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Title: Evidence for genetic factors in vasovagal syncope: a twin-family study.
Austin Authors: Klein, Karl Martin;Xu, San San ;Lawrence, Kate M;Fischer, Alexandra;Berkovic, Samuel F 
Affiliation: Epilepsy Research Centre, The University of Melbourne, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 7-Aug-2012
Publication information: Neurology; 79(6): 561-5
Abstract: 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.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.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.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.
Gov't Doc #: 22869686
DOI: 10.1212/WNL.0b013e3182635789
Journal: Neurology
Type: Journal Article
Subjects: Adult
Diseases in Twins.genetics
Genetic Predisposition to Disease
Syncope, Vasovagal.genetics
Twins, Dizygotic.genetics
Twins, Monozygotic.genetics
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