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Evidence for genetic factors in vasovagal syncope: a twin-family study.
Neurology 2012; 79(6):561-5Neur

Abstract

OBJECTIVE

Vasovagal syncope (VVS) is the most frequent type of syncope and a common differential diagnosis of epilepsy. The role of genetic factors in VVS is debated. We performed a twin-family study to clarify this question and to analyze the putative mode of inheritance.

METHODS

Fifty-one same-sex twin pairs where at least 1 had syncope were ascertained. The twins were interviewed via telephone using a standardized questionnaire. Available medical records were obtained. Information on the affected status of first- and second-degree relatives was acquired.

RESULTS

There was a trend toward higher casewise concordance in monozygous (MZ, 0.75) than dizygous (DZ, 0.50) twins for any syncope (p = 0.06). Significant and strong effects on concordance between MZ and DZ twins were found for fainting at least twice unrelated to external circumstances (0.71 vs 0.27, p = 0.018) and for syncope associated with typical vasovagal triggers (0.62 vs 0.00, p < 0.001). Twelve of 19 concordant MZ twin pairs reported sparse or no other affected family members whereas in the other 7 pairs multiple close relatives were affected.

CONCLUSIONS

The twin analysis provides strong evidence for the relevance of genetic factors in VVS. Analysis of the families suggests that complex inheritance (multiple genes ± environmental factors) is usual, with rarer families possibly segregating a major autosomal dominant gene.

Authors+Show Affiliations

Epilepsy Research Centre, The University of Melbourne, Austin Health, Heidelberg, Victoria, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Twin Study

Language

eng

PubMed ID

22869686

Citation

Klein, Karl Martin, et al. "Evidence for Genetic Factors in Vasovagal Syncope: a Twin-family Study." Neurology, vol. 79, no. 6, 2012, pp. 561-5.
Klein KM, Xu SS, Lawrence K, et al. Evidence for genetic factors in vasovagal syncope: a twin-family study. Neurology. 2012;79(6):561-5.
Klein, K. M., Xu, S. S., Lawrence, K., Fischer, A., & Berkovic, S. F. (2012). Evidence for genetic factors in vasovagal syncope: a twin-family study. Neurology, 79(6), pp. 561-5. doi:10.1212/WNL.0b013e3182635789.
Klein KM, et al. Evidence for Genetic Factors in Vasovagal Syncope: a Twin-family Study. Neurology. 2012 Aug 7;79(6):561-5. PubMed PMID: 22869686.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evidence for genetic factors in vasovagal syncope: a twin-family study. AU - Klein,Karl Martin, AU - Xu,San San, AU - Lawrence,Kate, AU - Fischer,Alexandra, AU - Berkovic,Samuel F, PY - 2012/8/8/entrez PY - 2012/8/8/pubmed PY - 2012/10/16/medline SP - 561 EP - 5 JF - Neurology JO - Neurology VL - 79 IS - 6 N2 - OBJECTIVE: Vasovagal syncope (VVS) is the most frequent type of syncope and a common differential diagnosis of epilepsy. The role of genetic factors in VVS is debated. We performed a twin-family study to clarify this question and to analyze the putative mode of inheritance. METHODS: Fifty-one same-sex twin pairs where at least 1 had syncope were ascertained. The twins were interviewed via telephone using a standardized questionnaire. Available medical records were obtained. Information on the affected status of first- and second-degree relatives was acquired. RESULTS: There was a trend toward higher casewise concordance in monozygous (MZ, 0.75) than dizygous (DZ, 0.50) twins for any syncope (p = 0.06). Significant and strong effects on concordance between MZ and DZ twins were found for fainting at least twice unrelated to external circumstances (0.71 vs 0.27, p = 0.018) and for syncope associated with typical vasovagal triggers (0.62 vs 0.00, p < 0.001). Twelve of 19 concordant MZ twin pairs reported sparse or no other affected family members whereas in the other 7 pairs multiple close relatives were affected. CONCLUSIONS: The twin analysis provides strong evidence for the relevance of genetic factors in VVS. Analysis of the families suggests that complex inheritance (multiple genes ± environmental factors) is usual, with rarer families possibly segregating a major autosomal dominant gene. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/22869686/Evidence_for_genetic_factors_in_vasovagal_syncope:_a_twin_family_study_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&amp;pmid=22869686 DB - PRIME DP - Unbound Medicine ER -