Mohamed El Sayed

191 Summary and general discussion are likely also applicable to men with non-classical FD. However, international cooperation is required to collect more data of men with non-classical FD (identified through family screening) so that a specific cardiac course model can be developed for this patient group. In addition, since women with nonclassical FD did not experience MACE, they were not included in the model below. Furthermore, only a small proportion of these patients (9%) experienced non-major cardiac problems (AF and conduction abnormalities) after the seventh decade [2]. Given the low likelihood of the development of cardiac complications in this group compared to other FD patients, it is questionable whether these few events are truly related to the genetic trait (carrying a GLA variant) or whether other cardiovascular risk factors may have contributed more in these patients. Future research should determine whether a non- classical variant in women may be considered as a cardiovascular risk with a minor contribution to the overall morbidity and mortality. As outlined in the beginning of this discussion, it is our ultimate goal to develop more differentiated guidelines for initiation and follow-up of treatment based upon additional markers, besides phenotype and sex. To this end we attempted to compile a cardiac disease model. This requires a thorough analysis of the course of the cardiac markers, which is discussed below. 6

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