1
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Blanco-Verea A, Piñeiro B, Gil R, Ramos-Luis E, Álvarez-Barredo M, López-Abel B, Sobrino B, Amigo J, González-Juanatey JR, Carracedo Á, Brion M. Detection of the Copy Number Variants of Genes in Patients with Familial Cardiac Diseases by Massively Parallel Sequencing. Mol Diagn Ther 2023; 27:105-113. [PMID: 36454422 DOI: 10.1007/s40291-022-00624-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION The implication of copy number variations in familial heart disease is known, although in-depth knowledge is lacking; hence, more studies are needed to further our understanding. Massively parallel sequencing, thanks to its recent surge in use, is emerging as a valid tool for the detection of this type of variant, through the use of appropriate software. METHODS We conducted a study with 182 patients diagnosed with mendelian cardiovascular diseases who underwent sequencing using a cardiac gene panel and then a specific calling process for copy number variations (CNVs) with ExomeDepth software, which provides us with a Bayes factor (BF), a score of the probability that a CNV detected is true. RESULTS After a rigorous CNV prioritization process, we confirmed the variants obtained by MLPA or SNP-based array, finding three real CNVs in five individuals in the MYH11, FBN1 and PDMI7 genes. CONCLUSION The confirmed CNVs present in all cases BF values > 60, thus establishing a threshold to consider real CNVs in the calling process carried out by ExomeDepth on our gene panel.
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Affiliation(s)
- Alejandro Blanco-Verea
- Cardiovascular Genetics, Santiago de Compostela Health Research Institute, Santiago de Compostela, Spain.
- Genomic Medicine Group, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
| | - Brais Piñeiro
- Cardiovascular Genetics, Santiago de Compostela Health Research Institute, Santiago de Compostela, Spain
| | - Rocio Gil
- Cardiovascular Genetics, Santiago de Compostela Health Research Institute, Santiago de Compostela, Spain
- Genomic Medicine Group, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Eva Ramos-Luis
- Cardiovascular Genetics, Santiago de Compostela Health Research Institute, Santiago de Compostela, Spain
- Genomic Medicine Group, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - María Álvarez-Barredo
- Cardiovascular Genetics, Santiago de Compostela Health Research Institute, Santiago de Compostela, Spain
- Inherited Cardiac Diseases Unit, Department of Cardiology, Santiago de Compostela University Hospital, Santiago de Compostela, Spain
- Centre for Biomedical Network Research on Cardiovascular Diseases (CIBERCV), Carlos III Health Institute, Madrid, Spain
| | - Bernardo López-Abel
- Cardiovascular Genetics, Santiago de Compostela Health Research Institute, Santiago de Compostela, Spain
- Inherited Cardiac Diseases Unit, Department of Paediatric, Santiago de Compostela University Hospital, Santiago de Compostela, Spain
| | - Beatriz Sobrino
- Genomic Medicine Group, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Fundación Pública Galega de Medicina Xenómica, Sistema Galego de Saúde, Santiago de Compostela, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Carlos III Health Institute, Madrid, Spain
| | - Jorge Amigo
- Genomic Medicine Group, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Fundación Pública Galega de Medicina Xenómica, Sistema Galego de Saúde, Santiago de Compostela, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Carlos III Health Institute, Madrid, Spain
| | - José Ramón González-Juanatey
- Centre for Biomedical Network Research on Cardiovascular Diseases (CIBERCV), Carlos III Health Institute, Madrid, Spain
- Cardiology Department, Santiago de Compostela University Hospital, Santiago de Compostela, Spain
| | - Ángel Carracedo
- Genomic Medicine Group, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Fundación Pública Galega de Medicina Xenómica, Sistema Galego de Saúde, Santiago de Compostela, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Carlos III Health Institute, Madrid, Spain
| | - María Brion
- Cardiovascular Genetics, Santiago de Compostela Health Research Institute, Santiago de Compostela, Spain
- Genomic Medicine Group, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Inherited Cardiac Diseases Unit, Department of Cardiology, Santiago de Compostela University Hospital, Santiago de Compostela, Spain
- Centre for Biomedical Network Research on Cardiovascular Diseases (CIBERCV), Carlos III Health Institute, Madrid, Spain
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2
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Martínez-Barrios E, Cesar S, Cruzalegui J, Hernandez C, Arbelo E, Fiol V, Brugada J, Brugada R, Campuzano O, Sarquella-Brugada G. Clinical Genetics of Inherited Arrhythmogenic Disease in the Pediatric Population. Biomedicines 2022; 10:106. [PMID: 35052786 PMCID: PMC8773373 DOI: 10.3390/biomedicines10010106] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/27/2021] [Accepted: 12/31/2021] [Indexed: 12/19/2022] Open
Abstract
Sudden death is a rare event in the pediatric population but with a social shock due to its presentation as the first symptom in previously healthy children. Comprehensive autopsy in pediatric cases identify an inconclusive cause in 40-50% of cases. In such cases, a diagnosis of sudden arrhythmic death syndrome is suggested as the main potential cause of death. Molecular autopsy identifies nearly 30% of cases under 16 years of age carrying a pathogenic/potentially pathogenic alteration in genes associated with any inherited arrhythmogenic disease. In the last few years, despite the increasing rate of post-mortem genetic diagnosis, many families still remain without a conclusive genetic cause of the unexpected death. Current challenges in genetic diagnosis are the establishment of a correct genotype-phenotype association between genes and inherited arrhythmogenic disease, as well as the classification of variants of uncertain significance. In this review, we provide an update on the state of the art in the genetic diagnosis of inherited arrhythmogenic disease in the pediatric population. We focus on emerging publications on gene curation for genotype-phenotype associations, cases of genetic overlap and advances in the classification of variants of uncertain significance. Our goal is to facilitate the translation of genetic diagnosis to the clinical area, helping risk stratification, treatment and the genetic counselling of families.
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Affiliation(s)
- Estefanía Martínez-Barrios
- Arrhythmias Unit, Hospital Sant Joan de Déu, University of Barcelona, 08007 Barcelona, Spain; (E.M.-B.); (S.C.); (J.C.); (C.H.); (V.F.); (J.B.)
| | - Sergi Cesar
- Arrhythmias Unit, Hospital Sant Joan de Déu, University of Barcelona, 08007 Barcelona, Spain; (E.M.-B.); (S.C.); (J.C.); (C.H.); (V.F.); (J.B.)
| | - José Cruzalegui
- Arrhythmias Unit, Hospital Sant Joan de Déu, University of Barcelona, 08007 Barcelona, Spain; (E.M.-B.); (S.C.); (J.C.); (C.H.); (V.F.); (J.B.)
| | - Clara Hernandez
- Arrhythmias Unit, Hospital Sant Joan de Déu, University of Barcelona, 08007 Barcelona, Spain; (E.M.-B.); (S.C.); (J.C.); (C.H.); (V.F.); (J.B.)
| | - Elena Arbelo
- Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain; (E.A.); (R.B.)
- Arrhythmias Unit, Hospital Clinic, University of Barcelona-IDIBAPS, 08036 Barcelona, Spain
| | - Victoria Fiol
- Arrhythmias Unit, Hospital Sant Joan de Déu, University of Barcelona, 08007 Barcelona, Spain; (E.M.-B.); (S.C.); (J.C.); (C.H.); (V.F.); (J.B.)
| | - Josep Brugada
- Arrhythmias Unit, Hospital Sant Joan de Déu, University of Barcelona, 08007 Barcelona, Spain; (E.M.-B.); (S.C.); (J.C.); (C.H.); (V.F.); (J.B.)
- Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain; (E.A.); (R.B.)
- Arrhythmias Unit, Hospital Clinic, University of Barcelona-IDIBAPS, 08036 Barcelona, Spain
| | - Ramon Brugada
- Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain; (E.A.); (R.B.)
- Medical Science Department, School of Medicine, University of Girona, 17004 Girona, Spain
- Cardiovascular Genetics Center, University of Girona-IDIBGI, 17190 Girona, Spain
- Cardiology Service, Hospital Josep Trueta, University of Girona, 17007 Girona, Spain
| | - Oscar Campuzano
- Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain; (E.A.); (R.B.)
- Medical Science Department, School of Medicine, University of Girona, 17004 Girona, Spain
- Cardiovascular Genetics Center, University of Girona-IDIBGI, 17190 Girona, Spain
| | - Georgia Sarquella-Brugada
- Arrhythmias Unit, Hospital Sant Joan de Déu, University of Barcelona, 08007 Barcelona, Spain; (E.M.-B.); (S.C.); (J.C.); (C.H.); (V.F.); (J.B.)
- Medical Science Department, School of Medicine, University of Girona, 17004 Girona, Spain
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3
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Beckmann BM, Scheiper-Welling S, Wilde AAM, Kääb S, Schulze-Bahr E, Kauferstein S. Clinical utility gene card for: Long-QT syndrome. Eur J Hum Genet 2021; 29:1825-1832. [PMID: 34031550 PMCID: PMC8633377 DOI: 10.1038/s41431-021-00904-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/25/2021] [Accepted: 04/23/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- Britt M Beckmann
- Department of Legal Medicine, University Hospital Frankfurt, Frankfurt am Main, Germany. .,Department of Medicine I, University Hospital, LMU Munich, Munich, Germany.
| | | | - Arthur A M Wilde
- Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam, The Netherlands.,European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARDHEART; http://guardheart.ern-net.eu), Amsterdam, The Netherlands.,Department of Clinical and Experimental Cardiology, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Stefan Kääb
- Department of Medicine I, University Hospital, LMU Munich, Munich, Germany.,German Center for Cardiovascular Research (DZHK), Partnersite Munich, Munich, Germany
| | - Eric Schulze-Bahr
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARDHEART; http://guardheart.ern-net.eu), Amsterdam, The Netherlands.,Institute for Genetics of Heart Diseases, University Hospital Münster, Münster, Germany
| | - Silke Kauferstein
- Department of Legal Medicine, University Hospital Frankfurt, Frankfurt am Main, Germany
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4
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Grassi S, Campuzano O, Coll M, Cazzato F, Sarquella-Brugada G, Rossi R, Arena V, Brugada J, Brugada R, Oliva A. Update on the Diagnostic Pitfalls of Autopsy and Post-Mortem Genetic Testing in Cardiomyopathies. Int J Mol Sci 2021; 22:ijms22084124. [PMID: 33923560 PMCID: PMC8074148 DOI: 10.3390/ijms22084124] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/04/2021] [Accepted: 04/14/2021] [Indexed: 02/08/2023] Open
Abstract
Inherited cardiomyopathies are frequent causes of sudden cardiac death (SCD), especially in young patients. Despite at the autopsy they usually have distinctive microscopic and/or macroscopic diagnostic features, their phenotypes may be mild or ambiguous, possibly leading to misdiagnoses or missed diagnoses. In this review, the main differential diagnoses of hypertrophic cardiomyopathy (e.g., athlete's heart, idiopathic left ventricular hypertrophy), arrhythmogenic cardiomyopathy (e.g., adipositas cordis, myocarditis) and dilated cardiomyopathy (e.g., acquired forms of dilated cardiomyopathy, left ventricular noncompaction) are discussed. Moreover, the diagnostic issues in SCD victims affected by phenotype-negative hypertrophic cardiomyopathy and the relationship between myocardial bridging and hypertrophic cardiomyopathy are analyzed. Finally, the applications/limits of virtopsy and post-mortem genetic testing in this field are discussed, with particular attention to the issues related to the assessment of the significance of the genetic variants.
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Affiliation(s)
- Simone Grassi
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.C.); (R.R.); (A.O.)
- Correspondence:
| | - Oscar Campuzano
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain; (O.C.); (M.C.); (J.B.); (R.B.)
- Cardiovascular Genetics Center, Institut d’Investigació Biomèdica Girona (IDIBGI), University of Girona, 17190 Girona, Spain
- Medical Science Department, School of Medicine, University of Girona, 17003 Girona, Spain;
| | - Mònica Coll
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain; (O.C.); (M.C.); (J.B.); (R.B.)
- Cardiovascular Genetics Center, Institut d’Investigació Biomèdica Girona (IDIBGI), University of Girona, 17190 Girona, Spain
- Medical Science Department, School of Medicine, University of Girona, 17003 Girona, Spain;
| | - Francesca Cazzato
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.C.); (R.R.); (A.O.)
| | - Georgia Sarquella-Brugada
- Medical Science Department, School of Medicine, University of Girona, 17003 Girona, Spain;
- Arrhythmias Unit, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain
| | - Riccardo Rossi
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.C.); (R.R.); (A.O.)
| | - Vincenzo Arena
- Area of Pathology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00147 Rome, Italy;
- Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Josep Brugada
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain; (O.C.); (M.C.); (J.B.); (R.B.)
