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Zheng J, Peng L, Cheng R, Li Z, Xie J, Huang E, Cheng J, Zhao Q. RAF1 mutation leading to hypertrophic cardiomyopathy in a Chinese family with a history of sudden cardiac death: A diagnostic insight into Noonan syndrome. Mol Genet Genomic Med 2024; 12:e2290. [PMID: 37787490 PMCID: PMC10767430 DOI: 10.1002/mgg3.2290] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 09/10/2023] [Accepted: 09/19/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Hypertrophic cardiomyopathy (HCM) is predominantly caused by mutations in sarcomeric genes. However, a subset of cases is attributed to genetic disorders unrelated to sarcomeric genes, such as Noonan syndrome (NS) and other RASopathies. In this study, we present a family with a history of sudden cardiac death (SCD) and focus on two adults with syndromic left ventricular hypertrophy (LVH). METHODS Clinical evaluations, including echocardiography, were conducted to assess cardiac manifestations. Whole-exome sequencing was performed to identify potential genetic variants underlying syndromic LVH in the study participants. RESULTS Whole-exome sequencing revealed a missense variant in the RAF1 gene, c.782C>T (p.Pro261Leu). This variant confirmed the diagnosis of NS in the affected individuals. CONCLUSION The findings of this study underscore the importance of family history investigation and genetic testing in diagnosing syndromic LVH. By identifying the underlying genetic cause, clinicians can better understand the etiology of RAS-HCM and its association with SCD in young adults.
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Affiliation(s)
- Jingjing Zheng
- Faculty of Forensic Medicine, Zhongshan School of MedicineSun Yat‐Sen UniversityGuangzhouChina
- Guangdong Province Translational Forensic Medicine Engineering Technology Research CenterSun Yat‐Sen UniversityGuangzhouChina
| | - Longyun Peng
- Department of CardiologyThe First Affiliated Hospital, Sun Yat‐Sen UniversityGuangzhouChina
| | - Ruofei Cheng
- Faculty of Forensic Medicine, Zhongshan School of MedicineSun Yat‐Sen UniversityGuangzhouChina
- Guangdong Province Translational Forensic Medicine Engineering Technology Research CenterSun Yat‐Sen UniversityGuangzhouChina
| | - Zhiyan Li
- Faculty of Forensic Medicine, Zhongshan School of MedicineSun Yat‐Sen UniversityGuangzhouChina
- Guangdong Province Translational Forensic Medicine Engineering Technology Research CenterSun Yat‐Sen UniversityGuangzhouChina
| | - Jianjie Xie
- Faculty of Forensic Medicine, Zhongshan School of MedicineSun Yat‐Sen UniversityGuangzhouChina
- Guangdong Province Translational Forensic Medicine Engineering Technology Research CenterSun Yat‐Sen UniversityGuangzhouChina
| | - Erwen Huang
- Faculty of Forensic Medicine, Zhongshan School of MedicineSun Yat‐Sen UniversityGuangzhouChina
- Guangdong Province Translational Forensic Medicine Engineering Technology Research CenterSun Yat‐Sen UniversityGuangzhouChina
| | - Jianding Cheng
- Faculty of Forensic Medicine, Zhongshan School of MedicineSun Yat‐Sen UniversityGuangzhouChina
- Guangdong Province Translational Forensic Medicine Engineering Technology Research CenterSun Yat‐Sen UniversityGuangzhouChina
| | - Qianhao Zhao
- Faculty of Forensic Medicine, Zhongshan School of MedicineSun Yat‐Sen UniversityGuangzhouChina
- Guangdong Province Translational Forensic Medicine Engineering Technology Research CenterSun Yat‐Sen UniversityGuangzhouChina
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Chumakova OS, Baulina NM. Advanced searching for hypertrophic cardiomyopathy heritability in real practice tomorrow. Front Cardiovasc Med 2023; 10:1236539. [PMID: 37583586 PMCID: PMC10425241 DOI: 10.3389/fcvm.2023.1236539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/17/2023] [Indexed: 08/17/2023] Open
Abstract
Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disease associated with morbidity and mortality at any age. As studies in recent decades have shown, the genetic architecture of HCM is quite complex both in the entire population and in each patient. In the rapidly advancing era of gene therapy, we have to provide a detailed molecular diagnosis to our patients to give them the chance for better and more personalized treatment. In addition to emphasizing the importance of genetic testing in routine practice, this review aims to discuss the possibility to go a step further and create an expanded genetic panel that contains not only variants in core genes but also new candidate genes, including those located in deep intron regions, as well as structural variations. It also highlights the benefits of calculating polygenic risk scores based on a combination of rare and common genetic variants for each patient and of using non-genetic HCM markers, such as microRNAs that can enhance stratification of risk for HCM in unselected populations alongside rare genetic variants and clinical factors. While this review is focusing on HCM, the discussed issues are relevant to other cardiomyopathies.
