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  1. Article ; Online: Frequency of genetic variants associated with arrhythmogenic right ventricular cardiomyopathy in the genome aggregation database.

    Hall, Charlotte L / Sutanto, Henry / Dalageorgou, Chrysoula / McKenna, William John / Syrris, Petros / Futema, Marta

    European journal of human genetics : EJHG

    2018  Volume 26, Issue 9, Page(s) 1312–1318

    Abstract: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare inherited heart-muscle disorder, which is the most common cause of life-threatening arrhythmias and sudden cardiac death (SCD) in young adults and athletes. Early and accurate diagnosis can ...

    Abstract Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare inherited heart-muscle disorder, which is the most common cause of life-threatening arrhythmias and sudden cardiac death (SCD) in young adults and athletes. Early and accurate diagnosis can be crucial in effective ARVC management and prevention of SCD.The genome Aggregation Database (gnomAD) population of 138,632 unrelated individuals was searched for previously identified ARVC variants, classified as pathogenic or unknown on the disease genetic variant database ( http://www.arvcdatabase.info/ ), in five most-commonly mutated genes: PKP2, DSP, DSG2, DSC2 and JUP, where variants account for 40-50% of all the ARVC cases. Minor allele frequency (MAF) of 0.001 was used to define variants as rare or common.The gnomAD data contained 117/364 (32%) of the previously reported pathogenic and 152/266 (57%) of the unknown ARVC variants. The cross-ethnic analysis of MAF revealed that 11 previously classified pathogenic and 57 unknown variants were common (MAF ≥ 0.001) in at least one ethnic gnomAD population and therefore unlikely to be ARVC causing.After applying our MAF analysis the overall frequency of pathogenic ARVC variants in gnomAD was one in 257 individuals, but a more stringent cut-off (MAF ≥ 0.0001) gave a frequency of one in 845, closer to the estimated phenotypic frequency of the disease.Our study demonstrates that the analysis of large cross-ethnic population sequencing data can significantly improve disease variant interpretation. Higher than expected frequency of ARVC variants suggests that a proportion of ARVC-causing variants may be inaccurately classified, implying reduced penetrance of some variants, and/or a polygenic aetiology of ARVC.
    MeSH term(s) Arrhythmogenic Right Ventricular Dysplasia/genetics ; Arrhythmogenic Right Ventricular Dysplasia/pathology ; Desmoglein 2/genetics ; Desmoplakins/genetics ; Gene Frequency ; Genome-Wide Association Study ; Humans ; Plakophilins/genetics ; gamma Catenin/genetics
    Chemical Substances DSG2 protein, human ; DSP protein, human ; Desmoglein 2 ; Desmoplakins ; JUP protein, human ; PKP2 protein, human ; Plakophilins ; gamma Catenin
    Language English
    Publishing date 2018-05-25
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1141470-4
    ISSN 1476-5438 ; 1018-4813
    ISSN (online) 1476-5438
    ISSN 1018-4813
    DOI 10.1038/s41431-018-0169-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Long-QT syndrome and torsades de pointes in a patient with Takotsubo cardiomyopathy: an unusual case.

    Mahida, Saagar / Dalageorgou, Chrysoula / Behr, Elijah R

    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

    2009  Volume 11, Issue 3, Page(s) 376–378

    Abstract: Takotsubo cardiomyopathy is a syndrome characterized by transient left ventricular apical ballooning associated with electrocardiogram (ECG) changes and minimal myocardial enzymatic release, mimicking acute myocardial infarction in patients without ... ...