- Arrhythmias Unit, Hospital Sant Joan de Déu, University of Barcelona, 08950 Barcelona, Spain
- Institut Clínic Cardiovascular (ICCV), Hospital Clínic, Universitat de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Ramon Brugada
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain; (O.C.); (M.C.); (J.B.); (R.B.)
- Cardiovascular Genetics Center, Institut d’Investigació Biomèdica Girona (IDIBGI), University of Girona, 17190 Girona, Spain
- Medical Science Department, School of Medicine, University of Girona, 17003 Girona, Spain;
| | - Antonio Oliva
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.C.); (R.R.); (A.O.)
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5
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Sarquella-Brugada G, García-Algar O, Zambrano MD, Fernández-Falgueres A, Sailer S, Cesar S, Sebastiani G, Martí-Almor J, Aurensanz E, Cruzalegui JC, Merchan EF, Coll M, Pérez-Serra A, Del Olmo B, Fiol V, Iglesias A, Ferrer-Costa C, Puigmulé M, Lopez L, Pico F, Arbelo E, Jordà P, Brugada J, Brugada R, Campuzano O. Early Identification of Prolonged QT Interval for Prevention of Sudden Infant Death. Front Pediatr 2021; 9:704580. [PMID: 34395343 PMCID: PMC8358435 DOI: 10.3389/fped.2021.704580] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/05/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction: Long QT syndrome is the main arrhythmogenic disease responsible for sudden death in infants, especially in the first days of life. Performing an electrocardiogram in newborns could enable early diagnosis and adoption of therapeutic measures focused on preventing lethal arrhythmogenic events. However, the inclusion of an electrocardiogram in neonatal screening protocols still remains a matter of discussion. To comprehensively analyse the potential clinical value of performing an electrocardiogram and subsequent follow-up in a cohort of newborns. Methods: Electrocardiograms were performed in 685 neonates within the first week of life. One year follow-up was performed if QTc > 450 ms identified. Comprehensive genetic analysis using massive sequencing was performed in all cases with QTc > 470 ms. Results: We identified 54 neonates with QTc > 450 ms/ <470 ms; all normalized QTc values within 6 months. Eight cases had QTc > 480 ms at birth and, if persistent, pharmacological treatment was administrated during follow-up. A rare variant was identified as the potential cause of long QT syndrome in five cases. Three cases showed a family history of sudden arrhythmogenic death. Conclusions: Our prospective study identifies 0.14% of cases with a definite long QT, supporting implementation of electrocardiograms in routine pediatric protocols. It is an effective, simple and non-invasive approach that can help prevent sudden death in neonates and their relatives. Genetic analyses help to unravel the cause of arrhythmogenic disease in diagnosing neonates. Further, clinical assessment and genetic analysis of relatives allowed early identification of family members at risk of arrhythmias helping to adopt preventive personalized measures.
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Affiliation(s)
- Georgia Sarquella-Brugada
- Arrhythmias Unit, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Medical Science Department, School of Medicine, University of Girona, Girona, Spain
| | - Oscar García-Algar
- Department of Neonatology, Hospital Clínic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatología, BCNatal, Barcelona, Spain
| | - María Dolores Zambrano
- Arrhythmias Unit, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | | | - Sebastian Sailer
- Department of Neonatology, Hospital Clínic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatología, BCNatal, Barcelona, Spain.,Department of Neonatology, Faculty of Medicine, Kepler University Hospital, Johannes Kepler University, Linz, Austria
| | - Sergi Cesar
- Arrhythmias Unit, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Giorgia Sebastiani
- Department of Neonatology, Hospital Clínic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatología, BCNatal, Barcelona, Spain
| | | | - Esther Aurensanz
- Arrhythmias Unit, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Jose Carlos Cruzalegui
- Arrhythmias Unit, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Erika Fernanda Merchan
- Arrhythmias Unit, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Mónica Coll
- Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain
| | - Alexandra Pérez-Serra
- Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain
| | - Bernat Del Olmo
- Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain
| | - Victoria Fiol
- Arrhythmias Unit, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Anna Iglesias
- Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain
| | - Carles Ferrer-Costa
- Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain
| | - Marta Puigmulé
- Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain
| | - Laura Lopez
- Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain
| | - Ferran Pico
- Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain
| | - Elena Arbelo
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain.,Arrhythmias Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Paloma Jordà
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain.,Arrhythmias Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Josep Brugada
- Arrhythmias Unit, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain.,Arrhythmias Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Ramon Brugada
- Medical Science Department, School of Medicine, University of Girona, Girona, Spain.,Cardiology Service, Hospital Josep Trueta, University of Girona, Girona, Spain.,Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain
| | - Oscar Campuzano
- Medical Science Department, School of Medicine, University of Girona, Girona, Spain.,Cardiovascular Genetics Center, University of Girona-Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain
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6
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Yatsenko SA, Aarabi M, Hu J, Surti U, Ortiz D, Madan-Khetarpal S, Saller DN, Bellissimo D, Rajkovic A. Copy number alterations involving 59 ACMG-recommended secondary findings genes. Clin Genet 2020; 98:577-588. [PMID: 33009833 DOI: 10.1111/cge.13852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/14/2020] [Accepted: 09/13/2020] [Indexed: 12/17/2022]
Abstract
In clinical exome/genome sequencing, the American College of Medical Genetics and Genomics (ACMG) recommends reporting of secondary findings unrelated to a patient's phenotype when pathogenic single-nucleotide variants (SNVs) are observed in one of 59 genes associated with a life-threatening, medically actionable condition. Little is known about the incidence and sensitivity of chromosomal microarray analysis (CMA) for detection of pathogenic copy number variants (CNVs) comprising medically-actionable genes. Clinical CMA has been performed on 8865 individuals referred for molecular cytogenetic testing. We retrospectively reviewed the CMA results to identify patients with CNVs comprising genes included in the 59-ACMG list of secondary findings. We evaluated the clinical significance of these CNVs in respect to pathogenicity, phenotypic manifestations, and heritability. We identified 23 patients (0.26%) with relevant CNV either deletions comprising the entire gene or intragenic alterations involving one or more secondary findings genes. A number of patients and/or their family members with pathogenic CNVs manifest or expected to develop an anticipated clinical phenotype and would benefit from preventive management similar to the patients with pathogenic SNVs. To improve patients' care standardization should apply to reporting of both sequencing and CNVs obtained via clinical genome-wide analysis, including chromosomal microarray and exome/genome sequencing.
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Affiliation(s)
- Svetlana A Yatsenko
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA.,Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mahmoud Aarabi
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jie Hu
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Urvashi Surti
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Damara Ortiz
- Department of Medical Genetics, Childrens Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA
| | - Suneeta Madan-Khetarpal
- Department of Medical Genetics, Childrens Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA
| | - Devereux N Saller
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Daniel Bellissimo
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Aleksandar Rajkovic
- Department of Pathology, University of California San Francisco, San Francisco, California, USA.,Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California, USA
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7
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Sudden Cardiac Death and Copy Number Variants: What Do We Know after 10 Years of Genetic Analysis? Forensic Sci Int Genet 2020; 47:102281. [PMID: 32248082 DOI: 10.1016/j.fsigen.2020.102281] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 03/02/2020] [Accepted: 03/18/2020] [Indexed: 02/07/2023]
Abstract
Over the last ten years, analysis of copy number variants has increasingly been applied to the study of arrhythmogenic pathologies associated with sudden death, mainly due to significant advances in the field of massive genetic sequencing. Nevertheless, few published reports have focused on the prevalence of copy number variants associated with sudden cardiac death. As a result, the frequency of these genetic alterations in arrhythmogenic diseases as well as their genetic interpretation and clinical translation has not been established. This review summarizes the current available data concerning copy number variants in sudden cardiac death-related diseases.
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8
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Harper AR, Parikh VN, Goldfeder RL, Caleshu C, Ashley EA. Delivering Clinical Grade Sequencing and Genetic Test Interpretation for Cardiovascular Medicine. ACTA ACUST UNITED AC 2019; 10:CIRCGENETICS.116.001221. [PMID: 28411191 DOI: 10.1161/circgenetics.116.001221] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Andrew R Harper
- From the Royal Brompton and Harefield NHS Foundation Trust, London (A.R.H.); Wellcome Trust Centre for Human Genetics, University of Oxford, United Kingdom (A.R.H.); Department of Genetics, Stanford University, Stanford, CA (E.A.A., R.L.G.); and Center for Inherited Cardiovascular Disease, Stanford University, Stanford, CA (V.N.P., R.L.G., C.C., E.A.A.)
| | - Victoria N Parikh
- From the Royal Brompton and Harefield NHS Foundation Trust, London (A.R.H.); Wellcome Trust Centre for Human Genetics, University of Oxford, United Kingdom (A.R.H.); Department of Genetics, Stanford University, Stanford, CA (E.A.A., R.L.G.); and Center for Inherited Cardiovascular Disease, Stanford University, Stanford, CA (V.N.P., R.L.G., C.C., E.A.A.)
| | - Rachel L Goldfeder
- From the Royal Brompton and Harefield NHS Foundation Trust, London (A.R.H.); Wellcome Trust Centre for Human Genetics, University of Oxford, United Kingdom (A.R.H.); Department of Genetics, Stanford University, Stanford, CA (E.A.A., R.L.G.); and Center for Inherited Cardiovascular Disease, Stanford University, Stanford, CA (V.N.P., R.L.G., C.C., E.A.A.)
| | - Colleen Caleshu
- From the Royal Brompton and Harefield NHS Foundation Trust, London (A.R.H.); Wellcome Trust Centre for Human Genetics, University of Oxford, United Kingdom (A.R.H.); Department of Genetics, Stanford University, Stanford, CA (E.A.A., R.L.G.); and Center for Inherited Cardiovascular Disease, Stanford University, Stanford, CA (V.N.P., R.L.G., C.C., E.A.A.)
| | - Euan A Ashley
- From the Royal Brompton and Harefield NHS Foundation Trust, London (A.R.H.); Wellcome Trust Centre for Human Genetics, University of Oxford, United Kingdom (A.R.H.); Department of Genetics, Stanford University, Stanford, CA (E.A.A., R.L.G.); and Center for Inherited Cardiovascular Disease, Stanford University, Stanford, CA (V.N.P., R.L.G., C.C., E.A.A.).
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9
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Dharmawan T, Nakajima T, Ohno S, Iizuka T, Tamura S, Kaneko Y, Horie M, Kurabayashi M. Identification of a novel exon3 deletion of RYR2 in a family with catecholaminergic polymorphic ventricular tachycardia. Ann Noninvasive Electrocardiol 2019; 24:e12623. [PMID: 30615235 PMCID: PMC6850420 DOI: 10.1111/anec.12623] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 11/01/2018] [Accepted: 11/13/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND RYR2, encoding cardiac ryanodine receptor, is the major responsible gene for catecholaminergic polymorphic ventricular tachycardia (CPVT). Meanwhile, KCNJ2, encoding inward-rectifier potassium channel (IK1 ), can be the responsible gene for atypical CPVT. We recently encountered a family with CPVT and sought to identify a responsible gene variant. METHODS A targeted panel sequencing (TPS) was employed in the proband. Copy number variation (CNV) in RYR2 was identified by focusing on read numbers in the TPS and long-range PCR. Cascade screening was conducted by a Sanger method and long-range PCR. KCNJ2 wild-type (WT) or an identified variant was expressed in COS-1 cells, and whole-cell currents (IK1 ) were recorded using patch-clamp techniques. RESULTS A 40-year-old female experienced cardiopulmonary arrest while cycling. Her ECG showed sinus bradycardia with prominent U-waves (≥0.2 mV). She had left ventricular hypertrabeculation at apex. Exercise induced frequent polymorphic ventricular arrhythmias. Her sister died suddenly at age 35 while bouldering. Her father and paternal aunt, with prominent U-waves, received permanent pacemaker due to sinus node dysfunction. The initial TPS and cascade screening identified a KCNJ2 E118D variant in all three symptomatic patients. However, after focusing on read numbers, we identified a novel exon3 deletion of RYR2 (RYR2-exon3 deletion) in all of them. Functional analysis revealed that KCNJ2 E118D generated IK1 indistinguishable from KCNJ2 WT, even in the presence of catecholaminergic stimulation. CONCLUSIONS Focusing on the read numbers in the TPS enabled us to identify a novel CNV, RYR2-exon3 deletion, which was associated with phenotypic features of this family.