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Affiliation(s)
- Olga S. Chumakova
- Laboratory of Functional Genomics of Cardiovascular Diseases, National Medical Research Centre of Cardiology Named After E.I. Chazov, Moscow, Russia
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Hilal N, Chen Z, Chen MH, Choudhury S. RASopathies and cardiac manifestations. Front Cardiovasc Med 2023; 10:1176828. [PMID: 37529712 PMCID: PMC10387527 DOI: 10.3389/fcvm.2023.1176828] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/20/2023] [Indexed: 08/03/2023] Open
Abstract
As binary switches, RAS proteins switch to an ON/OFF state during signaling and are on a leash under normal conditions. However, in RAS-related diseases such as cancer and RASopathies, mutations in the genes that regulate RAS signaling or the RAS itself permanently activate the RAS protein. The structural basis of this switch is well understood; however, the exact mechanisms by which RAS proteins are regulated are less clear. RAS/MAPK syndromes are multisystem developmental disorders caused by germline mutations in genes associated with the RAS/mitogen-activated protein kinase pathway, impacting 1 in 1,000-2,500 children. These include a variety of disorders such as Noonan syndrome (NS) and NS-related disorders (NSRD), such as cardio facio cutaneous (CFC) syndrome, Costello syndrome (CS), and NS with multiple lentigines (NSML, also known as LEOPARD syndrome). A frequent manifestation of cardiomyopathy (CM) and hypertrophic cardiomyopathy associated with RASopathies suggest that RASopathies could be a potential causative factor for CM. However, the current supporting evidence is sporadic and unclear. RASopathy-patients also display a broad spectrum of congenital heart disease (CHD). More than 15 genes encode components of the RAS/MAPK signaling pathway that are essential for the cell cycle and play regulatory roles in proliferation, differentiation, growth, and metabolism. These genes are linked to the molecular genetic pathogenesis of these syndromes. However, genetic heterogeneity for a given syndrome on the one hand and alleles for multiple syndromes on the other make classification difficult in diagnosing RAS/MAPK-related diseases. Although there is some genetic homogeneity in most RASopathies, several RASopathies are allelic diseases. This allelism points to the role of critical signaling nodes and sheds light on the overlap between these related syndromes. Even though considerable progress has been made in understanding the pathophysiology of RASopathy with the identification of causal mutations and the functional analysis of their pathophysiological consequences, there are still unidentified causal genes for many patients diagnosed with RASopathies.