    Abstract Takotsubo cardiomyopathy is a syndrome characterized by transient left ventricular apical ballooning associated with electrocardiogram (ECG) changes and minimal myocardial enzymatic release, mimicking acute myocardial infarction in patients without significant coronary disease at angiography. We report an unusual case of a patient who presented with Takotsubo cardiomyopathy associated with long-QT syndrome and who developed cardiac arrest secondary to torsades de pointes.The relationship between Takotsubo cardiomyopathy and abnormal repolarization has been well documented. Despite this, there have been few reports of malignant ventricular arrhythmias or sudden death. This report suggests that prolongation of QTc interval in Takotsubo cardiomyopathy may not be as benign as previously suggested but may in fact uncover an abnormality of repolarization that may be genetic in basis and carry a risk of sudden death.
    MeSH term(s) Female ; Humans ; Long QT Syndrome/diagnosis ; Middle Aged ; Rare Diseases/diagnosis ; Takotsubo Cardiomyopathy/diagnosis ; Torsades de Pointes/diagnosis
    Language English
    Publishing date 2009-03
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/eun336
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Filamin C variants are associated with a distinctive clinical and immunohistochemical arrhythmogenic cardiomyopathy phenotype.

    Hall, Charlotte L / Akhtar, Mohammed M / Sabater-Molina, Maria / Futema, Marta / Asimaki, Angeliki / Protonotarios, Alexandros / Dalageorgou, Chrysoula / Pittman, Alan M / Suarez, Mari Paz / Aguilera, Beatriz / Molina, Pilar / Zorio, Esther / Hernández, Juan Pedro / Pastor, Francisco / Gimeno, Juan R / Syrris, Petros / McKenna, William J

    International journal of cardiology

    2019  Volume 307, Page(s) 101–108

    Abstract: Background: Pathogenic variants in the filamin C (FLNC) gene are associated with inherited cardiomyopathies including dilated cardiomyopathy with an arrhythmogenic phenotype. We evaluated FLNC variants in arrhythmogenic cardiomyopathy (ACM) and ... ...

    Abstract Background: Pathogenic variants in the filamin C (FLNC) gene are associated with inherited cardiomyopathies including dilated cardiomyopathy with an arrhythmogenic phenotype. We evaluated FLNC variants in arrhythmogenic cardiomyopathy (ACM) and investigated the disease mechanism at a molecular level.
    Methods: 120 gene-elusive ACM patients who fulfilled diagnostic criteria for arrhythmogenic right ventricular cardiomyopathy (ARVC) were screened by whole exome sequencing. Fixed cardiac tissue from FLNC variant carriers who had died suddenly was investigated by histology and immunohistochemistry.
    Results: Novel or rare FLNC variants, four null and five variants of unknown significance, were identified in nine ACM probands (7.5%). In FLNC null variant carriers (including family members, n = 16) Task Force diagnostic electrocardiogram repolarization/depolarization abnormalities were uncommon (19%), echocardiography was normal in 69%, while 56% had >500 ventricular ectopics/24 h or ventricular tachycardia on Holter and 67% had late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMRI). Ten gene positive individuals (63%) had abnormalities on ECG or CMRI that are not included in the current diagnostic criteria for ARVC. Immunohistochemistry showed altered key protein distribution, distinctive from that observed in ARVC, predominantly in the left ventricle.
    Conclusions: ACM associated with FLNC variants presents with a distinctive phenotype characterized by Holter arrhythmia and LGE on CMRI with unremarkable ECG and echocardiographic findings. Clinical presentation in asymptomatic mutation carriers at risk of sudden death may include abnormalities which are currently non-diagnostic for ARVC. At the molecular level, the pathogenic mechanism related to FLNC appears different to classic forms of ARVC caused by desmosomal mutations.
    MeSH term(s) Arrhythmogenic Right Ventricular Dysplasia/diagnostic imaging ; Arrhythmogenic Right Ventricular Dysplasia/genetics ; Cardiomyopathies ; Contrast Media ; Filamins/genetics ; Gadolinium ; Humans ; Mutation ; Phenotype
    Chemical Substances Contrast Media ; Filamins ; Gadolinium (AU0V1LM3JT)
    Language English
    Publishing date 2019-10-08
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 779519-1
    ISSN 1874-1754 ; 0167-5273
    ISSN (online) 1874-1754
    ISSN 0167-5273
    DOI 10.1016/j.ijcard.2019.09.048
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Novel genotype-phenotype associations demonstrated by high-throughput sequencing in patients with hypertrophic cardiomyopathy.

