Key result
Short QT interval with sudden death links to rare electrophysiology gene variants and structural hypertrabeculation.
Why the study?
Structural heart abnormalities are not typically linked to SQTS-related sudden unexpected death, and few autopsy studies have evaluated the underlying pathology and genetic factors.
What are the underlying pathological and genetic factors in young adults with a short QT interval and sudden unexpected death?
Case Report (n=4)
What are the underlying pathological and genetic factors in young adults with a short QT interval and sudden unexpected death?
Individuals with a short QT interval may be at risk of sudden death even without a clinical or family history, potentially due to underlying cardiomyopathy-related gene variants and structural abnormalities.
Answers are grounded in this paper and cite their sources.
No known SQTS variants in these cases cautions against narrow genetic panels; leaves open novel genes or modifiers in sudden death.
While structural heart abnormalities are not typically associated with short QT syndrome (SQTS)-related sudden unexpected death, few autopsy studies have examined the underlying pathology and genetic factors of SQTS. Therefore, we conducted comprehensive pathological examinations and whole-exome sequencing in four men (aged 24, 28, 31, and 45 years) with sudden unexpected death and a short QT interval (sQT). No variants were identified in genes currently known to be associated with SQTS. An enrichment analysis was performed to identify potential genetic causes and mechanisms. None of the men had a history of cardiovascular disease, familial sudden death, or arrhythmia. Rare variants in SCN10A, ANK2, KCNQ2, and CACNA1H were detected, potentially associated with cardiac electrophysiology. One case showed apical hypertrophic cardiomyopathy with a rare PLEC variant. The other three showed left ventricular hypertrabeculation with poor compaction, deep recess formation, myocardial fibrosis, micronecrosis, and minimal inflammatory cell infiltration. The enrichment analysis showed that these variants were associated with cardiac electrophysiology and morphogenesis. These results showed that individuals with sQT may be at risk of sudden death even without a clinical or family history. This risk may be increased by cardiomyopathy-related gene variants in preclinical or early disease stages. Electrocardiographic evaluation to identify sQT cases followed by morphological and genetic evaluations improves the assessment of a sudden death risk in individuals with sQT.
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Hata et al. (2026) conducted a case report in Short QT interval and sudden unexpected death (n=4). Pathological examination and whole-exome sequencing was evaluated. Pathological and genetic evaluation of 4 men with short QT interval and sudden death revealed rare variants in electrophysiology-related genes and structural abnormalities like hypertrabeculation.
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