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… continued from page 8
LVHT frequently occurs familiarly.
5
Were any other first-
degree relatives investigated for LVHT? Did any of the first-
degree relatives present with clinical cardiac disease? Was
the family history positive for syncope, severe arrhythmias or
sudden cardiac death?
LVHT is frequently associated with chromosomal aberrations
or NMDs. Did the boy undergo cytogenetic investigations to
confirm a chromosomal defect or was he ever investigated by
a myologist to confirm or rule out NMD? When examining
the patient cardiologically, did he present with myopathic face,
weakness of the limb, axial or respiratory muscles, wasting, or
with fasciculations? What was the level of serum creatine kinase
and serum lactate?
We do not agree with the view that LVHT may develop into
cardiomyopathy (discussion). LVHT is
per se
classified as an
unclassified cardiomyopathy by the European and American
Cardiological Society.
A follow up of two months is very short. It would be
interesting to know about any long-term results. Did ventricular
arrhythmias recur? Did left ventricular dysfunction or dilatation
of the cardiac cavities re-emerge?
Overall, it would be helpful to receive more detailed
information about the affected patient and his relatives to
assess whether LVHT was associated with hereditary disease
or not. Long-term data would help to assess whether the
applied therapeutic measures truly had a long-term effect in this
particular patient without developing arrhythmias other than
ventricular ectopic beats or heart failure since then.
Josef Finsterer, MD, PhD,
Krankenanstalt Rudolfstiftung, Vienna, Austria
Sinda Zarrouk-Mahjoub, PhD
Laboratory of Biochemistry, UR Human Nutrition and
Metabolic Disorders, Faculty of Medicine, Monastir, Tunisia
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