HFE mutations in idiopathic dilated cardiomyopathy

Background and Purpose: Dilated cardiomyopathy is a typical complication of hereditary hemochromatosis (HH). The present study investigated, whether Mutations of the hemochromatosis (HFE) gene might be etiologic and disease-modifying factors in idiopathic dilated cardiomyopathy (IDCM). Patients and Methods: Clinical and biochemical assessment and HFE gene analysis were perfomed in 46 patients with IDCM and 350 healthy controls. Cardiomyopathy was angiographically defined according to the criteria of the Collaborative Research Group of the European Human and Capital Mobility Project of Familial Dilated Cardiomyopathy. Results: A higher prevalence of C282Y homozygosity was found among patients with IDCM compared to healthy subjects (4.3% vs. 0.6%; p < 0.02). A total of 6.5% of the patients with IDCM were either C282Y homozygotes or C282Y/H63D compound heterozygotes. The C282Y allele frequency was somewhat higher among patients with IDCM (8.7%) compared to healthy controls (5.4%; p < 0.2), whereas the HOD allele frequency was not increased. No significant differences of serum iron, ferritin or transferrin saturation, cardiac iron loading, NYHA classification, Lown's classification, the history of cardiopulmonary resuscitation, LVEDD (left ventricular end-diastolic diameter), EF (ejection fraction), LADD (left atrial end-diastolic diameter) and CI (cardiac index) were seen between HFE carriers and noncarriers. Conclusion: The present study indicates that it is,worth screening patients with IDCM for iron parameters given the increased prevalence of disease predisposing HFE constellations. It remains unclear, to whit extent iron or immune-mediated processes contribute to the pathomechanism of IDCM.