Prevalence of fabry disease in a cohort of 508 unrelated patients with hypertrophic cardiomyopathy

J Am Coll Cardiol. 2007 Dec 18;50(25):2399-403. doi: 10.1016/j.jacc.2007.06.062.


Objectives: We aimed to study the prevalence of Fabry disease (FD) in patients with hypertrophic cardiomyopathy (HCM).

Background: There are limited and controversial data about the prevalence of FD in patients with HCM.

Methods: We screened the plasma alpha-galactosidase A activity from 508 unrelated patients with HCM (328 men, 180 women, ages 58 +/- 16 years). Patients with low activity (0% to 30% of the normal control in men, and 0% to 50% in women) underwent genetic study of the GLA gene.

Results: We found low plasma activity in 15 patients (3%). Three men had GLA mutations (0.9%): S238N (novel) in 2 and E358del (described) in 1. Two women had described mutations (1.1%): L89P and A143T. Three unrelated men had the D313Y variant previously associated with enzyme pseudo-deficiency. Two women had polymorphisms that did not segregate with the disease in their families. Five women (activity 39% to 47%) had no sequence variants. The familial studies allowed the diagnosis of 14 carriers: 6 women without Fabry manifestations, 3 women with cardiomyopathy, 2 men with renal and cardiac disease, 1 man with microhematuria, 1 woman with first-degree atrioventricular block, and a 32-year-old woman with only renal disease.

Conclusions: By means of a screening based on genotyping of patients with low plasma enzymatic activity, the prevalence of FD in our population of HCM is 1% (0.9% in men and 1.1% in women). This diagnosis is relevant, because it allows the identification of disease carriers that might benefit from enzyme replacement therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiomyopathy, Hypertrophic / diagnosis
  • Cardiomyopathy, Hypertrophic / epidemiology*
  • Cardiomyopathy, Hypertrophic / genetics
  • Cohort Studies
  • Cross-Sectional Studies
  • DNA Mutational Analysis
  • Fabry Disease / diagnosis
  • Fabry Disease / epidemiology*
  • Fabry Disease / genetics
  • Female
  • Genetic Carrier Screening
  • Genetic Predisposition to Disease / genetics
  • Genetic Testing
  • Humans
  • Male
  • alpha-Galactosidase / genetics


  • alpha-Galactosidase