Evidence map›Paper›PMID 40692291›Full record

ArticleESC heart failure2025

Genetics, cardiac phenotype and cardiovascular outcomes in Fabry disease patients in Finland.

Kati Valtola, Päivi Pietilä-Effati, Jonna M E Männistö, Susanne Walls, Ilkka Kantola, Johanna Kuusisto

Abstract readMulticenter Study
In one paragraph

Article in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Kati ValtolaHeart Center of Kuopio University Hospital, Kuopio, Finland.
Päivi Pietilä-EffatiVaasa Central Hospital, Vaasa, Finland.
Jonna M E MännistöDepartment of Clinical Genetics, Kuopio University Hospital, Kuopio, Finland.
Susanne WallsDivision of Medicine, Turku University Hospital, Turku University, Turku, Finland.
Ilkka KantolaDivision of Medicine, Turku University Hospital, Turku University, Turku, Finland.
Johanna KuusistoCentre for Medicine and Clinical Research, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland.

Funding

Academy of FinlandKuopion Yliopistollinen SairaalaSanofi GenzymeSydäntutkimussäätiö
6 · The paper itself

Abstract

aimsTo investigate the genetics, cardiac phenotype and cardiovascular outcomes of Finnish Fabry patients. METHODS AND

resultsAmong the 109 patients with Fabry disease (FD) diagnosed in Finland by 2018, 97 (89%; 32 males and 65 females, mean ages 42 and 52 years) were followed for a mean of 12 years. Data on genetics, phenotypes, cardiac imaging and cardiovascular outcomes were collected from the Fabry Registry and medical records. The 26 families with FD harboured 22 different hemi-/heterozygous GLA variants, most commonly p.R227X, p.A143T or p.P409A. The Fabry phenotype in males was classic in 19 (59%), late-onset in 10 (31%) and intermediate in 3 (9%) patients. Among the females, 62 (95%) were symptomatic. Fabry cardiomyopathy (FC, maximal left ventricular wall thickness ≥13 mm, or an increased cardiac mass and decreased T1 time, or typical late gadolinium enhancement (LGE) in CMR) was present in 21 (66%) males manifesting since their 20s, and in 32 (49%) females since their 40s. LGE in CMR was detected in most subjects with cardiomyopathy, particularly in females. Among the 53 patients with FC, 16 (30%) developed atrial fibrillation, 17 (32%) stroke, 14 (26%) heart failure (HF) and 3 (6%) end-stage renal disease. Nine patients died during the follow-up at mean ages of 48 (males) and 75 years (females), three of whom died from HF and three from stroke. Eight of those who died had cardiomyopathy.

conclusionsIn Finland, FD is caused by multiple GLA variants. Classic phenotype is more common. Contrasting previous studies, most women are symptomatic. Cardiomyopathy is very common also in women since their 40s and associates with atrial fibrillation, HF, stroke and death, emphasizing the malignant natural course of FC. Our findings highlight the need for even more diligent monitoring of cardiac manifestations also in females with FD by regular cardiac imaging with CMR.

Indexed as

Fabry DiseaseRegistriesAdultFemaleFinlandFollow-Up StudiesHumansMagnetic Resonance Imaging, CineMaleMiddle AgedPhenotypeRetrospective StudiesCardiac imagingCardiomyopathyFabry diseaseGLAOutcomes

Identifiers

PMID40692291
PMCPMC12450783

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