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Affiliation(s)
- Nazia Hilal
- Division of Genetics and Genomics, Department of Pediatrics, Boston Children’s Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- Broad Institute of Harvard and MIT, Cambridge, MA, United States
| | - Zi Chen
- Harvard Medical School, Boston, MA, United States
- Department of Surgery, Brigham, and Women’s Hospital, Boston, MA, United States
| | - Ming Hui Chen
- Harvard Medical School, Boston, MA, United States
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, United States
| | - Sangita Choudhury
- Division of Genetics and Genomics, Department of Pediatrics, Boston Children’s Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- Broad Institute of Harvard and MIT, Cambridge, MA, United States
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4
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Serraino GF, Jiritano F, Costa D, Ielapi N, Napolitano D, Mastroroberto P, Bracale UM, Andreucci M, Serra R. Metalloproteinases and Hypertrophic Cardiomyopathy: A Systematic Review. Biomolecules 2023; 13:biom13040665. [PMID: 37189412 DOI: 10.3390/biom13040665] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/30/2023] [Accepted: 04/07/2023] [Indexed: 05/17/2023] Open
Abstract
Hypertrophic cardiomyopathy (HCM) is a genetic condition determined by an altered collagen turnover of the extracellular matrix. Matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) are abnormally released in patients with HCM. The purpose of this systematic review was to thoroughly summarize and discuss the existing knowledge of MMPs profile in patients with HCM. All studies meeting the inclusion criteria (detailed data regarding MMPs in patients with HCM) were selected, after screening the literature from July 1975 to November 2022. Sixteen trials that enrolled a total of 892 participants were included. MMPs-particularly MMP2-levels were found higher in HCM patients compared to healthy subjects. MMPs were used as biomarkers after surgical and percutaneous treatments. Understanding the molecular processes that control the cardiac ECM's collagen turnover allows for a non-invasive evaluation of HCM patients through the monitoring of MMPs and TIMPs.
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Affiliation(s)
- Giuseppe Filiberto Serraino
- Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Federica Jiritano
- Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Davide Costa
- Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Nicola Ielapi
- Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
- Department of Public Health and Infectious Disease, "Sapienza" University of Rome, 00185 Roma, Italy
| | - Desirèe Napolitano
- Ph.D. Student "Digital Medicine" Ph.D. Programm-Magna Graecia, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Pasquale Mastroroberto
- Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Umberto Marcello Bracale
- Department of Public Health, Vascular Surgery Unit, University of Naples "Federico II", 80126 Naples, Italy
| | - Michele Andreucci
- Department of Health Sciences, Nephrology Unit, University of Catanzaro, 88100 Catanzaro, Italy
| | - Raffaele Serra
- Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
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5
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Lynch A, Tatangelo M, Ahuja S, Steve Fan CP, Min S, Lafreniere-Roula M, Papaz T, Zhou V, Armstrong K, Aziz PF, Benson LN, Butts R, Dragulescu A, Gardin L, Godown J, Jeewa A, Kantor PF, Kaufman BD, Lal AK, Parent JJ, Richmond M, Russell MW, Balaji S, Stephenson EA, Villa C, Jefferies JL, Whitehill R, Conway J, Howard TS, Nakano SJ, Rossano J, Weintraub RG, Mital S. Risk of Sudden Death in Patients With RASopathy Hypertrophic Cardiomyopathy. J Am Coll Cardiol 2023; 81:1035-1045. [PMID: 36922089 DOI: 10.1016/j.jacc.2023.01.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/29/2022] [Accepted: 01/09/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Genetic defects in the RAS/mitogen-activated protein kinase pathway are an important cause of hypertrophic cardiomyopathy (RAS-HCM). Unlike primary HCM (P-HCM), the risk of sudden cardiac death (SCD) and long-term survival in RAS-HCM are poorly understood. OBJECTIVES The study's objective was to compare transplant-free survival, incidence of SCD, and implantable cardioverter-defibrillator (ICD) use between RAS-HCM and P-HCM patients. METHODS In an international, 21-center cohort study, we analyzed phenotype-positive pediatric RAS-HCM (n = 188) and P-HCM (n = 567) patients. The between-group differences in cumulative incidence of all outcomes from first evaluation were compared using Gray's tests, and age-related hazard of all-cause mortality was determined. RESULTS RAS-HCM patients had a lower median age at diagnosis compared to P-HCM (0.9 years [IQR: 0.2-5.0 years] vs 9.8 years [IQR: 2.0-13.9 years], respectively) (P < 0.001). The 10-year cumulative incidence of SCD from first evaluation was not different between RAS-HCM and P-HCM (4.7% vs 4.2%, respectively; P = 0.59). The 10-year cumulative incidence of nonarrhythmic deaths or transplant was higher in RAS-HCM compared with P-HCM (11.0% vs 5.4%, respectively; P = 0.011). The 10-year cumulative incidence of ICD insertions, however, was 5-fold lower in RAS-HCM compared with P-HCM (6.9% vs 36.6%; P < 0.001). Nonarrhythmic deaths occurred primarily in infancy and SCD primarily in adolescence. CONCLUSIONS RAS-HCM was associated with a higher incidence of nonarrhythmic death or transplant but similar incidence of SCD as P-HCM. However, ICDs were used less frequently in RAS-HCM compared to P-HCM. In addition to monitoring for heart failure and timely consideration of advanced heart failure therapies, better risk stratification is needed to guide ICD practices in RAS-HCM.
