.

Conclusion:

Children diagnosed with PRKAG2 showed echocardiographic findings indicative of a tendency toward cardiac hypertrophy. Echocardiography can be a useful tool in the evaluation and follow-up of this patient group before the onset of clinical manifestations.

  • Child
  • Echocardiography/methods
  • Glycogen Storage Disease/complications
  • PRKAG2 Syndrome/genetics
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Creative Commons Attribution (CC BY) Creative Commons license
02/09/2024 DOI: 10.36660/abc.20230531i
Figure 1
ABC
Original Article

Right Ventricle Involvement by Glycogen Storage Cardiomyopathy (PRKAG2): Standard and Advanced Echocardiography Analyses

José Luiz Barros Pena et al. Fabricio Junqueira de Melo Wander Costa Santos Isabel Cristina Gomes Moura … Gabriela Pansanato Nakashima Natalia Costa Freitas Eduardo Back Sternick

Abstract

Background

PRKAG2 syndrome is a rare, early-onset autosomal dominant inherited disease. We aimed to describe the right ventricle (RV) echocardiographic findings using two and three-dimensional (2D and 3D) modalities including myocardial deformation indices in this cardiomyopathy. We also aimed to demonstrate whether this technique could identify changes in RV function that could distinguish any particular findings.

Methods

Thirty patients with genetically proven PRKAG2 (R302Q and H401Q), 16 (53.3%) males, mean age 39.1 ± 15.4 years, underwent complete echocardiography examination. RV-focused, 4-chamber view was acquired for 2D and 3D measurements. Student’s t or Wilcoxon-Mann-Whitney tests were used to compare numerical variables between 2 groups, and p < 0.05 was considered significant.

Results

Twelve patients (40%) had a pacemaker implanted for 12.4 ± 9.9 years. RV free wall mean diastolic thickness was 7.9 ± 2.9 mm. RV 4-chamber longitudinal strain (RV4LS), including the free wall and interventricular septum, was –17.3% ± 6.7%, and RV free wall longitudinal strain (RVFWLS) was −19.1% ± 8.5%. The RVFWLS apical ratio measured 0.63 ± 0.15. Mean RV 3D ejection fraction (EF) was 42.6% ± 10.9% and below normal limits in 56.7% of patients. Positive correlation occurred between RV 3DEF, RV4LS, and RVFWLS, especially for patients without a pacemaker (p = 0.006).

Conclusion

RV involvement in PRKAG2 syndrome is frequent, occurring in different degrees. Echocardiography is a valuable tool in detecting RV myocardial abnormalities in this condition. The use of 2D RV4LS, RVFWLS, and 3DEF offers reliable indicators of RV systolic dysfunction in this rare, challenging cardiomyopathy.

  • Cardiomyopathy, Hypertrophic, Familial
  • Echocardiography/methods
  • Glycogen Storage Disease/complications
  • Hypertrophy, Right Ventricular
  • Pacemaker, Artificial
  • PRKAG2 Syndrome/genetics
  • Stroke Volume
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Creative Commons Attribution (CC BY) Creative Commons license
21/11/2022 DOI: 10.36660/abc.20210801 Views 1

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Santos Neto DA, Souza Neto I, Barbosa AP, Sternick EB, Pena JLB. Echocardiographic Findings in Children of Patients Diagnosed with PRKAG2 Syndrome. Arquivos Brasileiros de Cardiologia 2024;121(8):e20230531.

Electronic Document Format (ABNT)

Santos Neto, Dinamar Amador dos; Souza Neto, Igor de; Barbosa, Alice Pinheiro; Sternick, Eduardo Back; Pena, José Luiz Barros. Echocardiographic Findings in Children of Patients Diagnosed with PRKAG2 Syndrome. Arquivos Brasileiros de Cardiologia, v. 121, n. 8, e20230531, Sep. 2024.

Electronic Document Format (APA)

Santos Neto, D. A. , Souza Neto, I. , Barbosa, A. P., Sternick, E. B., & Pena, J. L. B. (2024). Echocardiographic Findings in Children of Patients Diagnosed with PRKAG2 Syndrome. Arquivos Brasileiros de Cardiologia, 121(8), e20230531.

Electronic Document Format (ISO)

Santos Neto, Dinamar Amador dos and Souza Neto, Igor de and Barbosa, Alice Pinheiro and Sternick, Eduardo Back and Pena, José Luiz Barros. Echocardiographic Findings in Children of Patients Diagnosed with PRKAG2 Syndrome. Arquivos Brasileiros de Cardiologia [online]. 2024, vol. 121, n. 8, [cited 2026-10-14], e20230531. Available from: <https://journals.cardiol.br/en/article/echocardiographic-findings-in-children-of-patients-diagnosed-with-prkag2-syndrome/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Pena JLB, Melo FJ, Santos WC, Moura ICG, Nakashima GP, Freitas NC, Sternick EB, et al. Right Ventricle Involvement by Glycogen Storage Cardiomyopathy (PRKAG2): Standard and Advanced Echocardiography Analyses. Arquivos Brasileiros de Cardiologia 2022;119(6):902-9.

Electronic Document Format (ABNT)

Pena, José Luiz Barros; Melo, Fabricio Junqueira de; Santos, Wander Costa; Moura, Isabel Cristina Gomes; Nakashima, Gabriela Pansanato; Freitas, Natalia Costa; Sternick, Eduardo Back. Right Ventricle Involvement by Glycogen Storage Cardiomyopathy (PRKAG2): Standard and Advanced Echocardiography Analyses. Arquivos Brasileiros de Cardiologia, v. 119, n. 6, p. 902-909, Nov. 2022.

Electronic Document Format (APA)

Pena, J. L. B., Melo, F. J. , Santos, W. C., Moura, I. C. G., Nakashima, G. P., Freitas, N. C., & Sternick, E. B. (2022). Right Ventricle Involvement by Glycogen Storage Cardiomyopathy (PRKAG2): Standard and Advanced Echocardiography Analyses. Arquivos Brasileiros de Cardiologia, 119(6), 902-909.

Electronic Document Format (ISO)

Pena, José Luiz Barros and Melo, Fabricio Junqueira de and Santos, Wander Costa and Moura, Isabel Cristina Gomes and Nakashima, Gabriela Pansanato and Freitas, Natalia Costa and Sternick, Eduardo Back. Right Ventricle Involvement by Glycogen Storage Cardiomyopathy (PRKAG2): Standard and Advanced Echocardiography Analyses. Arquivos Brasileiros de Cardiologia [online]. 2022, vol. 119, n. 6, [cited 2026-10-14], pp. 902-909. Available from: <https://journals.cardiol.br/en/article/right-ventricle-involvement-by-glycogen-storage-cardiomyopathy-prkag2-standard-and-advanced-echocardiography-analyses/>. ISSN 0066-782X

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