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Affiliation(s)
- Tommy Dharmawan
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tadashi Nakajima
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Seiko Ohno
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center, Suita, Japan.,Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Takashi Iizuka
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Shuntaro Tamura
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yoshiaki Kaneko
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Minoru Horie
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | - Masahiko Kurabayashi
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
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10
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Abstract
Genetic testing has an increasingly important role in the diagnosis and management of cardiac disorders, where it confirms the diagnosis, aids prognostication and risk stratification and guides treatment. A genetic diagnosis in the proband also enables clarification of the risk for family members by cascade testing. Genetics in cardiac disorders is complex where epigenetic and environmental factors might come into interplay. Incomplete penetrance and variable expressivity is also common. Genetic results in cardiac conditions are mostly probabilistic and should be interpreted with all available clinical information. With this complexity in cardiac genetics, testing is only indicated in patients with a strong suspicion of an inheritable cardiac disorder after a full clinical evaluation. In this review we discuss the genetics underlying the major cardiomyopathies and channelopathies, and the practical aspects of diagnosing these conditions in the laboratory.
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11
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Lacey CJ, Doudney K, Bridgman PG, George PM, Mulder RT, Zarifeh JJ, Kimber B, Cadzow MJ, Black MA, Merriman TR, Lehnert K, Bickley VM, Pearson JF, Cameron VA, Kennedy MA. Copy number variants implicate cardiac function and development pathways in earthquake-induced stress cardiomyopathy. Sci Rep 2018; 8:7548. [PMID: 29765130 PMCID: PMC5954162 DOI: 10.1038/s41598-018-25827-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 04/25/2018] [Indexed: 02/07/2023] Open
Abstract
The pathophysiology of stress cardiomyopathy (SCM), also known as takotsubo syndrome, is poorly understood. SCM usually occurs sporadically, often in association with a stressful event, but clusters of cases are reported after major natural disasters. There is some evidence that this is a familial condition. We have examined three possible models for an underlying genetic predisposition to SCM. Our primary study cohort consists of 28 women who suffered SCM as a result of two devastating earthquakes that struck the city of Christchurch, New Zealand, in 2010 and 2011. To seek possible underlying genetic factors we carried out exome analysis, genotyping array analysis, and array comparative genomic hybridization on these subjects. The most striking finding was the observation of a markedly elevated rate of rare, heterogeneous copy number variants (CNV) of uncertain clinical significance (in 12/28 subjects). Several of these CNVs impacted on genes of cardiac relevance including RBFOX1, GPC5, KCNRG, CHODL, and GPBP1L1. There is no physical overlap between the CNVs, and the genes they impact do not appear to be functionally related. The recognition that SCM predisposition may be associated with a high rate of rare CNVs offers a novel perspective on this enigmatic condition.
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Affiliation(s)
- Cameron J Lacey
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
| | - Kit Doudney
- Molecular Pathology Laboratory, Canterbury Health Laboratories, Canterbury District Health Board, Christchurch, New Zealand
| | - Paul G Bridgman
- Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand
| | - Peter M George
- Molecular Pathology Laboratory, Canterbury Health Laboratories, Canterbury District Health Board, Christchurch, New Zealand
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Roger T Mulder
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Julie J Zarifeh
- Psychiatric Consultation Service, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand
| | - Bridget Kimber
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Murray J Cadzow
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Michael A Black
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Tony R Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Klaus Lehnert
- School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Vivienne M Bickley
- Molecular Pathology Laboratory, Canterbury Health Laboratories, Canterbury District Health Board, Christchurch, New Zealand
| | - John F Pearson
- Biostatistics and Computational Biology Unit, University of Otago, Christchurch, New Zealand
| | - Vicky A Cameron
- Christchurch Heart Institute, Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Martin A Kennedy
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand.
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12
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Sonoda K, Ohno S, Ozawa J, Hayano M, Hattori T, Kobori A, Yahata M, Aburadani I, Watanabe S, Matsumoto Y, Makiyama T, Horie M. Copy number variations of SCN5A in Brugada syndrome. Heart Rhythm 2018; 15:1179-1188. [PMID: 29574140 DOI: 10.1016/j.hrthm.2018.03.033] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Loss-of-function mutations in SCN5A are associated in ∼20% of Brugada syndrome (BrS) patients. Copy number variations (CNVs) have been shown to be associated with several inherited arrhythmia syndromes. OBJECTIVE The purpose of this study was to investigate SCN5A CNVs among BrS probands. METHODS The study cohort consisted of 151 BrS probands who were symptomatic or had a family history of BrS, sudden death, syncope, or arrhythmic diseases. We performed sequence analysis of SCN5A by the Sanger method. For detecting CNVs in SCN5A, we performed multiplex ligation-dependent probe amplification analysis of the 151 BrS probands. RESULTS We identified pathogenic SCN5A mutations in 20 probands by the Sanger method. In 140 probands in whom multiplex ligation-dependent probe amplification was successfully performed, 4 probands were found to present different CNVs (deletion in 3 and duplication in 1). Three of them had fatal arrhythmia events; the remaining 1 was asymptomatic but had a family history. Mean age at diagnosis was 23 ± 14 years. All of the baseline 12-lead electrocardiograms showed PQ-interval prolongation. The characteristics of these 4 probands with CNVs were similar to those of the probands with mutations leading to premature truncation of the protein or missense mutations causing peak INa reduction >90%. CONCLUSION We identified SCN5A CNVs in 2.9% of BrS probands who were symptomatic or had a family history.
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Affiliation(s)
- Keiko Sonoda
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; Department of Molecular Biology, National Cerebral and Cardiovacular Center, Suita, Japan
| | - Seiko Ohno
- Department of Molecular Biology, National Cerebral and Cardiovacular Center, Suita, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan; Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Junichi Ozawa
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Mamoru Hayano
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tetsuhisa Hattori
- Department of Molecular Biology, National Cerebral and Cardiovacular Center, Suita, Japan; Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Atsushi Kobori
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Mitsuhiko Yahata
- Department of Cardiovascular Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Isao Aburadani
- Department of Cardiovascular Medicine, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Seiichi Watanabe
- Department of Pediatrics, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Yuichi Matsumoto
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Takeru Makiyama
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Minoru Horie
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.
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13
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Role of copy number variants in sudden cardiac death and related diseases: genetic analysis and translation into clinical practice. Eur J Hum Genet 2018; 26:1014-1025. [PMID: 29511324 DOI: 10.1038/s41431-018-0119-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 01/31/2018] [Accepted: 02/01/2018] [Indexed: 12/22/2022] Open
Abstract
Several studies have identified copy number variants (CNVs) as responsible for cardiac diseases associated with sudden cardiac death (SCD), but very few exhaustive analyses in large cohorts of patients have been performed, and they have been generally focused on a specific SCD-related disease. The aim of the present study was to screen for CNVs the most prevalent genes associated with SCD in a large cohort of patients who suffered sudden unexplained death or had an inherited cardiac disease (cardiomyopathy or channelopathy). A total of 1765 European patients were analyzed with a homemade algorithm for the assessment of CNVs using high-throughput sequencing data. Thirty-six CNVs were identified (2%), and most of them appeared to have a pathogenic role. The frequency of CNVs among cases of sudden unexplained death, patients with a cardiomyopathy or a channelopathy was 1.4% (8/587), 2.3% (20/874), and 2.6% (8/304), respectively. Detection rates were particularly high for arrhythmogenic cardiomyopathy (5.1%), long QT syndrome (4.7%), and dilated cardiomyopathy (4.4%). As such large genomic rearrangements underlie a non-neglectable portion of cases, we consider that their analysis should be performed as part of the routine genetic testing of sudden unexpected death cases and patients with SCD-related diseases.
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14
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Rueda M, Wagner JL, Phillips TC, Topol SE, Muse ED, Lucas JR, Wagner GN, Topol EJ, Torkamani A. Molecular Autopsy for Sudden Death in the Young: Is Data Aggregation the Key? Front Cardiovasc Med 2017; 4:72. [PMID: 29181379 PMCID: PMC5694161 DOI: 10.3389/fcvm.2017.00072] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 10/27/2017] [Indexed: 12/18/2022] Open
Abstract
The Scripps molecular autopsy study seeks to incorporate genetic testing into the postmortem examination of cases of sudden death in the young (<45 years old). Here, we describe the results from the first 2 years of the study, which consisted of whole exome sequencing (WES) of a cohort of 50 cases predominantly from San Diego County. Apart from the individual description of cases, we analyzed the data at the cohort-level, which brought new perspectives on the genetic causes of sudden death. We investigated the advantages and disadvantages of using WES compared to a gene panel for cardiac disease (usually the first genetic test used by medical examiners). In an attempt to connect complex clinical phenotypes with genotypes, we classified samples by their genetic fingerprint. Finally, we studied the benefits of analyzing the mitochondrial DNA genome. In this regard, we found that half of the cases clinically diagnosed as sudden infant death syndrome had an increased ratio of heteroplasmic variants, and that the variants were also present in the mothers. We believe that community-based data aggregation and sharing will eventually lead to an improved classification of variants. Allele frequencies for the all cases can be accessed via our genomics browser at https://genomics.scripps.edu/browser.
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Affiliation(s)
- Manuel Rueda
- The Scripps Translational Science Institute, Scripps Health, The Scripps Research Institute, La Jolla, CA, United States
| | - Jennifer L Wagner
- The Scripps Translational Science Institute, Scripps Health, The Scripps Research Institute, La Jolla, CA, United States
| | - Tierney C Phillips
- The Scripps Translational Science Institute, Scripps Health, The Scripps Research Institute, La Jolla, CA, United States
| | - Sarah E Topol
- The Scripps Translational Science Institute, Scripps Health, The Scripps Research Institute, La Jolla, CA, United States
| | - Evan D Muse
- The Scripps Translational Science Institute, Scripps Health, The Scripps Research Institute, La Jolla, CA, United States.,Division of Cardiology, Scripps Clinic, La Jolla, CA, United States
| | - Jonathan R Lucas
- Medical Examiner Department, San Diego County, San Diego, CA, United States
| | - Glenn N Wagner
- Medical Examiner Department, San Diego County, San Diego, CA, United States
| | - Eric J Topol
- The Scripps Translational Science Institute, Scripps Health, The Scripps Research Institute, La Jolla, CA, United States.,Division of Cardiology, Scripps Clinic, La Jolla, CA, United States
| | - Ali Torkamani
- The Scripps Translational Science Institute, Scripps Health, The Scripps Research Institute, La Jolla, CA, United States
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15
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Repeat genetic testing with targeted capture sequencing in primary arrhythmia syndrome and cardiomyopathy. Eur J Hum Genet 2017; 25:1313-1323. [PMID: 29255176 DOI: 10.1038/s41431-017-0004-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 08/01/2017] [Accepted: 08/04/2017] [Indexed: 11/09/2022] Open
Abstract
In inherited primary arrhythmia syndromes (PAS) and cardiomyopathies (CMP), the yield of genetic testing varies between 20 and 75% in different diseases according to studies performed in the pre next-generation sequencing (NGS) era. It is unknown whether retesting historical negative samples with NGS techniques is worthwhile. Therefore, we assessed the value of NGS-based panel testing in previously genotype negative-phenotype positive probands. We selected 107 patients (47 PAS and 60 CMP) with a clear phenotype who remained genotype negative after genetic analysis of the main genes implicated in their specific phenotype. Targeted sequencing of the coding regions of 71 PAS- and CMP-related genes was performed. Variant interpretation and classification was done according to a cardiology-specific scoring algorithm ('Amsterdam criteria') and the ACMG-AMP criteria. Co-segregation analysis was performed when DNA and clinical data of family members were available. Finally, a genetic diagnosis could be established in 21 patients (20%), 5 PAS (11%) and 16 CMP (27%) patients, respectively. The increased detection rate was due to sequencing of novel genes in 52% of the cases and due to technical failures with the historical analysis in 48%. A total of 118 individuals were informed about their carrier state and either reassured or scheduled for proper follow-up. To conclude, genetic retesting in clinically overt PAS and CMP cases, who were genotype negative with older techniques, resulted in an additional genetic diagnosis in up to 20% of the cases. This clearly supports a policy for genetic retesting with NGS-based panels.