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Affiliation(s)
- Aine Lynch
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto Ontario, Canada
| | - Mark Tatangelo
- Ted Rogers Computational Program, Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
| | - Sachin Ahuja
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Chun-Po Steve Fan
- Ted Rogers Computational Program, Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
| | - Sandar Min
- Genetics and Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Myriam Lafreniere-Roula
- Applied Health Research Centre, St Michael's Hospital of Unity Health Toronto, Toronto, Ontario, Canada
| | - Tanya Papaz
- Genetics and Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada; Ted Rogers Centre for Heart Research, Toronto, Ontario, Canada
| | - Vivian Zhou
- Genetics and Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kathryn Armstrong
- Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Peter F Aziz
- Department of Pediatrics, Cleveland Clinic Children's Hospital, Cleveland, Ohio, USA
| | - Lee N Benson
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto Ontario, Canada
| | - Ryan Butts
- Department of Pediatrics, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Andreea Dragulescu
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto Ontario, Canada
| | - Letizia Gardin
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Justin Godown
- Department of Pediatrics, Monroe Carrell Jr Children's Hospital at Vanderbilt University, Nashville, Tennessee, USA
| | - Aamir Jeewa
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto Ontario, Canada
| | - Paul F Kantor
- Department of Pediatrics, Children's Hospital of Los Angeles, Los Angeles, California, USA
| | - Beth D Kaufman
- Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University, Palo Alto, California, USA
| | - Ashwin K Lal
- Department of Pediatrics, Primary Children's Hospital, University of Utah, Salt Lake City, Utah, USA
| | - John J Parent
- Department of Pediatrics, Riley Children's Hospital, Indianapolis, Indiana, USA
| | - Marc Richmond
- Department of Pediatrics, Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, New York, USA
| | - Mark W Russell
- Department of Pediatrics, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Seshadri Balaji
- Department of Pediatrics, Oregon Health and Science University, Portland, Oregon, USA
| | - Elizabeth A Stephenson
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto Ontario, Canada
| | - Chet Villa
- Department of Pediatrics, Cincinnati Children's Hospital, Cincinnati, Ohio, USA
| | - John L Jefferies
- Department of Pediatrics, University of Tennessee Health Sciences Centre, Memphis, Tennessee, USA
| | - Robert Whitehill
- Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Jennifer Conway
- Department of Pediatrics, Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Taylor S Howard
- Department of Pediatrics, Texas Children's Hospital, Houston, Texas, USA
| | - Stephanie J Nakano
- Department of Pediatrics, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Joseph Rossano
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Robert G Weintraub
- Department of Cardiology, The Royal Children's Hospital of Melbourne, Melbourne, Victoria, Australia
| | - Seema Mital
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto Ontario, Canada; Ted Rogers Computational Program, Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada; Ted Rogers Centre for Heart Research, Toronto, Ontario, Canada.
