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Concealed cardiomyopathy as an emerging cause of sudden cardiac arrest and sudden cardiac death

Nature Cardiovascular Research volume 3, pages 1274–1283 (2024)Cite this article

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Abstract

The inherited cardiomyopathies exhibit a broad spectrum of disease, with some patients remaining asymptomatic throughout life, while, for others, the first symptom of disease is sudden cardiac death at a young age. The risk of malignant ventricular arrhythmia in these conditions has traditionally been linked to the degree of structural myocardial abnormalities and functional impairment. However, recent advances in genetic testing and knowledge of the genetic basis of the diseases have led to the identification of concealed cardiomyopathy, in which sudden cardiac arrest or sudden cardiac death occurs in the absence of observable clinical features of cardiomyopathy, with a diagnosis being made only after the identification of a causative genetic variant. Increased awareness of concealed cardiomyopathy, a better understanding of mechanisms of arrhythmia and identification of risk modulators will be vital to improve care for families with concealed cardiomyopathy.

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Fig. 1: Representation of a cardiomyocyte highlighting the components implicated in cardiomyopathy.
Fig. 2: Hypothesized drivers of concealed cardiomyopathy.

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Acknowledgements

C.S. is the recipient of a National Health and Medical Research Council Investigator grant (2016822) and a New South Wales Health Cardiovascular Disease Clinician Scientist grant. R.T. holds the Canada Research Chair in Translational Cardiovascular Genetics.

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Authors and Affiliations

  1. Faculty of Medicine and Heath, the University of Sydney, Sydney, New South Wales, Australia

    Julia C. Isbister & Christopher Semsarian

  2. Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia

    Julia C. Isbister & Christopher Semsarian

  3. Cardiovascular Genetics Center, Montreal Heart Institute, Montreal, Québec, Canada

    Rafik Tadros

  4. Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada

    Rafik Tadros

  5. Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia

    Hariharan Raju

  6. Agnes Ginges Centre for Molecular Cardiology at the Centenary Institute, the University of Sydney, Sydney, New South Wales, Australia

    Christopher Semsarian

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Isbister, J.C., Tadros, R., Raju, H. et al. Concealed cardiomyopathy as an emerging cause of sudden cardiac arrest and sudden cardiac death. Nat Cardiovasc Res 3, 1274–1283 (2024). https://doi.org/10.1038/s44161-024-00558-1

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