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16
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Pilichou K, Lazzarini E, Rigato I, Celeghin R, De Bortoli M, Perazzolo Marra M, Cason M, Jongbloed J, Calore M, Rizzo S, Regazzo D, Poloni G, Iliceto S, Daliento L, Delise P, Corrado D, Van Tintelen JP, Thiene G, Rampazzo A, Basso C, Bauce B, Lorenzon A, Occhi G. Large Genomic Rearrangements of Desmosomal Genes in Italian Arrhythmogenic Cardiomyopathy Patients. Circ Arrhythm Electrophysiol 2017; 10:CIRCEP.117.005324. [DOI: 10.1161/circep.117.005324] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 08/23/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Kalliopi Pilichou
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Elisabetta Lazzarini
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Ilaria Rigato
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Rudy Celeghin
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Marzia De Bortoli
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Marina Perazzolo Marra
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Marco Cason
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Jan Jongbloed
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Martina Calore
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Stefania Rizzo
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Daniela Regazzo
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Giulia Poloni
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Sabino Iliceto
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Luciano Daliento
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Pietro Delise
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Domenico Corrado
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - J. Peter Van Tintelen
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Gaetano Thiene
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Alessandra Rampazzo
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Cristina Basso
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Barbara Bauce
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Alessandra Lorenzon
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
| | - Gianluca Occhi
- From the Departments of Cardiac, Thoracic, and Vascular Sciences (K.P., E.L., I.R., R.C., M.P.M., M.C., S.R., S.I., L.D., D.C., G. T., C.B., B.B.) and Medicine (D.R.), University of Padua, Italy; Department of Biology, University of Padua, Italy (M.D.B., M.C., G.P., A.R., A.L., G.O.); University Medical Center Groningen, University of Groningen, The Netherlands (J.J.); Cardiology Division, Casa di Cura Pederzoli, Peschiera del Garda, Italy (P.D.); and Department of Clinical Genetics, University of
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17
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Bagnall RD, Semsarian C. Role of the molecular autopsy in the investigation of sudden cardiac death. PROGRESS IN PEDIATRIC CARDIOLOGY 2017. [DOI: 10.1016/j.ppedcard.2017.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Sonoda K, Ohno S, Otuki S, Kato K, Yagihara N, Watanabe H, Makiyama T, Minamino T, Horie M. Quantitative analysis of PKP2 and neighbouring genes in a patient with arrhythmogenic right ventricular cardiomyopathy caused by heterozygous PKP2 deletion. Europace 2017; 19:644-650. [PMID: 28431057 DOI: 10.1093/europace/euw038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 02/02/2016] [Indexed: 10/13/2023] Open
Abstract
AIMS Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a disease mainly caused by desmosome gene mutations. The genetic culprit, however, remains elusive in ∼50% of ARVC patients. One of the reasons for missing genetic abnormalities is the difficulty in detecting large deletions/duplications, which are called as copy number variation (CNV) by the Sanger sequencing method. This study aimed to identify CNVs in PKP2 and a part of other desmosome genes in ARVC patients. METHODS AND RESULTS The study cohort consisted of 71 ARVC probands who were diagnosed as definite or borderline cases based on 2010 Task Force Criteria. Among them, 32 (45%) carried at least one mutation in desmosome genes detected by the Sanger method. Using the multiplex ligation-dependent probe amplification method, we identified a male proband (1.4%) with a complete deletion of all PKP2 coding exons. He was 31 years old and showed exercise-induced sustained ventricular tachycardia with superior axis and left bundle-branch block pattern. His cardiac magnetic resonance imaging and computed tomography showed right ventricular dilatation and reduced ejection fraction. His 12-lead electrocardiogram showed T-wave inversion in V1-V3, and late potentials were positive, indicating definite ARVC. To confirm the precise location of the deletion, we performed relative quantitative PCR. We found complete deletion of both SYT10 and ALG10 located in 3' of PKP2; the total deletion size was at least 1.23 Mb. CONCLUSION Screening for CNVs in desmosome genes is useful to identify the genetic basis of disease in clinically suspected ARVC patients.
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Affiliation(s)
- Keiko Sonoda
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Tsukiwa-cho, Seta, Otsu 520-2192, Japan
| | - Seiko Ohno
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Tsukiwa-cho, Seta, Otsu 520-2192, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sou Otuki
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Koichi Kato
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Tsukiwa-cho, Seta, Otsu 520-2192, Japan
| | - Nobue Yagihara
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroshi Watanabe
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takeru Makiyama
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Minoru Horie
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Tsukiwa-cho, Seta, Otsu 520-2192, Japan
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19
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Hof T, Liu H, Sallé L, Schott JJ, Ducreux C, Millat G, Chevalier P, Probst V, Guinamard R, Bouvagnet P. TRPM4 non-selective cation channel variants in long QT syndrome. BMC MEDICAL GENETICS 2017; 18:31. [PMID: 28315637 PMCID: PMC5357330 DOI: 10.1186/s12881-017-0397-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 03/08/2017] [Indexed: 12/21/2022]
Abstract
Background Long QT syndrome (LQTS) is an inherited arrhythmic disorder characterized by prolongation of the QT interval, a risk of syncope, and sudden death. There are already a number of causal genes in LQTS, but not all LQTS patients have an identified mutation, which suggests LQTS unknown genes. Methods A cohort of 178 LQTS patients, with no mutations in the 3 major LQTS genes (KCNQ1, KCNH2, and SCN5A), was screened for mutations in the transient potential melastatin 4 gene (TRPM4). Results Four TRPM4 variants (2.2% of the cohort) were found to change highly conserved amino-acids and were either very rare or absent from control populations. Therefore, these four TRPM4 variants were predicted to be disease causing. Furthermore, no mutations were found in the DNA of these TRPM4 variant carriers in any of the 13 major long QT syndrome genes. Two of these variants were further studied by electrophysiology (p.Val441Met and p.Arg499Pro). Both variants showed a classical TRPM4 outward rectifying current, but the current was reduced by 61 and 90% respectively, compared to wild type TRPM4 current. Conclusions This study supports the view that TRPM4 could account for a small percentage of LQTS patients. TRPM4 contribution to the QT interval might be multifactorial by modulating whole cell current but also, as shown in Trpm4−/− mice, by modulating cardiomyocyte proliferation. TRPM4 enlarges the subgroup of LQT genes (KCNJ2 in Andersen syndrome and CACNA1C in Timothy syndrome) known to increase the QT interval through a more complex pleiotropic effect than merely action potential alteration.
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Affiliation(s)
- Thomas Hof
- Normandie University, UNICAEN, EA 4650, Groupe Signalisation, Electrophysiologie et Imagerie des Lésions d'Ischémie-Reperfusion Myocardique, F-14032, Caen, France
| | - Hui Liu
- Laboratoire Cardiogénétique, Institut de Biologie et Chimie des Protéines, INSERM UMR 5305, Université Lyon 1, Lyon, France.,Laboratoire Cardiogénétique, Centre de Biologie et Pathologie Est, Hospices Civils de Lyon, Bron, France.,Present Address: Department of Anatomy, Hainan Medical College, Haikou, 571101, Hainan, China
| | - Laurent Sallé
- Normandie University, UNICAEN, EA 4650, Groupe Signalisation, Electrophysiologie et Imagerie des Lésions d'Ischémie-Reperfusion Myocardique, F-14032, Caen, France
| | | | - Corinne Ducreux
- Service de Cardiologie Pédiatrique, Hôpital Louis Pradel, Bron, France
| | - Gilles Millat
- Laboratoire Cardiogénétique Moléculaire, Centre de Biologie et Pathologie Est, Hospices Civils de Lyon, Bron, France
| | | | - Vincent Probst
- Institut du thorax, INSERM UMR 1087, CNRS UMR 6291, Nantes, France.,Institut du thorax, Service de Cardiologie, CHU Nantes, Nantes, France
| | - Romain Guinamard
- Normandie University, UNICAEN, EA 4650, Groupe Signalisation, Electrophysiologie et Imagerie des Lésions d'Ischémie-Reperfusion Myocardique, F-14032, Caen, France
| | - Patrice Bouvagnet
- Laboratoire Cardiogénétique, Institut de Biologie et Chimie des Protéines, INSERM UMR 5305, Université Lyon 1, Lyon, France. .,Laboratoire Cardiogénétique, Centre de Biologie et Pathologie Est, Hospices Civils de Lyon, Bron, France. .,Service de Cardiologie Pédiatrique, Hôpital Louis Pradel, Bron, France. .,Laboratoire Cardiogénétique, Groupe Hospitalier Est, 59 boulevard Pinel, CBPE, 69677, Bron, France.
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20
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Fabbri C, Boriani G, Diemberger I, Filippi MG, Ravegnini G, Hrelia P, Minarini A, Albani D, Forloni G, Angelini S, Serretti A. Electrocardiogram Alterations Associated With Psychotropic Drug Use and CACNA1C Gene Variants in Three Independent Samples. Basic Clin Pharmacol Toxicol 2016; 120:482-490. [PMID: 27893184 DOI: 10.1111/bcpt.12720] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 11/22/2016] [Indexed: 12/17/2022]
Abstract
Several antipsychotics and antidepressants have been associated with QTc prolongation or other electrocardiogram (ECG) alterations, but their impact is still debated and other risk factors are known to affect QTc. We investigated the effect of antidepressants and antipsychotics on QTc and other ECG intervals/waves in three samples. Two discovery samples (cross-sectional sample n = 145 and prospective sample n = 68, naturalistic treatment) and a replication prospective sample (Clinical Antipsychotic Trials of Intervention Effectiveness, n = 515, randomized treatment) were analysed. In both prospective samples, baseline/follow-up changes in ECG parameters were analysed in relation to the number of psychotropic drugs stratified according to their known cardiovascular risk. In the cross-sectional sample, ECG parameters were compared among drugs with different risk profile. The possible effect of single nucleotide polymorphisms (SNPs) in the CACNA1C gene on QTc was also investigated. There was no evidence of mean QTc prolongation or increased risk of clinically relevant QTc prolongation (≥20 msec.) in association with psychotropic drugs stratified according to their known cardiovascular risk. The prescription of drugs with cardiovascular risk was less common in older individuals or individuals with cardiovascular comorbidities. Other factors (gender, baseline QTc, renal function) affected QTc. rs1006737 and SNPs in linkage disequilibrium with it modulated QTc duration/changes in all samples. An association between risk drugs and shorter RR interval or higher heart rate was found in all samples. A relevant effect of psychotropic drugs with cardiovascular risk on QTc duration was not observed. A number of factors other than psychotropic drugs may influence QTc. CACNA1C rs1006737 may modulate QTc in patients treated with psychotropic drugs.