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6
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Woodland M, Al-Horani RA. New Era: Mavacamten for Obstructive Hypertrophic Cardiomyopathy. Cardiovasc Hematol Agents Med Chem 2023; 21:78-83. [PMID: 36278454 PMCID: PMC10249146 DOI: 10.2174/1871525721666221019095218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/23/2022] [Accepted: 09/16/2022] [Indexed: 11/22/2022]
Abstract
Obstructive hypertrophic cardiomyopathy results from asymmetric septal hypertrophy, which eventually obstructs the outflow of the left ventricle. Obstructive hypertrophic cardiomyopathy is linked to mutations in genes that encode for sarcomere proteins, including actin, β-myosin heavy chain, titin, and troponin. The mutations lead to structural abnormalities in myocytes and myofibrils, causing conduction irregularities and abnormal force generation. Obstructive hypertrophic cardiomyopathy is a chronic disease that worsens over time, and patients become at higher risk of developing atrial fibrillation, heart failure, and stroke. Up until recently, there were no disease- specific medications for obstructive hypertrophic cardiomyopathy. Nevertheless, the US Food and Drug Administration approved mavacamten on April 28, 2022, for the treatment of symptomatic obstructive hypertrophic cardiomyopathy (New York Heart Association class II to III) in adults to improve functional capacity and symptoms. Its approval was based on data from EXPLORER- HCM and EXPLORER-LTE (NCT03723655). Mavacamten is a novel, first-in-class, orally active, allosteric inhibitor of cardiac myosin ATPase, which decreases the formation of actin- myosin cross-bridges, and thus, it reduces myocardial contractility, and it improves myocardial energetics. It represents a paradigm-shifting pharmacological treatment of obstructive hypertrophic cardiomyopathy. In this review, we describe its chemical and mechanistic aspects as well as its pharmacokinetics, adverse effects and warnings, potential drug-drug interactions, and contraindications.
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Affiliation(s)
- Ma’Lik Woodland
- Division of Basic Pharmaceutical Sciences, College of Pharmacy, Xavier University of Louisiana, New Orleans LA 70125, USA
| | - Rami A. Al-Horani
- Division of Basic Pharmaceutical Sciences, College of Pharmacy, Xavier University of Louisiana, New Orleans LA 70125, USA
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7
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Hathaway J, Heliö K, Saarinen I, Tallila J, Seppälä EH, Tuupanen S, Turpeinen H, Kangas-Kontio T, Schleit J, Tommiska J, Kytölä V, Valori M, Muona M, Sistonen J, Gentile M, Salmenperä P, Myllykangas S, Paananen J, Alastalo TP, Heliö T, Koskenvuo J. Diagnostic yield of genetic testing in a heterogeneous cohort of 1376 HCM patients. BMC Cardiovasc Disord 2021; 21:126. [PMID: 33673806 PMCID: PMC7934228 DOI: 10.1186/s12872-021-01927-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 02/22/2021] [Indexed: 12/20/2022] Open
Abstract
Background Genetic testing in hypertrophic cardiomyopathy (HCM) is a published guideline-based recommendation. The diagnostic yield of genetic testing and corresponding HCM-associated genes have been largely documented by single center studies and carefully selected patient cohorts. Our goal was to evaluate the diagnostic yield of genetic testing in a heterogeneous cohort of patients with a clinical suspicion of HCM, referred for genetic testing from multiple centers around the world. Methods A retrospective review of patients with a suspected clinical diagnosis of HCM referred for genetic testing at Blueprint Genetics was undertaken. The analysis included syndromic, myopathic and metabolic etiologies. Genetic test results and variant classifications were extracted from the database. Variants classified as pathogenic (P) or likely pathogenic (LP) were considered diagnostic. Results A total of 1376 samples were analyzed. Three hundred and sixty-nine tests were diagnostic (26.8%); 373 P or LP variants were identified. Only one copy number variant was identified. The majority of diagnostic variants involved genes encoding the sarcomere (85.0%) followed by 4.3% of diagnostic variants identified in the RASopathy genes. Two percent of diagnostic variants were in genes associated with a cardiomyopathy other than HCM or an inherited arrhythmia. Clinical variables that increased the likelihood of identifying a diagnostic variant included: an earlier age at diagnosis (p < 0.0001), a higher maximum wall thickness (MWT) (p < 0.0001), a positive family history (p < 0.0001), the absence of hypertension (p = 0.0002), and the presence of an implantable cardioverter-defibrillator (ICD) (p = 0.0004). Conclusion The diagnostic yield of genetic testing in this heterogeneous cohort of patients with a clinical suspicion of HCM is lower than what has been reported in well-characterized patient cohorts. We report the highest yield of diagnostic variants in the RASopathy genes identified in a laboratory cohort of HCM patients to date. The spectrum of genes implicated in this unselected cohort highlights the importance of pre-and post-test counseling when offering genetic testing to the broad HCM population. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-01927-5.
