Some previous studies also reported that some SUNDS cases are likely caused by the same allelic disorder that causes BrS (Vatta et al. Additionally, both SUNDS and BrS represent the same autosomal dominant familial disorder, and they can result from mutations in the cardiac sodium channel SCN5A, thus causing loss of channel function (Sangwatanaroj et al. Previous studies reported that these conditions are allelic disorders, and some sporadic SUNDS cases may be caused by inherited cardiac arrhythmia, such as LQTS and BrS (Cheng et al. Cardiac arrhythmia has also been assumed to be associated with the pathogenesis of sudden cardiac death in the young, such as congenital long QT syndrome (LQTS), catecholaminergic polymorphic ventricular tachycardia, arrhythmogenic right ventricular cardiomyopathy, and Brugada syndrome (BrS) (Elger et al. However, the true incidence of SUNDS is unknown.Ĭardiac arrhythmia has been proposed as the factor responsible for death in individuals who experience SUNDS (Nademanee et al. 1992 Tungsanga and Sriboonlue 1993) and as low as 1–2 per 100,000 people predominantly in men aged 17–55 years in Southern China (Cheng et al. 2007) 26–38 per 100,000 people, all being men aged 20–49 years in Northeast Thailand (Tatsanavivat et al. The annual incidence of SUNDS has been reported to be as high as 43 per 100,000 people, all being men aged 20–40 years in the Philippines (Gervacio-Domingo et al. 2011), and “lai-tai” in Thailand (Srettabunjong 2019). SUNDS has been given different local names, including “bangungut” in the Philippines (Munger and Booton 1998), “pokkuri” in Japan (Gotoh 1976), “sudden manhood death syndrome” in China (Cheng et al. 2011 Srettabunjong 2019), and it may have devastating effects on families in many different ways. SUNDS is highly prevalent in healthy young Southeast Asian males (Munger and Booton 1998 Gotoh 1976 Cheng et al. The clinical and pathologic features of these cases of sudden death, especially the characteristic lack of overt structural heart disease, are similar among cases.
Autopsy findings in cases of SUNDS reveal no evident histopathological changes that explain the cause of death. Sudden unexplained nocturnal death syndrome (SUNDS) is a genetic disorder that can cause sudden death in young, healthy adults during sleep at night. Sudden death is a major concern in forensic medicine, especially when the decedent is young and healthy and the postmortem examination fails to reveal any significant findings.
Two identified variants (rs1805126 and rs7429945) deserved further study because of their strong odd ratios. Twelve variants of SCN5A were identified, including six polymorphisms and another six variants previously reported to be related with cardiac conduction defects. The identified variants were also genotyped in control subjects using high-resolution melting analysis and sequencing. Genomic DNA from SUNDS cases was screened for genetic variations for the entire 28 coding exons of SCN5A. Subjects were divided into three subgroups as follows: subjects who resided in regions other than Northeastern Thailand ( n = 99), age-matched subjects who resided in Northeastern Thailand ( n = 28), and subjects older than 40 years who resided in Northeastern Thailand ( n = 24). Genomic DNA was extracted using blood samples from 12 unrelated SUNDS subjects and 151 unrelated non-SUNDS control decedents.
This study was thus aimed to investigate the association between SCN5A, the gene that has been extensively studied and thought to be associated with cardiac conduction system abnormality causing sudden cardiac death, and SUNDS in Thai decedents. Cardiac arrhythmia has been proposed as the factor responsible for such deaths. Sudden unexplained nocturnal death syndrome (SUNDS) is a genetic disorder that can cause sudden death in young and healthy adults during sleep at night.
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