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Affiliation(s)
- Chiara Fabbri
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Boriani
- Department of Cardiology, Modena University Hospital, University of Modena and Reggio Emilia, Modena MO, Italy
| | - Igor Diemberger
- Department of Specialist, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | | | - Gloria Ravegnini
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Patrizia Hrelia
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Alessandro Minarini
- Department of Diagnostic, Clinical and Public Health Medicine, Section of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
| | - Diego Albani
- IRCCS - Institute for Pharmacological Research "Mario Negri", Milan, Italy
| | - Gianluigi Forloni
- IRCCS - Institute for Pharmacological Research "Mario Negri", Milan, Italy
| | - Sabrina Angelini
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
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21
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Baurand A, Falcon-Eicher S, Laurent G, Villain E, Bonnet C, Thauvin-Robinet C, Jacquot C, Eicher JC, Gourraud JB, Schmitt S, Bézieau S, Giraud M, Dumont S, Kuentz P, Probst V, Burguet A, Kyndt F, Faivre L. Incomplete Timothy syndrome secondary to a mosaic mutation of the CACNA1C gene diagnosed using next-generation sequencing. Am J Med Genet A 2016; 173:531-536. [PMID: 27868338 DOI: 10.1002/ajmg.a.38045] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 10/14/2016] [Indexed: 11/12/2022]
Abstract
Autosomal dominant genetic diseases can occur de novo and in the form of somatic mosaicism, which can give rise to a less severe phenotype, and make diagnosis more difficult given the sensitivity limits of the methods used. We report the case of female child with a history of surgery for syndactyly of the hands and feet, who was admitted at 6 years of age to a pediatric intensive care unit following cardiac arrest. The electrocardiogram (ECG) showed a long QT interval that on occasions reached 500 ms. Despite the absence of facial dysmorphism and the presence of normal psychomotor development, a diagnosis of Timothy syndrome was made given the association of syndactyly and the ECG features. Sanger sequencing of the CACNA1C gene, followed by sequencing of the genes KCNQ1, KCNH2, KCNE1, KCNE2, were negative. The subsequent analysis of a panel of genes responsible for hereditary cardiac rhythm disorders using Haloplex technology revealed a recurrent mosaic p.Gly406Arg missense mutation of the CACNA1C gene in 18% of the cells. This mosaicism can explain the negative Sanger analysis and the less complete phenotype in this patient. Given the other cases in the literature, mosaic mutations in Timothy syndrome appear more common than previously thought. This case demonstrates the importance of using next-generation sequencing to identify mosaic mutations when the clinical picture supports a specific mutation that is not identified using conventional testing. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Amandine Baurand
- Centre de Génétique et Centre de Référence des Maladies Rares-Anomalies du Développement et Syndromes Malformatifs, CHU Dijon, Dijon, France
| | - Sylvie Falcon-Eicher
- Cardiologie Pédiatrique, CHU Dijon, Dijon, France.,Cardiologie et Centre de Compétence des Troubles du Rythme Cardiaque Héréditaires, CHU Dijon, Dijon, France
| | - Gabriel Laurent
- Cardiologie et Centre de Compétence des Troubles du Rythme Cardiaque Héréditaires, CHU Dijon, Dijon, France
| | - Elisabeth Villain
- Cardiologie Pédiatrique, Hôpital Necker-Enfants Malades, Paris, France
| | - Caroline Bonnet
- Cardiologie Pédiatrique, CHU Dijon, Dijon, France.,Cardiologie et Centre de Compétence des Troubles du Rythme Cardiaque Héréditaires, CHU Dijon, Dijon, France
| | - Christel Thauvin-Robinet
- Centre de Génétique et Centre de Référence des Maladies Rares-Anomalies du Développement et Syndromes Malformatifs, CHU Dijon, Dijon, France
| | - Caroline Jacquot
- Centre de Génétique et Centre de Référence des Maladies Rares-Anomalies du Développement et Syndromes Malformatifs, CHU Dijon, Dijon, France
| | - Jean-Christophe Eicher
- Cardiologie et Centre de Compétence des Troubles du Rythme Cardiaque Héréditaires, CHU Dijon, Dijon, France
| | | | | | | | | | - Solenne Dumont
- Service de Génétique Médicale, CHU Nantes, Nantes, France
| | - Paul Kuentz
- EA4271, Génétique des Anomalies du Développement, Université de Bourgogne-Franche Comté, Dijon, France
| | - Vincent Probst
- Institut du Thorax, INSERM U1087, CHU Nantes, Nantes, France
| | | | - Florence Kyndt
- Institut du Thorax, INSERM U1087, CHU Nantes, Nantes, France.,Service de Génétique Médicale, CHU Nantes, Nantes, France
| | - Laurence Faivre
- Centre de Génétique et Centre de Référence des Maladies Rares-Anomalies du Développement et Syndromes Malformatifs, CHU Dijon, Dijon, France.,Cardiologie et Centre de Compétence des Troubles du Rythme Cardiaque Héréditaires, CHU Dijon, Dijon, France.,EA4271, Génétique des Anomalies du Développement, Université de Bourgogne-Franche Comté, Dijon, France
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22
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Abstract
Approximately 80 genes in the human genome code for pore-forming subunits of potassium (K(+)) channels. Rare variants (mutations) in K(+) channel-encoding genes may cause heritable arrhythmia syndromes. Not all rare variants in K(+) channel-encoding genes are necessarily disease-causing mutations. Common variants in K(+) channel-encoding genes are increasingly recognized as modifiers of phenotype in heritable arrhythmia syndromes and in the general population. Although difficult, distinguishing pathogenic variants from benign variants is of utmost importance to avoid false designations of genetic variants as disease-causing mutations.
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Affiliation(s)
- Ahmad S Amin
- Department of Clinical and Experimental Cardiology, Heart Centre, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Arthur A M Wilde
- Department of Clinical and Experimental Cardiology, Heart Centre, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands; King Abdulaziz University, Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders, PO Box 80200, Jeddah 21589, Kingdom of Saudi Arabia.
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23
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Demir E, Hasdemir C, Ak H, Atay S, Aydin HH. Genome-Wide Association Study of Copy Number Variations in Patients with Familial Neurocardiogenic Syncope. Biochem Genet 2016; 54:487-494. [PMID: 27156083 DOI: 10.1007/s10528-016-9735-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 04/20/2016] [Indexed: 11/25/2022]
Abstract
Neurocardiogenic syncope (NCS) is the most frequent type of syncope characterized by a self-limited episode of systemic hypotension. In this study, we conducted the first genome-wide association study testing copy number variations for association with NCS. Study population consisted of 107 consecutive patients with recurrent syncope and positive head-up tilt table testing. Four families with NCS were selected for CNV analysis. Affymetrix GeneChip(®) SNP 6.0 array was used for CNV analysis. Data and statistical analysis were performed with Affymetrix genotyping console 4.0 and GraphPad Prism v6. Positive family history of NCS was present in 19.6 % (n = 21) in our study population (n = 107). Twenty-six CNV regions were found to be significantly altered in families with NCS (P < 0.05). Several CNVs were identified in families with NCS. Further studies comprising wider study population are required to determine the effect of these variations on NCS development.
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Affiliation(s)
- Emre Demir
- Department of Cardiology, Ege University School of Medicine, 35100, Izmir, Turkey
| | - Can Hasdemir
- Department of Cardiology, Ege University School of Medicine, 35100, Izmir, Turkey
| | - Handan Ak
- Department of Medical Biochemistry, Ege University School of Medicine, Bornova, 35100, Izmir, Turkey
| | - Sevcan Atay
- Department of Medical Biochemistry, Ege University School of Medicine, Bornova, 35100, Izmir, Turkey
| | - Hikmet Hakan Aydin
- Department of Medical Biochemistry, Ege University School of Medicine, Bornova, 35100, Izmir, Turkey.
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24
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WANG M, CUI D. Influence of cross-disorder analyses on the diagnostic criteria of mental illnesses. SHANGHAI ARCHIVES OF PSYCHIATRY 2016; 28:45-7. [PMID: 27688644 PMCID: PMC4984609 DOI: 10.11919/j.issn.1002-0829.216032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Cross-disorder studies are identifying shared genetic variations among common mental illnesses - including schizophrenia, bipolar disorder, and major depression - which are classified as independent disorders in the current diagnostic system. These cross-disorder studies are challenging the traditional system of diagnosing mental disorders based on clinical symptoms, but it remains to be seen whether or not they will lead to an improved method of classifying psychiatric disorders that can, in turn, lead to better outcomes for individuals suffering from these conditions.
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Affiliation(s)
| | - Donghong CUI
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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25
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Abstract
PURPOSE OF REVIEW Recent international expert consensus statements have updated the clinical and genetic diagnoses of patients suffering from arrhythmogenic diseases. However, a lack of genotype-phenotype correlations has hampered the development of a risk stratification scale for sudden cardiac death. RECENT FINDINGS The improvement in the field of genetics has prompted the discovery of new genes associated with sudden cardiac death. Sudden cardiac death is a socially devastating event, especially when it occurs in the pediatric population. Physical activity can often trigger the arrhythmia and sudden death may be the first symptom. These inherited cardiac diseases may be difficult to diagnose, leaving family members also at risk. Thanks to the development of new high-throughput technologies, genetics may be used in the diagnosis of these diseases and even cases that remain unexplained after a comprehensive autopsy. Genetic testing cannot only identify the causative genetic variant in the index case, but it enables the detection of relatives at risk of sudden death, despite remaining clinically asymptomatic. SUMMARY We review the recent advances in the genetics of inherited arrhythmias associated with sudden cardiac death. We focus on the pediatric population, the main group of people suffering from lethal inherited arrhythmias.
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26
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Abstract
Ion channels in the myocardial cellular membrane are responsible for allowing the cardiac action potential. Genetic abnormalities in these channels can predispose to life-threatening arrhythmias. We discuss the basic science of the cardiac action potential; outline the different clinical entities, including information regarding overlapping diagnoses, touching upon relevant genetics, new innovations in screening, diagnosis, risk stratification, and management. The special considerations of sudden unexplained death and sudden infant death syndrome are discussed. Scientists and clinicians continue to reconcile the rapidly growing body of knowledge regarding the molecular mechanisms and genetics while continuing to improve our understanding of the various clinical entities and their diagnosis and management in clinical setting. Two separate searches were run on the National Center for Biotechnology Information's website. The first using the term cardiac channelopathies was run on the PubMed database using filters for time (published in past 5 years) and age (birth-18 years), yielding 47 results. The second search using the medical subject headings (MeSH) database with the search terms “Long QT Syndrome” (MeSH) and “Short QT Syndrome” (MeSH) and “Brugada Syndrome” (MeSH) and “Catecholaminergic Polymorphic Ventricular Tachycardia” (MeSH), applying the same filters yielded 467 results. The abstracts of these articles were studied, and the articles were categorized and organized. Articles of relevance were read in full. As and where applicable, relevant references and citations from the primary articles where further explored and read in full.
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Affiliation(s)
- Shashank P Behere
- Department of Pediatrics, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Steven N Weindling
- Department of Pediatric Cardiology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
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27
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Farrugia A, Keyser C, Hollard C, Raul J, Muller J, Ludes B. Targeted next generation sequencing application in cardiac channelopathies: Analysis of a cohort of autopsy-negative sudden unexplained deaths. Forensic Sci Int 2015; 254:5-11. [DOI: 10.1016/j.forsciint.2015.06.023] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 05/22/2015] [Accepted: 06/24/2015] [Indexed: 12/19/2022]
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Millat G, Chanavat V, Rousson R. Evaluation of a new high-throughput next-generation sequencing method based on a custom AmpliSeq™ library and ion torrent PGM™ sequencing for the rapid detection of genetic variations in long QT syndrome. Mol Diagn Ther 2015; 18:533-9. [PMID: 24687331 DOI: 10.1007/s40291-014-0099-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND OBJECTIVE Inherited long QT syndrome (LQTS) is a cardiac channelopathy associated with a high risk of sudden death. The prevalence has been estimated at close to 1:2,000. Due to large cohorts to investigate and high rate of private mutations, mutational screening must be performed using an extremely sensitive and specific detection method. Mutational screening is crucial as this may have implications for therapy and management of LQTS patients. METHODS Next-generation sequencing (NGS) workflow based on a custom AmpliSeq™ panel was designed for sequencing the five most prevalent cardiomyopathy-causing genes (KCNQ1, KCNH2, SCN5A, KCNE1, KCNE2) on Ion PGM™ Sequencer. A cohort of 30 previously studied patients was screened to evaluate this strategy in terms of sensitivity, specificity, practicability, and cost. In silico analysis was performed using NextGENe(®) software. RESULTS Our AmpliSeq™ custom panel allowed us to explore 86 % of targeted sequences efficiently. Using adjusted alignment settings, all genetic variants (40 substitutions, 17 indels) present in covered regions and previously detected by high-resolution melt (HRM)/sequencing were readily identified. Uncovered targeted regions, which were mainly located in KCNH2, were further analyzed by HRM/sequencing strategy. Complete molecular investigation was performed faster and cheaper than with previously used mutation detection methods. CONCLUSION Finally, these results suggested that our new NGS approach based on AmpliSeq™ libraries and Ion PGM™ sequencing is a highly efficient, fast, and cheap high-throughput mutation detection method that is ready to be deployed in clinical laboratories. This method will allow fast identification of LQTS mutations that will have further implications for therapeutics.