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Affiliation(s)
- Julie Hathaway
- Blueprint Genetics, a Quest Diagnostics Company, 2505 3rd Ave, Suite 204, Seattle, 98121, USA.
| | - Krista Heliö
- Heart and Lung Center, Meilahti Tower Hospital, Helsinki University Hospital, Haartmaninkatu 4, P.O. Box 340, 00029, Helsinki, Finland
| | - Inka Saarinen
- Blueprint Genetics, a Quest Diagnostics Company, Keilaranta 16 A-B, 02150, Espoo, Finland
| | - Jonna Tallila
- Blueprint Genetics, a Quest Diagnostics Company, Keilaranta 16 A-B, 02150, Espoo, Finland
| | - Eija H Seppälä
- Blueprint Genetics, a Quest Diagnostics Company, Keilaranta 16 A-B, 02150, Espoo, Finland
| | - Sari Tuupanen
- Blueprint Genetics, a Quest Diagnostics Company, Keilaranta 16 A-B, 02150, Espoo, Finland
| | - Hannu Turpeinen
- Blueprint Genetics, a Quest Diagnostics Company, Keilaranta 16 A-B, 02150, Espoo, Finland
| | - Tiia Kangas-Kontio
- Blueprint Genetics, a Quest Diagnostics Company, Keilaranta 16 A-B, 02150, Espoo, Finland
| | - Jennifer Schleit
- Blueprint Genetics, a Quest Diagnostics Company, 2505 3rd Ave, Suite 204, Seattle, 98121, USA
| | - Johanna Tommiska
- Blueprint Genetics, a Quest Diagnostics Company, Keilaranta 16 A-B, 02150, Espoo, Finland
| | - Ville Kytölä
- Blueprint Genetics, a Quest Diagnostics Company, Keilaranta 16 A-B, 02150, Espoo, Finland
| | - Miko Valori
- Blueprint Genetics, a Quest Diagnostics Company, Keilaranta 16 A-B, 02150, Espoo, Finland
| | - Mikko Muona
- Blueprint Genetics, a Quest Diagnostics Company, Keilaranta 16 A-B, 02150, Espoo, Finland
| | - Johanna Sistonen
- Blueprint Genetics, a Quest Diagnostics Company, Keilaranta 16 A-B, 02150, Espoo, Finland
| | - Massimiliano Gentile
- Blueprint Genetics, a Quest Diagnostics Company, Keilaranta 16 A-B, 02150, Espoo, Finland
| | - Pertteli Salmenperä
- Blueprint Genetics, a Quest Diagnostics Company, Keilaranta 16 A-B, 02150, Espoo, Finland
| | - Samuel Myllykangas
- Blueprint Genetics, a Quest Diagnostics Company, Keilaranta 16 A-B, 02150, Espoo, Finland
| | - Jussi Paananen
- Blueprint Genetics, a Quest Diagnostics Company, Keilaranta 16 A-B, 02150, Espoo, Finland
| | - Tero-Pekka Alastalo
- Blueprint Genetics, a Quest Diagnostics Company, 2505 3rd Ave, Suite 204, Seattle, 98121, USA
| | - Tiina Heliö
- Heart and Lung Center, Meilahti Tower Hospital, Helsinki University Hospital, Haartmaninkatu 4, P.O. Box 340, 00029, Helsinki, Finland
| | - Juha Koskenvuo
- Blueprint Genetics, a Quest Diagnostics Company, Keilaranta 16 A-B, 02150, Espoo, Finland
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8
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Risi C, Schäfer LU, Belknap B, Pepper I, White HD, Schröder GF, Galkin VE. High-Resolution Cryo-EM Structure of the Cardiac Actomyosin Complex. Structure 2021; 29:50-60.e4. [PMID: 33065066 PMCID: PMC7796959 DOI: 10.1016/j.str.2020.09.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/29/2020] [Accepted: 09/25/2020] [Indexed: 12/31/2022]
Abstract
Heart contraction depends on a complicated array of interactions between sarcomeric proteins required to convert chemical energy into mechanical force. Cyclic interactions between actin and myosin molecules, controlled by troponin and tropomyosin, generate the sliding force between the actin-based thin and myosin-based thick filaments. Alterations in this sophisticated system due to missense mutations can lead to cardiovascular diseases. Numerous structural studies proposed pathological mechanisms of missense mutations at the myosin-myosin, actin-tropomyosin, and tropomyosin-troponin interfaces. However, despite the central role of actomyosin interactions a detailed structural description of the cardiac actomyosin interface remained unknown. Here, we report a cryo-EM structure of a cardiac actomyosin complex at 3.8 Å resolution. The structure reveals the molecular basis of cardiac diseases caused by missense mutations in myosin and actin proteins.
