Today, there are 3,397 patients on various heart transplant wait lists in the United States. 401 patients are status 1A. 1,105 patients are status 1B. 982 patients are status 2 and 909 are designated status 7.
If you are related to a young person who died suddenly from a heart-related illness, you have an increased risk of cardiovascular disease than you may realize. In early November, The European Heart Journal published the results of a study led by Dr. Mattis Flyvholm Ranthe MD of the Statens Serum Institut and co-authors from The Heart Centre, Unit for Inherited Cardiac Diseases, Copenhagen University Hospital.
The study focused on the families connected to 470 victims of sudden cardiac death (SCD). All victims were between 1 and 35 years of age and lived in Denmark. The study monitored first and second degree relatives of the deceased. The study was performed from 2000 through 2006 and relatives of the deceased were monitored for up to 11 years.
The authors say the study has two clear implications:
- The study supports the belief that autopsies should always be performed in cases where the cause of the young person’s death is unexplained.
- Because the cause of death is treatable, relatives should be advised of the cause of death and referred for preventive care with a cardiologist if the cause of death is related to heart disease.
The findings were specific. First and second degree relatives under the age of 35 were at greater risk of several categories of heart disease than the general public.
- 3 times as likely to suffer ischemic heart disease (reduced blood pressure).
- 10 times more likely to suffer cardiomyopathies (damaged or weakened heart).
- 10 times more susceptible to ventricular arrhythmias that could cause death.
For the very young, first-degree relatives of young SCD victims, the study had even more compelling data. For these relatives, the risk of ischemic heart disease is 6 times the risk for the general public. The risk for cardiomyopathy and ventricular arrhythmia is 20 times that of the general public.
For this study, “Sudden cardiac death (SCD) is a sudden, unexpected death due to natural unknown or cardiac causes with an acute change in cardiovascular status within one hour of death or, in unwitnessed cases, in a person last seen functioning normally within 24 hours of being found dead.” In young people, SCD is most often caused by previously undiagnosed heart problems that can be hereditary. Dr. Ranthe’s team surmised that there may be genetic mutations involved when this sudden death occurs.
“If sudden cardiac death has genetic causes then this would suggest that relatives of young SCD victims are at greater risk of heart disease than the general population and would benefit from screening to identify those at risk so they they could be give appropriate preventive treatment. This could save a significant number of lives,” wrote Ranthe.
In my own travels to and from cardiology departments, I have been surprised by the number of very young people either waiting for transplant or who are recovering after transplantation. The relatives of these young persons would do well to follow Dr. Ranthe’s suggestion of submitting to a cardiology screening.
The study indicates that SCD has a significant propensity to be a hereditary component with first degree relatives at great risk of loving with heart disease or developing heart disease. Systematic cardiology screening is recommended.
In this study, 67 percent of the SCD were submitted for an autopsy. Of the 314 submissions, 178 were heart related. 136 fatalities were unexplained. The remainder was identified as SCDs without autopsy. Ranthe says the data is compelling enough to warrant automatic autopsies for the benefit of the related survivors.
Dr. Ranthe states that this study also underscores the risks of ventricular arrhythmia as a genetic characteristic. The study revealed several cases where ventricular arrhythmia was rampant in families of the prematurely deceased.
Dr. Ranthe’s team will next tackle the inherited effects of SCDs over age 35. The concentration will be on the survival and disease courses of relatives of these SCD cases.