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Affiliation(s)
- Gilles Millat
- Laboratoire de Cardiogénétique Moléculaire, Centre de Biologie et Pathologie Est, Hospices Civils de Lyon, Lyon, 69677, Bron Cedex, France,
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29
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Williams VS, Cresswell CJ, Ruspi G, Yang T, Atak TC, McLoughlin M, Ingram CD, Ramirez AH, Roden D, Armstrong M. Multiplex ligation-dependent probe amplification copy number variant analysis in patients with acquired long QT syndrome. Europace 2015; 17:635-41. [PMID: 25564553 DOI: 10.1093/europace/euu288] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 09/16/2014] [Indexed: 01/06/2023] Open
Abstract
AIMS Thirteen genetic loci map to families with congenital long QT syndrome (cLQT) and multiple single nucleotide mutations have been functionally implicated in cLQT. Studies have investigated copy number variations (CNVs) in the cLQT genes to ascertain their involvement in cLQT. In these studies 3-12% of cLQT patients who were mutation negative by all other methods carried CNVs in cLQT genes. Prolongation of the QT interval can also be acquired after exposure to certain drugs [acquired LQT (aLQT)]. Single nucleotide mutations in cLQT genes have also been associated with and functionally implicated in aLQT, but to date no studies have explored CNVs as an additional susceptibility factor in aLQT. The aim of this study was to explore the contribution of CNVs in determining susceptibility to aLQT. METHODS AND RESULTS In this study we screened the commonest cLQT genes (KCNQ1; KCNH2; SCN5A; KCNE1, and KCNE2) in a general population of healthy volunteers and in a cohort of subjects presenting with aLQT for CNVs using the multiplex ligation-dependent probe amplification method. Copy number variants were detected and confirmed in 1 of 197 of the healthy volunteers and in 1 of 90 subjects with aLQT. The CNV in the aLQT subject was functionally characterized and demonstrated impaired channel function. CONCLUSION Copy number variation is a possible additional risk factor for aLQT and should be considered for incorporation into pharmacogenetic screening of LQTS genes in addition to mutation detection to improve the safety of medication administration.
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Affiliation(s)
- Victoria S Williams
- AstraZeneca, Personalised Healthcare and Biomarkers, R&D Genetics, Alderley Park, UK
| | - Carl J Cresswell
- AstraZeneca, Personalised Healthcare and Biomarkers, R&D Genetics, Alderley Park, UK
| | - Gerhard Ruspi
- School of Biomedical Sciences, King's College London, London, UK
| | - Tao Yang
- Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Thomas C Atak
- Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Matthew McLoughlin
- AstraZeneca, Personalised Healthcare and Biomarkers, R&D Genetics, Alderley Park, UK
| | | | - Andrea H Ramirez
- Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Dan Roden
- Department of Medicine, Vanderbilt University, Nashville, TN, USA Department of Pharmacology, Vanderbilt University, Nashville, TN, USA
| | - Martin Armstrong
- AstraZeneca, Personalised Healthcare and Biomarkers, R&D Genetics, Alderley Park, UK Shire AG, Business Park Terre-Bonne, Route de Crassier 7, 1262 Eysins, Switzerland
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Identification of Genetic Alterations, as Causative Genetic Defects in Long QT Syndrome, Using Next Generation Sequencing Technology. PLoS One 2014; 9:e114894. [PMID: 25494010 PMCID: PMC4262446 DOI: 10.1371/journal.pone.0114894] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 11/15/2014] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Long QT Syndrome is an inherited channelopathy leading to sudden cardiac death due to ventricular arrhythmias. Despite that several genes have been associated with the disease, nearly 20% of cases remain without an identified genetic cause. Other genetic alterations such as copy number variations have been recently related to Long QT Syndrome. Our aim was to take advantage of current genetic technologies in a family affected by Long QT Syndrome in order to identify the cause of the disease. METHODS Complete clinical evaluation was performed in all family members. In the index case, a Next Generation Sequencing custom-built panel, including 55 sudden cardiac death-related genes, was used both for detection of sequence and copy number variants. Next Generation Sequencing variants were confirmed by Sanger method. Copy number variations variants were confirmed by Multiplex Ligation dependent Probe Amplification method and at the mRNA level. Confirmed variants and copy number variations identified in the index case were also analyzed in relatives. RESULTS In the index case, Next Generation Sequencing revealed a novel variant in TTN and a large deletion in KCNQ1, involving exons 7 and 8. Both variants were confirmed by alternative techniques. The mother and the brother of the index case were also affected by Long QT Syndrome, and family cosegregation was observed for the KCNQ1 deletion, but not for the TTN variant. CONCLUSIONS Next Generation Sequencing technology allows a comprehensive genetic analysis of arrhythmogenic diseases. We report a copy number variation identified using Next Generation Sequencing analysis in Long QT Syndrome. Clinical and familiar correlation is crucial to elucidate the role of genetic variants identified to distinguish the pathogenic ones from genetic noise.
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Post-mortem genetic analysis in juvenile cases of sudden cardiac death. Forensic Sci Int 2014; 245:30-7. [PMID: 25447171 DOI: 10.1016/j.forsciint.2014.10.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 09/18/2014] [Accepted: 10/04/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND The reason behind a sudden death of a young individual remains unknown in up to 50% of postmortem cases. Pathogenic mutations in genes encoding heart proteins are known to cause sudden cardiac death. OBJECTIVE The aim of our study was to ascertain whether genetic alterations could provide an explanation for sudden cardiac death in a juvenile cohort with no-conclusive cause of death after comprehensive autopsy. METHODS Twenty-nine cases <15 years showing no-conclusive cause of death after a complete autopsy were studied. Genetic analysis of 7 main genes associated with sudden cardiac death was performed using Sanger technology in low quality DNA cases, while in good quality cases the analysis of 55 genes associated with sudden cardiac death was performed using Next Generation Sequencing technology. RESULTS Thirty-five genetic variants were identified in 12 cases (41.37%). Ten genetic/variants in genes encoding cardiac ion channels were identified in 8 cases (27.58%). We also identified 9 cases (31.03%) carrying 25 genetic variants in genes encoding structural cardiac proteins. Nine cases carried more than one genetic variation, 5 of them combining structural and non-structural genes. CONCLUSIONS Our study supports the inclusion of molecular autopsy in forensic routine protocols when no conclusive cause of death is identified. Around 40% of sudden cardiac death young cases carry a genetic variant that could provide an explanation for the cause of death. Because relatives could be at risk of sudden cardiac death, our data reinforce their need of clinical assessment and, if indicated, of genetic analysis.
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Sung JY, Bae EJ, Park S, Kim SY, Hyun YJ, Park SS, Seong MW. Large deletion in KCNQ1 identified in a family with Jervell and Lange-Nielsen syndrome. Ann Lab Med 2014; 34:395-8. [PMID: 25187895 PMCID: PMC4151011 DOI: 10.3343/alm.2014.34.5.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 01/23/2014] [Accepted: 06/24/2014] [Indexed: 11/19/2022] Open
Abstract
Long QT syndrome (LQTS) is a genetically heterogeneous disorder associated with sequence variations in more than 10 genes; in some cases, it is caused by large deletions or duplications among the main, known LQTS-associated genes. Here, we describe a 14-month-old Korean boy with congenital hearing loss and prolonged QT interval whose condition was clinically diagnosed as Jervell and Lange-Nielsen syndrome (JLNS), a recessive form of LQTS. Genetic analyses using sequence analysis and multiplex ligation-dependent probe amplification (MLPA) assay revealed a large deletion spanning exons 7-10 as well as a frameshift mutation (c.1893dup; p.Arg632Glnfs*20). To our knowledge, this is the first report of a large deletion in KCNQ1 identified in JLNS patients. This case indicates that a method such as MLPA, which can identify large deletions or duplications needs to be considered in addition to sequence analysis to diagnose JLNS.
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Affiliation(s)
- Ji Yeon Sung
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Eun Jung Bae
- Department of Pediatrics, Seoul National University Hospital, Seoul, Korea
| | | | - So Yeon Kim
- Department of Laboratory Medicine, National Medical Center, Seoul, Korea
| | - Ye Jin Hyun
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sung Sup Park
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Moon-Woo Seong
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
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Xie L, Chen JL, Zhang WZ, Wang SZ, Zhao TL, Huang C, Wang J, Yang JF, Yang YF, Tan ZP. Rare de novo copy number variants in patients with congenital pulmonary atresia. PLoS One 2014; 9:e96471. [PMID: 24826987 PMCID: PMC4020819 DOI: 10.1371/journal.pone.0096471] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Accepted: 04/08/2014] [Indexed: 11/18/2022] Open
Abstract
Background Ongoing studies using genomic microarrays and next-generation sequencing have demonstrated that the genetic contributions to cardiovascular diseases have been significantly ignored in the past. The aim of this study was to identify rare copy number variants in individuals with congenital pulmonary atresia (PA). Methods and Results Based on the hypothesis that rare structural variants encompassing key genes play an important role in heart development in PA patients, we performed high-resolution genome-wide microarrays for copy number variations (CNVs) in 82 PA patient-parent trios and 189 controls with an Illumina SNP array platform. CNVs were identified in 17/82 patients (20.7%), and eight of these CNVs (9.8%) are considered potentially pathogenic. Five de novo CNVs occurred at two known congenital heart disease (CHD) loci (16p13.1 and 22q11.2). Two de novo CNVs that may affect folate and vitamin B12 metabolism were identified for the first time. A de novo 1-Mb deletion at 17p13.2 may represent a rare genomic disorder that involves mild intellectual disability and associated facial features. Conclusions Rare CNVs contribute to the pathogenesis of PA (9.8%), suggesting that the causes of PA are heterogeneous and pleiotropic. Together with previous data from animal models, our results might help identify a link between CHD and folate-mediated one-carbon metabolism (FOCM). With the accumulation of high-resolution SNP array data, these previously undescribed rare CNVs may help reveal critical gene(s) in CHD and may provide novel insights about CHD pathogenesis.
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MESH Headings
- Adolescent
- Case-Control Studies
- Child
- Child, Preschool
- Chromosome Aberrations
- Chromosomes, Human, Pair 16
- Chromosomes, Human, Pair 17
- Chromosomes, Human, Pair 22
- DNA Copy Number Variations
- Female
- Folic Acid/metabolism
- Genetic Loci
- Genome-Wide Association Study
- Heart Defects, Congenital/diagnostic imaging
- Heart Defects, Congenital/genetics
- Heart Defects, Congenital/pathology
- Heart Defects, Congenital/surgery
- Humans
- Infant
- Infant, Newborn
- Male
- Oligonucleotide Array Sequence Analysis
- Pulmonary Atresia/diagnostic imaging
- Pulmonary Atresia/genetics
- Pulmonary Atresia/pathology
- Pulmonary Atresia/surgery
- Ultrasonography
- Vitamin B 12/metabolism
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Affiliation(s)
- Li Xie
- Department of Cardiothoracic Surgery, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Jin-Lan Chen
- Department of Cardiothoracic Surgery, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Wei-Zhi Zhang
- Department of Cardiothoracic Surgery, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Shou-Zheng Wang
- Department of Cardiothoracic Surgery, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Tian-Li Zhao
- Department of Cardiothoracic Surgery, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Can Huang
- Department of Cardiothoracic Surgery, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Jian Wang
- Department of Cardiothoracic Surgery, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
- The Clinical Center for Gene Diagnosis and Therapy of the State Key Laboratory of Medical Genetics, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Jin-Fu Yang
- Department of Cardiothoracic Surgery, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
- The Clinical Center for Gene Diagnosis and Therapy of the State Key Laboratory of Medical Genetics, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Yi-Feng Yang
- Department of Cardiothoracic Surgery, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
- The Clinical Center for Gene Diagnosis and Therapy of the State Key Laboratory of Medical Genetics, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
- * E-mail: (ZPT); (YFY)
| | - Zhi-Ping Tan
- Department of Cardiothoracic Surgery, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
- The Clinical Center for Gene Diagnosis and Therapy of the State Key Laboratory of Medical Genetics, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
- * E-mail: (ZPT); (YFY)
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Yoshinaga M, Kucho Y, Sarantuya J, Ninomiya Y, Horigome H, Ushinohama H, Shimizu W, Horie M. Genetic Characteristics of Children and Adolescents With Long-QT Syndrome Diagnosed by School-Based Electrocardiographic Screening Programs. Circ Arrhythm Electrophysiol 2014; 7:107-12. [DOI: 10.1161/circep.113.000426] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
A school-based electrocardiographic screening program has been developed in Japan. However, few data are available on the genetic characteristics of pediatric patients with long-QT syndrome who were diagnosed by this program.