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Affiliation(s)
- Cristina Risi
- Department of Physiological Sciences, Eastern Virginia Medical School, Norfolk, VA 23507, USA
| | - Luisa U Schäfer
- Institute of Biological Information Processing (IBI-7), Forschungszentrum Jülich, 52425 Jülich, Germany
| | - Betty Belknap
- Department of Physiological Sciences, Eastern Virginia Medical School, Norfolk, VA 23507, USA
| | - Ian Pepper
- Department of Physiological Sciences, Eastern Virginia Medical School, Norfolk, VA 23507, USA
| | - Howard D White
- Department of Physiological Sciences, Eastern Virginia Medical School, Norfolk, VA 23507, USA
| | - Gunnar F Schröder
- Institute of Biological Information Processing (IBI-7), Forschungszentrum Jülich, 52425 Jülich, Germany; Physics Department, Heinrich-Heine Universität Düsseldorf, 40225 Düsseldorf, Germany
| | - Vitold E Galkin
- Department of Physiological Sciences, Eastern Virginia Medical School, Norfolk, VA 23507, USA.
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9
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Cowan JR, Salyer L, Wright NT, Kinnamon DD, Amaya P, Jordan E, Bamshad MJ, Nickerson DA, Hershberger RE. SOS1 Gain-of-Function Variants in Dilated Cardiomyopathy. CIRCULATION-GENOMIC AND PRECISION MEDICINE 2020; 13:e002892. [PMID: 32603605 DOI: 10.1161/circgen.119.002892] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Dilated cardiomyopathy (DCM) is a genetically heterogeneous cardiac disease characterized by progressive ventricular enlargement and reduced systolic function. Here, we report genetic and functional analyses implicating the rat sarcoma signaling protein, SOS1 (Son of sevenless homolog 1), in DCM pathogenesis. METHODS Exome sequencing was performed on 412 probands and family members from our DCM cohort, identifying several SOS1 variants with potential disease involvement. As several lines of evidence have implicated dysregulated rat sarcoma signaling in the pathogenesis of DCM, we assessed functional impact of each variant on the activation of ERK (extracellular signal-regulated kinase), AKT (protein kinase B), and JNK (c-Jun N-terminal kinase) pathways. Relative expression levels were determined by Western blot in HEK293T cells transfected with variant or wild-type human SOS1 expression constructs. RESULTS A rare SOS1 variant [c.571G>A, p.(Glu191Lys)] was found to segregate alongside an A-band TTN truncating variant in a pedigree with aggressive, early-onset DCM. Reduced disease severity in the absence of the SOS1 variant suggested its potential involvement as a genetic risk factor for DCM in this family. Exome sequencing identified 5 additional SOS1 variants with potential disease involvement in 4 other families [c.1820T>C, p.(Ile607Thr); c.2156G>C, p.(Gly719Ala); c.2230A>G, p.(Arg744Gly); c.2728G>C, p.(Asp910His); c.3601C>T, p.(Arg1201Trp)]. Impacted amino acids occupied a number of functional domains relevant to SOS1 activity, including the N-terminal histone fold, as well as the C-terminal REM (rat sarcoma exchange motif), CDC25 (cell division cycle 25), and PR (proline-rich) tail domains. Increased phosphorylated ERK expression relative to wild-type levels was seen for all 6 SOS1 variants, paralleling known disease-relevant SOS1 signaling profiles. CONCLUSIONS These data support gain-of-function variation in SOS1 as a contributing factor to isolated DCM.
