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The International Calmodulinopathy Registry (ICalmR) aims to define and link the increasing complexity of the clinical presentation to the underlying molecular mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>The ICalmR is an international, collaborative, observational study, assembling and analysing clinical and genetic data on CALM-positive patients. The ICalmR has enrolled 140 subjects (median age 10.8 years [interquartile range 5\u201319]), 97 index cases and 43 family members. CALM-LQTS and CALM-CPVT are the prevalent phenotypes. Primary neurological manifestations, unrelated to post-anoxic sequelae, manifested in 20 patients. Calmodulinopathy remains associated with a high arrhythmic event rate (symptomatic patients, n = 103, 74%). However, compared with the original 2019 cohort, there was a reduced frequency and severity of all cardiac events (61% vs. 85%; P = .001) and sudden death (9% vs. 27%; P = .008). Data on therapy do not allow definitive recommendations. Cardiac structural abnormalities, either cardiomyopathy or congenital heart defects, are present in 30% of patients, mainly CALM-LQTS, and lethal cases of heart failure have occurred. The number of familial cases and of families with strikingly different phenotypes is increasing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Calmodulinopathy has pleiotropic presentations, from channelopathy to syndromic forms. Clinical severity ranges from the early onset of life-threatening arrhythmias to the absence of symptoms, and the percentage of milder and familial forms is increasing. There are no hard data to guide therapy, and current management includes pharmacological and surgical antiadrenergic interventions with sodium channel blockers often accompanied by an implantable cardioverter\u2013defibrillator.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehad418","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T21:56:47Z","timestamp":1686866207000},"page":"3357-3370","source":"Crossref","is-referenced-by-count":69,"title":["Clinical presentation of calmodulin mutations: the International Calmodulinopathy Registry"],"prefix":"10.1093","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8739-6527","authenticated-orcid":false,"given":"Lia","family":"Crotti","sequence":"first","affiliation":[{"name":"Istituto Auxologico Italiano IRCCS, Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics , Via Pier Lombardo 22, 20135 Milan , Italy"},{"name":"Department of Medicine and Surgery, University of Milano-Bicocca , Piazza dell'Ateneo Nuovo, 1, 20126 Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1209-0157","authenticated-orcid":false,"given":"Carla","family":"Spazzolini","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano IRCCS, Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics , Via Pier Lombardo 22, 20135 Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4973-8543","authenticated-orcid":false,"given":"Mette","family":"Nyegaard","sequence":"additional","affiliation":[{"name":"Department of Health Science and Technology, Aalborg University , Aalborg , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1423-2481","authenticated-orcid":false,"given":"Michael T","family":"Overgaard","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Bioscience, Aalborg University , Aalborg , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9629-2172","authenticated-orcid":false,"given":"Maria-Christina","family":"Kotta","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano IRCCS, Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics , Via Pier Lombardo 22, 20135 Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1090-3292","authenticated-orcid":false,"given":"Federica","family":"Dagradi","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano IRCCS, Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics , Via Pier Lombardo 22, 20135 Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4129-6632","authenticated-orcid":false,"given":"Luca","family":"Sala","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano IRCCS, Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics , Via Pier Lombardo 22, 20135 Milan , Italy"},{"name":"Department of Biotechnology and Biosciences, University of Milano-Bicocca , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5590-7388","authenticated-orcid":false,"given":"Takeshi","family":"Aiba","sequence":"additional","affiliation":[{"name":"Division of Arrhythmia, National Cerebral and Cardiovascular Center , Suita , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8571-2098","authenticated-orcid":false,"given":"Mark 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