Methods and Results—
A total of 117 unrelated probands aged ≤18 years were the subjects who were referred to our centers for genetic testing. Of these, 69 subjects diagnosed by the program formed the screened group. A total of 48 subjects were included in the clinical group and were diagnosed with long-QT syndrome–related symptoms, familial study, or by chance. Mutations were classified as radical, of high probability of pathogenicity, or of uncertain significance. Two subjects in the clinical group died. Genotypes were identified in 50 (72%) and 23 (48%) of subjects in the screened and clinical groups, respectively. Of the
KCNQ1
or
KCNH2
mutations, 31 of 33 (94%) in the screened group and 14 of 15 (93%) in the clinical group were radical and of high probability of pathogenicity. Prevalence of symptoms before (9/69 versus 31/48;
P
<0.0001) and after (12/69 versus 17/48;
P
=0.03) diagnosis was significantly lower in the screened group when compared with that in the clinical group although the QTc values, family history of long-QT syndrome, sudden death, and follow-up periods were not different between the groups.
Conclusions—
These data suggest that the screening program may be effective for early diagnosis of long-QT syndrome that may allow intervention before symptoms. In addition, screened patients should have follow-up equivalent to clinically identified patients.
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Affiliation(s)
- Masao Yoshinaga
- From the Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan (M.Y., Y.K., Y.N.); Department of Molecular Biology and Genetics, School of Bio-medicine, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia (J.S.); Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (H.H.); Department of Cardiology, Fukuoka Children’s Hospital and Medical Center for Infectious Diseases, Fukuoka, Japan (H.U.); Department of
| | - Yu Kucho
- From the Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan (M.Y., Y.K., Y.N.); Department of Molecular Biology and Genetics, School of Bio-medicine, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia (J.S.); Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (H.H.); Department of Cardiology, Fukuoka Children’s Hospital and Medical Center for Infectious Diseases, Fukuoka, Japan (H.U.); Department of
| | - Jav Sarantuya
- From the Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan (M.Y., Y.K., Y.N.); Department of Molecular Biology and Genetics, School of Bio-medicine, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia (J.S.); Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (H.H.); Department of Cardiology, Fukuoka Children’s Hospital and Medical Center for Infectious Diseases, Fukuoka, Japan (H.U.); Department of
| | - Yumiko Ninomiya
- From the Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan (M.Y., Y.K., Y.N.); Department of Molecular Biology and Genetics, School of Bio-medicine, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia (J.S.); Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (H.H.); Department of Cardiology, Fukuoka Children’s Hospital and Medical Center for Infectious Diseases, Fukuoka, Japan (H.U.); Department of
| | - Hitoshi Horigome
- From the Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan (M.Y., Y.K., Y.N.); Department of Molecular Biology and Genetics, School of Bio-medicine, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia (J.S.); Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (H.H.); Department of Cardiology, Fukuoka Children’s Hospital and Medical Center for Infectious Diseases, Fukuoka, Japan (H.U.); Department of
| | - Hiroya Ushinohama
- From the Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan (M.Y., Y.K., Y.N.); Department of Molecular Biology and Genetics, School of Bio-medicine, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia (J.S.); Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (H.H.); Department of Cardiology, Fukuoka Children’s Hospital and Medical Center for Infectious Diseases, Fukuoka, Japan (H.U.); Department of
| | - Wataru Shimizu
- From the Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan (M.Y., Y.K., Y.N.); Department of Molecular Biology and Genetics, School of Bio-medicine, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia (J.S.); Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (H.H.); Department of Cardiology, Fukuoka Children’s Hospital and Medical Center for Infectious Diseases, Fukuoka, Japan (H.U.); Department of
| | - Minoru Horie
- From the Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan (M.Y., Y.K., Y.N.); Department of Molecular Biology and Genetics, School of Bio-medicine, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia (J.S.); Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (H.H.); Department of Cardiology, Fukuoka Children’s Hospital and Medical Center for Infectious Diseases, Fukuoka, Japan (H.U.); Department of
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A Review of JACC Articles on the Topic of Heart Rhythm Disorders: 2011–2012. J Am Coll Cardiol 2013; 62:e451-e519. [DOI: 10.1016/j.jacc.2013.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Li Mura IEA, Bauce B, Nava A, Fanciulli M, Vazza G, Mazzotti E, Rigato I, De Bortoli M, Beffagna G, Lorenzon A, Calore M, Dazzo E, Nobile C, Luisa Mostacciuolo M, Corrado D, Basso C, Daliento L, Thiene G, Rampazzo A. Identification of a PKP2 gene deletion in a family with arrhythmogenic right ventricular cardiomyopathy. Eur J Hum Genet 2013; 21:1226-31. [PMID: 23486541 PMCID: PMC3798844 DOI: 10.1038/ejhg.2013.39] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 02/01/2013] [Accepted: 02/06/2013] [Indexed: 11/09/2022] Open
Abstract
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a primary heart muscle disease characterized by progressive myocardial loss, with fibro-fatty replacement, and high frequency of ventricular arrhythmias that can lead to sudden cardiac death. ARVC is a genetically determined disorder, usually caused by point mutations in components of the cardiac desmosome. Conventional mutation screening of ARVC genes fails to detect causative mutations in about 50% of index cases, suggesting a further genetic heterogeneity. We performed a genome-wide linkage study and a copy number variations (CNVs) analysis, using high-density SNP arrays, in an ARVC family showing no mutations in any of the desmosomal genes. The CNVs analysis identified a heterozygous deletion of about 122 kb on chromosome 12p11.21, including the entire plakophilin-2 gene and shared by all affected family members. It was not listed on any of available public CNVs databases and was confirmed by quantitative real-time PCR. This is the first SNP array-based genome-wide study leading to the identification of a CNV segregating with the disease phenotype in an ARVC family. This result underscores the importance of performing additional analysis for possible genomic deletions/duplications in ARVC patients without point mutations in known disease genes.
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Affiliation(s)
| | - Barbara Bauce
- Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy
| | - Andrea Nava
- Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy
| | | | - Giovanni Vazza
- Department of Biology, University of Padua, Padua, Italy
| | - Elisa Mazzotti
- Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy
| | - Ilaria Rigato
- Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy
| | | | | | | | - Martina Calore
- Department of Biology, University of Padua, Padua, Italy
| | - Emanuela Dazzo
- Department of Biology, University of Padua, Padua, Italy
| | - Carlo Nobile
- CNR-Institute of Neurosciences, University of Padova, Padova, Italy
| | | | - Domenico Corrado
- Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy
| | - Cristina Basso
- Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy
| | - Luciano Daliento
- Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy
| | - Gaetano Thiene
- Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy
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Moric-Janiszewska E, Węglarz L, Szczurko M. Quantitative PCR as an alternative in the diagnosis of long-QT syndrome. BIOMED RESEARCH INTERNATIONAL 2013; 2013:418604. [PMID: 23936797 PMCID: PMC3713592 DOI: 10.1155/2013/418604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 06/13/2013] [Accepted: 06/13/2013] [Indexed: 11/18/2022]
Abstract
Congenital long-QT syndrome is a genetic disorder associated with abnormalities in the function and/or structure of cardiac ion channels. Up to the present, 13 types of the disease have been described (LQTS1-13) which result from the fact that 13 genes of which mutations can have an influence on the occurrence of the disease have been identified. Characteristic symptoms of the disease include the changes in the ECG (QT interval prolonged above 450 ms), "torsade de pointes," fainting, and even sudden cardiac death. The present study has been focused on two types of the disease, namely, LQTS1 and LQTS2. The examination of two appropriate genes expression (KCNQ1; KCNH2) at the transcription level by QRT-PCR in a group of LQTS patients and a healthy control group showed different transcriptional activities of KCNH2 gene in LQTS2 patients compared to the control individuals. KCNQ1 gene expression study did not reveal such differences between both groups. The results indicate that QRT-PCR may serve as a complimentary method to the identification of molecular alterations in genetic determinants of LQTS2 only, but it cannot be used as a sole diagnostic criterion.
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Array comparative genomic hybridization as a clinical diagnostic tool in syndromic and nonsyndromic congenital heart disease. Pediatr Res 2013; 73:772-6. [PMID: 23481551 DOI: 10.1038/pr.2013.41] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Congenital heart diseases (CHDs) are often associated with other congenital anomalies, dysmorphic features, and developmental delay, and only a few cases of chromosomal abnormalities are detected by conventional cytogenetic techniques. The microarray comparative genomic hybridization (CGH) analysis allows the identification of submicroscopic genomic rearrangements. METHODS During the past 3 y, 55 of 330 patients referred for array CGH had CHD of unknown etiology plus at least one additional indication of abnormal chromosomal phenotype. High-resolution 1 × 244 K or 4 × 180 K Agilent arrays were used in this study (average resolution 7-13 kb). RESULTS Copy-number variations were detected in 37 of 55 patients, and in 29 of 37 patients there were genes that have been associated with CHD. All 37 patients had at least one additional phenotypic abnormality: 30 of 37 had one or more other congenital anomalies, 23 of 37 had dysmorphic features, 16 of 37 had intellectual disability, 13 of 37 had abnormal magnetic resonance imaging, 10 of 37 had hypotonia, and 7 of 37 had seizures. In 9 of 55 patients, unexpected genomic rearrangements in relation to their phenotype were identified. CONCLUSION In patients with CHD and at least one additional indication of abnormal chromosomal phenotype, array CGH analysis could detect possible submicroscopic chromosomal abnormalities and provide proper genetic counseling.
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Rush ET, Stevens JM, Sanger WG, Olney AH. Report of a patient with developmental delay, hearing loss, growth retardation, and cleft lip and palate and a deletion of 7q34-36.1: review of distal 7q deletions. Am J Med Genet A 2013; 161A:1726-32. [PMID: 23696251 DOI: 10.1002/ajmg.a.35951] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 02/09/2013] [Indexed: 11/10/2022]
Abstract
The use of aCGH has improved our ability to find subtle cytogenetic abnormalities as well as to find more precise information in patients with previously known abnormalities. In addition, it has allowed more specific genotype-phenotype correlation. In this report we describe a patient with a chromosomal deletion initially diagnosed with conventional cytogenetic analysis which was redemonstrated and more specifically described upon aCGH analysis. Our patient is a 12-year-old female born to a 26-year-old G1P0 mother. She was noted as a neonate to have a bilateral cleft lip and cleft palate, abnormal external ears, dysmorphic facies, and moderate to severe hearing loss. She has subsequently shown developmental delay, hyperreflexia, seizures, hyperactivity, and absence of speech. Chromosomal analysis showed deletion of 7q34q36.1. FISH studies confirmed the deletion was interstitial. Parental chromosomes were performed and did not show any cytogenetic abnormalities. aCGH was recently performed for the patient to further characterize the breakpoints of the deletion and confirmed the deletion was interstitial and of 13.2 Mb in size. Both proximal and terminal 7q deletion show a different phenotype than that of our patient. A number of patients with similar deletions have been found and while significant variability is observed, a number of findings appear to be common to deletions in this region. Therefore, we feel that distal interstitial deletions of chromosome 7q represent a recognizable phenotype and could be considered a separate deletion syndrome.
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Affiliation(s)
- Eric T Rush
- Munroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA.
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Sroubek J, Krishnan Y, McDonald TV. Sequence and structure-specific elements of HERG mRNA determine channel synthesis and trafficking efficiency. FASEB J 2013; 27:3039-53. [PMID: 23608144 DOI: 10.1096/fj.12-227009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Human ether-á-gogo-related gene (HERG) encodes a potassium channel that is highly susceptible to deleterious mutations resulting in susceptibility to fatal cardiac arrhythmias. Most mutations adversely affect HERG channel assembly and trafficking. Why the channel is so vulnerable to missense mutations is not well understood. Since nothing is known of how mRNA structural elements factor in channel processing, we synthesized a codon-modified HERG cDNA (HERG-CM) where the codons were synonymously changed to reduce GC content, secondary structure, and rare codon usage. HERG-CM produced typical IKr-like currents; however, channel synthesis and processing were markedly different. Translation efficiency was reduced for HERG-CM, as determined by heterologous expression, in vitro translation, and polysomal profiling. Trafficking efficiency to the cell surface was greatly enhanced, as assayed by immunofluorescence, subcellular fractionation, and surface labeling. Chimeras of HERG-NT/CM indicated that trafficking efficiency was largely dependent on 5' sequences, while translation efficiency involved multiple areas. These results suggest that HERG translation and trafficking rates are independently governed by noncoding information in various regions of the mRNA molecule. Noncoding information embedded within the mRNA may play a role in the pathogenesis of hereditary arrhythmia syndromes and could provide an avenue for targeted therapeutics.
