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Ross SB, Singer ES, Driscoll E, Nowak N, Yeates L, Puranik R, Sy RW, Rajagopalan S, Barratt A, Ingles J, Bagnall RD, Semsarian C. Genetic architecture of left ventricular noncompaction in adults. Hum Genome Var 2020; 7:33. [PMID: 33082984 PMCID: PMC7566488 DOI: 10.1038/s41439-020-00120-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 12/01/2022] Open
Abstract
The genetic etiology and heritability of left ventricular noncompaction (LVNC) in adults is unclear. This study sought to assess the value of genetic testing in adults with LVNC. Adults diagnosed with LVNC while undergoing screening in the context of a family history of cardiomyopathy were excluded. Clinical data for 35 unrelated patients diagnosed with LVNC at ≥18 years of age were retrospectively analyzed. Left ventricular (LV) dysfunction, electrocardiogram (ECG) abnormalities, cardiac malformations or syndromic features were identified in 25 patients; 10 patients had isolated LVNC in the absence of cardiac dysfunction or syndromic features. Exome sequencing was performed, and analysis using commercial panels targeted 193 nuclear and mitochondrial genes. Nucleotide variants in coding regions or in intron-exon boundaries with predicted impacts on splicing were assessed. Fifty-four rare variants were identified in 35 nuclear genes. Across all 35 LVNC patients, the clinically meaningful genetic diagnostic yield was 9% (3/35), with heterozygous likely pathogenic or pathogenic variants identified in the NKX2-5 and TBX5 genes encoding cardiac transcription factors. No pathogenic variants were identified in patients with isolated LVNC in the absence of cardiac dysfunction or syndromic features. In conclusion, the diagnostic yield of genetic testing in adult index patients with LVNC is low. Genetic testing is most beneficial in LVNC associated with other cardiac and syndromic features, in which it can facilitate correct diagnoses, and least useful in adults with only isolated LVNC without a family history. Cardiac transcription factors are important in the development of LVNC and should be included in genetic testing panels.
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Affiliation(s)
- Samantha Barratt Ross
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Newtown, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Newtown, Australia
- Wiser Healthcare, Sydney, Australia
| | - Emma S. Singer
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Newtown, Australia
| | - Elizabeth Driscoll
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Newtown, Australia
| | - Natalie Nowak
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Newtown, Australia
| | - Laura Yeates
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Newtown, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Newtown, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Rajesh Puranik
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Newtown, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Raymond W. Sy
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Newtown, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
| | | | - Alexandra Barratt
- Wiser Healthcare, Sydney, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jodie Ingles
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Newtown, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Newtown, Australia
- Wiser Healthcare, Sydney, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Richard D. Bagnall
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Newtown, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Newtown, Australia
| | - Christopher Semsarian
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, The University of Sydney, Newtown, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Newtown, Australia
- Wiser Healthcare, Sydney, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
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Ross SB, Bagnall RD, Yeates L, Sy RW, Semsarian C. Holt-Oram syndrome in two families diagnosed with left ventricular noncompaction and conduction disease. HeartRhythm Case Rep 2018; 4:146-151. [PMID: 29755943 PMCID: PMC5944048 DOI: 10.1016/j.hrcr.2017.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Samantha Barratt Ross
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Newtown, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Richard D Bagnall
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Newtown, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Laura Yeates
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Newtown, Australia.,Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Raymond W Sy
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Christopher Semsarian
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Newtown, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia.,Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
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Yokoyama R, Kinoshita K, Hata Y, Abe M, Matsuoka K, Hirono K, Kano M, Nakazawa M, Ichida F, Nishida N, Tabata T. A mutant HCN4 channel in a family with bradycardia, left bundle branch block, and left ventricular noncompaction. Heart Vessels 2018; 33:802-819. [DOI: 10.1007/s00380-018-1116-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 01/05/2018] [Indexed: 01/09/2023]
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