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Affiliation(s)
- Jason R Cowan
- Dorothy M. Davis Heart and Lung Research Institute (J.R.C., L.S., D.D.K., P.A., E.J., R.E.H.), Department of Internal Medicine, The Ohio State University College of Medicine, Columbus.,Division of Human Genetics (J.R.C., L.S., D.D.K., P.A., E.J., R.E.H.), Department of Internal Medicine, The Ohio State University College of Medicine, Columbus
| | - Lorien Salyer
- Dorothy M. Davis Heart and Lung Research Institute (J.R.C., L.S., D.D.K., P.A., E.J., R.E.H.), Department of Internal Medicine, The Ohio State University College of Medicine, Columbus.,Division of Human Genetics (J.R.C., L.S., D.D.K., P.A., E.J., R.E.H.), Department of Internal Medicine, The Ohio State University College of Medicine, Columbus
| | - Nathan T Wright
- Department of Chemistry and Biochemistry, James Madison University, Harrisonburg, VA (N.T.W.)
| | - Daniel D Kinnamon
- Dorothy M. Davis Heart and Lung Research Institute (J.R.C., L.S., D.D.K., P.A., E.J., R.E.H.), Department of Internal Medicine, The Ohio State University College of Medicine, Columbus.,Division of Human Genetics (J.R.C., L.S., D.D.K., P.A., E.J., R.E.H.), Department of Internal Medicine, The Ohio State University College of Medicine, Columbus
| | - Pedro Amaya
- Dorothy M. Davis Heart and Lung Research Institute (J.R.C., L.S., D.D.K., P.A., E.J., R.E.H.), Department of Internal Medicine, The Ohio State University College of Medicine, Columbus.,Division of Human Genetics (J.R.C., L.S., D.D.K., P.A., E.J., R.E.H.), Department of Internal Medicine, The Ohio State University College of Medicine, Columbus
| | - Elizabeth Jordan
- Dorothy M. Davis Heart and Lung Research Institute (J.R.C., L.S., D.D.K., P.A., E.J., R.E.H.), Department of Internal Medicine, The Ohio State University College of Medicine, Columbus.,Division of Human Genetics (J.R.C., L.S., D.D.K., P.A., E.J., R.E.H.), Department of Internal Medicine, The Ohio State University College of Medicine, Columbus
| | - Michael J Bamshad
- Department of Pediatrics (M.J.B.), University of Washington, Seattle
| | | | - Ray E Hershberger
- Dorothy M. Davis Heart and Lung Research Institute (J.R.C., L.S., D.D.K., P.A., E.J., R.E.H.), Department of Internal Medicine, The Ohio State University College of Medicine, Columbus.,Division of Human Genetics (J.R.C., L.S., D.D.K., P.A., E.J., R.E.H.), Department of Internal Medicine, The Ohio State University College of Medicine, Columbus.,Division of Cardiovascular Medicine (R.E.H.), Department of Internal Medicine, The Ohio State University College of Medicine, Columbus
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