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Affiliation(s)
- Jakub Sroubek
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, New York, USA
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Lee J, Lee U, Kim B, Yoon J. A computational method for detecting copy number variations using scale-space filtering. BMC Bioinformatics 2013; 14:57. [PMID: 23418726 PMCID: PMC3637191 DOI: 10.1186/1471-2105-14-57] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Accepted: 01/23/2013] [Indexed: 11/11/2022] Open
Abstract
Background As next-generation sequencing technology made rapid and cost-effective sequencing available, the importance of computational approaches in finding and analyzing copy number variations (CNVs) has been amplified. Furthermore, most genome projects need to accurately analyze sequences with fairly low-coverage read data. It is urgently needed to develop a method to detect the exact types and locations of CNVs from low coverage read data. Results Here, we propose a new CNV detection method, CNV_SS, which uses scale-space filtering. The scale-space filtering is evaluated by applying to the read coverage data the Gaussian convolution for various scales according to a given scaling parameter. Next, by differentiating twice and finding zero-crossing points, inflection points of scale-space filtered read coverage data are calculated per scale. Then, the types and the exact locations of CNVs are obtained by analyzing the finger print map, the contours of zero-crossing points for various scales. Conclusions The performance of CNV_SS showed that FNR and FPR stay in the range of 1.27% to 2.43% and 1.14% to 2.44%, respectively, even at a relatively low coverage (0.5x ≤C ≤2x). CNV_SS gave also much more effective results than the conventional methods in the evaluation of FNR, at 3.82% at least and 76.97% at most even when the coverage level of read data is low. CNV_SS source code is freely available from http://dblab.hallym.ac.kr/CNV SS/.
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Affiliation(s)
- Jongkeun Lee
- Cancer Genomics Branch and Research Institute and Hospital, National Cancer Center, Goyang, Korea
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Hu RM, Tan BH, Orland KM, Valdivia CR, Peterson A, Pu J, Makielski JC. Digenic inheritance novel mutations in SCN5a and SNTA1 increase late I(Na) contributing to LQT syndrome. Am J Physiol Heart Circ Physiol 2013; 304:H994-H1001. [PMID: 23376825 DOI: 10.1152/ajpheart.00705.2012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
SCN5A and SNTA1 are reported susceptible genes for long QT syndrome (LQTS). This study was designed to elucidate a plausible pathogenic arrhythmia mechanism for the combined novel mutations R800L-SCN5A and A261V-SNTA1 on cardiac sodium channels. A Caucasian family with syncope and marginally prolonged QT interval was screened for LQTS-susceptibility genes and found to harbor the R800L mutation in SCN5A and A261V mutation in SNTA1, and those with both mutations had the strongest clinical phenotype. The mutations were engineered into the most common splice variant of human SCN5A and SNTA1 cDNA, respectively, and sodium current (INa) was characterized in human embryonic kidney 293 cells cotransfected with neuronal nitric oxide synthase (nNOS) and the cardiac isoform of the plasma membrane Ca-ATPase (PMCA4b). Peak INa densities were unchanged for wild-type (WT) and for mutant channels containing R800L-SCN5A, A261V-SNTA1, or R800L-SCN5A plus A261V-SNTA1. However, late INa for either single mutant was moderately increased two- to threefold compared with WT. The combined mutations of R800L-SCN5A plus A261V-SNTA1 significantly enhanced the INa late/peak ratio by 5.6-fold compared with WT. The time constants of current decay of combined mutant channel were markedly increased. The gain-of-function effect could be blocked by the N(G)-monomethyl-l-arginine, a nNOS inhibitor. We conclude that novel mutations in SCN5A and SNTA1 jointly exert a nNOS-dependent gain-of-function on SCN5A channels, which may consequently prolong the action potential duration and lead to LQTS phenotype.
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Affiliation(s)
- Rou-Mu Hu
- Center for Arrhythmia Diagnosis and Treatment, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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He FZ, McLeod HL, Zhang W. Current pharmacogenomic studies on hERG potassium channels. Trends Mol Med 2013; 19:227-38. [PMID: 23369369 DOI: 10.1016/j.molmed.2012.12.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 12/18/2012] [Accepted: 12/27/2012] [Indexed: 11/25/2022]
Abstract
Genetic polymorphisms in human ether-a-go-go-related gene (hERG) potassium channels are associated with many complex diseases and sensitivity to channel-related drugs. Genotypes may underlie different sensitivities to the same drug, and different drugs selectively repair the functional deficits caused by individual mutations. In fact, not all drugs that block hERG function have adverse effects as previously thought. This suggests that the severe adverse reactions observed clinically may only occur in subjects with a particular genotype, but to others may be safe. Similarly, a drug that is ineffective in one population may be both safe and effective in another. Therefore, detecting polymorphisms in KCNH2 encoding hERG1 is of great significance in guiding the prevention and treatment of related diseases, re-evaluating drug safety, and individualizing treatment. This article reviews current pharmacogenomic studies on hERG potassium channels to provide a reference for developing individualized treatments and evaluating their safety.
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Affiliation(s)
- Fa-Zhong He
- Pharmacogenetics Research Institute, Institute of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, Central South University, Changsha, Hunan 410078, PR China
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Abriel H, Zaklyazminskaya EV. Cardiac channelopathies: genetic and molecular mechanisms. Gene 2012; 517:1-11. [PMID: 23266818 DOI: 10.1016/j.gene.2012.12.061] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 12/03/2012] [Indexed: 12/20/2022]
Abstract
Channelopathies are diseases caused by dysfunctional ion channels, due to either genetic or acquired pathological factors. Inherited cardiac arrhythmic syndromes are among the most studied human disorders involving ion channels. Since seminal observations made in 1995, thousands of mutations have been found in many of the different genes that code for cardiac ion channel subunits and proteins that regulate the cardiac ion channels. The main phenotypes observed in patients carrying these mutations are congenital long QT syndrome (LQTS), Brugada syndrome (BrS), catecholaminergic polymorphic ventricular tachycardia (CPVT), short QT syndrome (SQTS) and variable types of conduction defects (CD). The goal of this review is to present an update of the main genetic and molecular mechanisms, as well as the associated phenotypes of cardiac channelopathies as of 2012.
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Affiliation(s)
- Hugues Abriel
- Department of Clinical Research, University of Bern, Switzerland.
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Stattin EL, Boström IM, Winbo A, Cederquist K, Jonasson J, Jonsson BA, Diamant UB, Jensen SM, Rydberg A, Norberg A. Founder mutations characterise the mutation panorama in 200 Swedish index cases referred for Long QT syndrome genetic testing. BMC Cardiovasc Disord 2012; 12:95. [PMID: 23098067 PMCID: PMC3520728 DOI: 10.1186/1471-2261-12-95] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 10/10/2012] [Indexed: 11/24/2022] Open
Abstract
Background Long QT syndrome (LQTS) is an inherited arrhythmic disorder characterised by prolongation of the QT interval on ECG, presence of syncope and sudden death. The symptoms in LQTS patients are highly variable, and genotype influences the clinical course. This study aims to report the spectrum of LQTS mutations in a Swedish cohort. Methods Between March 2006 and October 2009, two hundred, unrelated index cases were referred to the Department of Clinical Genetics, Umeå University Hospital, Sweden, for LQTS genetic testing. We scanned five of the LQTS-susceptibility genes (KCNQ1, KCNH2, SCN5A, KCNE1, and KCNE2) for mutations by DHPLC and/or sequencing. We applied MLPA to detect large deletions or duplications in the KCNQ1, KCNH2, SCN5A, KCNE1, and KCNE2 genes. Furthermore, the gene RYR2 was screened in 36 selected LQTS genotype-negative patients to detect cases with the clinically overlapping disease catecholaminergic polymorphic ventricular tachycardia (CPVT). Results In total, a disease-causing mutation was identified in 103 of the 200 (52%) index cases. Of these, altered exon copy numbers in the KCNH2 gene accounted for 2% of the mutations, whereas a RYR2 mutation accounted for 3% of the mutations. The genotype-positive cases stemmed from 64 distinct mutations, of which 28% were novel to this cohort. The majority of the distinct mutations were found in a single case (80%), whereas 20% of the mutations were observed more than once. Two founder mutations, KCNQ1 p.Y111C and KCNQ1 p.R518*, accounted for 25% of the genotype-positive index cases. Genetic cascade screening of 481 relatives to the 103 index cases with an identified mutation revealed 41% mutation carriers who were at risk of cardiac events such as syncope or sudden unexpected death. Conclusion In this cohort of Swedish index cases with suspected LQTS, a disease-causing mutation was identified in 52% of the referred patients. Copy number variations explained 2% of the mutations and 3 of 36 selected cases (8%) harboured a mutation in the RYR2 gene. The mutation panorama is characterised by founder mutations (25%), even so, this cohort increases the amount of known LQTS-associated mutations, as approximately one-third (28%) of the detected mutations were unique.
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Affiliation(s)
- Eva-Lena Stattin
- Department of Medical Biosciences, Medical and Clinical Genetics, Umeå University, Umeå, Sweden.
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Perrin MJ, Gollob MH. Genetics of cardiac electrical disease. Can J Cardiol 2012; 29:89-99. [PMID: 23062665 DOI: 10.1016/j.cjca.2012.07.847] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Revised: 07/27/2012] [Accepted: 07/30/2012] [Indexed: 10/27/2022] Open
Abstract
Few tragedies compare to the sudden death of a family member. Sadly, this may represent the first sign of a familial vulnerability to such events. One common cause is an inherited cardiac arrhythmia syndrome. Sufferers are prone to premature sudden cardiac death due to altered ion channel function in the heart. Typical causes include Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia, and the newly recognized early repolarization syndrome. Our knowledge of the genetic underpinnings of each of these disorders has increased markedly in recent years. Genetic screening is now a routine part of clinical care and promises more accurate diagnosis and efficient family screening. This review summarizes the diagnosis and management of each of the listed syndromes in the context of currently available genetic testing.
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Affiliation(s)
- Mark J Perrin
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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Pezzoli L, Sana ME, Ferrazzi P, Iascone M. A new mutational mechanism for hypertrophic cardiomyopathy. Gene 2012; 507:165-9. [DOI: 10.1016/j.gene.2012.06.097] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 06/21/2012] [Accepted: 06/25/2012] [Indexed: 12/31/2022]
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Perrin MJ, Gollob MH. The genetics of cardiac disease associated with sudden cardiac death: a paper from the 2011 William Beaumont Hospital Symposium on molecular pathology. J Mol Diagn 2012; 14:424-36. [PMID: 22749884 DOI: 10.1016/j.jmoldx.2012.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 04/03/2012] [Accepted: 04/13/2012] [Indexed: 11/17/2022] Open
Abstract
Sudden cardiac death due to ventricular arrhythmia most commonly occurs in the setting of coronary artery disease. However, a number of inherited syndromes have now been identified that carry a significant risk of sudden cardiac death and that are disproportionately represented in the young. Arrhythmia in such conditions may result from genetically mediated structural heart disease (eg, hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy) or from altered function of cardiac ion channels in the absence of overt structural disease (eg, Brugada syndrome and long QT syndrome). The past 15 years have seen considerable progress in our understanding of the genetic underpinnings of these disorders. With the advent of clinical genetic testing as a routine part of clinical care, a new knowledge base is required of practicing cardiologists and genetic testing facilities, particularly related to the rational ordering of genetic testing and the interpretation of results. This review addresses the latest findings in regard to the genetic causes of inherited syndromes associated with sudden cardiac death and summarizes recently published guidelines for the genetic testing of affected individuals and their families.
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Affiliation(s)
- Mark J Perrin
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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Obeyesekere MN, Leong-Sit P, Gula LJ, Yee R, Skanes AC, Klein GJ, Krahn AD. The Evaluation of a Borderline Long QT Interval in an Asymptomatic Patient. Card Electrophysiol Clin 2012; 4:227-238. [PMID: 26939820 DOI: 10.1016/j.ccep.2012.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
QT prolongation on resting electrocardiography (ECG) is common, and the clinician is often challenged by the dilemma of excluding acquired causes and recognizing potential congenital long QT syndrome (LQTS). The hallmark of LQTS is an abnormally long QT interval. However, a normal or borderline long QT interval may be observed in up to 50% of patients with LQTS because of the intermittent nature of QT prolongation. This review presents an approach to evaluating the asymptomatic patient with a borderline long QT interval, which incorporates a comprehensive clinical assessment, rest and provocative ECG testing, and genetic testing when appropriate.
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Affiliation(s)
- Manoj N Obeyesekere
- Division of Cardiology, The University of Western Ontario, 339 Windermere Road, London, Ontario N6A 5A5, Canada
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