    Lopes, Luis R / Syrris, Petros / Guttmann, Oliver P / O'Mahony, Constantinos / Tang, Hak Chiaw / Dalageorgou, Chrysoula / Jenkins, Sharon / Hubank, Mike / Monserrat, Lorenzo / McKenna, William J / Plagnol, Vincent / Elliott, Perry M

    Heart (British Cardiac Society)

    2014  Volume 101, Issue 4, Page(s) 294–301

    Abstract: Objective: A predictable relation between genotype and disease expression is needed in order to use genetic testing for clinical decision-making in hypertrophic cardiomyopathy (HCM). The primary aims of this study were to examine the phenotypes ... ...

    Abstract Objective: A predictable relation between genotype and disease expression is needed in order to use genetic testing for clinical decision-making in hypertrophic cardiomyopathy (HCM). The primary aims of this study were to examine the phenotypes associated with sarcomere protein (SP) gene mutations and test the hypothesis that variation in non-sarcomere genes modifies the phenotype.
    Methods: Unrelated and consecutive patients were clinically evaluated and prospectively followed in a specialist clinic. High-throughput sequencing was used to analyse 41 genes implicated in inherited cardiac conditions. Variants in SP and non-SP genes were tested for associations with phenotype and survival.
    Results: 874 patients (49.6±15.4 years, 67.8% men) were studied; likely disease-causing SP gene variants were detected in 383 (43.8%). Patients with SP variants were characterised by younger age and higher prevalence of family history of HCM, family history of sudden cardiac death, asymmetric septal hypertrophy, greater maximum LV wall thickness (all p values<0.0005) and an increased incidence of cardiovascular death (p=0.012). Similar associations were observed for individual SP genes. Patients with ANK2 variants had greater maximum wall thickness (p=0.0005). Associations at a lower level of significance were demonstrated with variation in other non-SP genes.
    Conclusions: Patients with HCM caused by rare SP variants differ with respect to age at presentation, family history of the disease, morphology and survival from patients without SP variants. Novel associations for SP genes are reported and, for the first time, we demonstrate possible influence of variation in non-SP genes associated with other forms of cardiomyopathy and arrhythmia syndromes on the clinical phenotype of HCM.
    MeSH term(s) Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Cardiomyopathy, Hypertrophic, Familial/diagnosis ; Cardiomyopathy, Hypertrophic, Familial/genetics ; Cardiomyopathy, Hypertrophic, Familial/mortality ; Child ; DNA Mutational Analysis/methods ; Death, Sudden, Cardiac/etiology ; Female ; Genetic Association Studies ; Genetic Predisposition to Disease ; High-Throughput Nucleotide Sequencing ; Humans ; Kaplan-Meier Estimate ; London ; Male ; Middle Aged ; Muscle Proteins/genetics ; Mutation ; Pedigree ; Phenotype ; Predictive Value of Tests ; Retrospective Studies ; Risk Factors ; Young Adult
    Chemical Substances Muscle Proteins
    Language English
    Publishing date 2014-10-28
    Publishing country England
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 1303417-0
    ISSN 1468-201X ; 1355-6037
    ISSN (online) 1468-201X
    ISSN 1355-6037
    DOI 10.1136/heartjnl-2014-306387
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Genetic complexity in hypertrophic cardiomyopathy revealed by high-throughput sequencing.

    Lopes, Luis R / Zekavati, Anna / Syrris, Petros / Hubank, Mike / Giambartolomei, Claudia / Dalageorgou, Chrysoula / Jenkins, Sharon / McKenna, William / Plagnol, Vincent / Elliott, Perry M

    Journal of medical genetics

    2013  Volume 50, Issue 4, Page(s) 228–239

    Abstract: Background: Clinical interpretation of the large number of rare variants identified by high throughput sequencing (HTS) technologies is challenging. The aim of this study was to explore the clinical implications of a HTS strategy for patients with ... ...

    Abstract Background: Clinical interpretation of the large number of rare variants identified by high throughput sequencing (HTS) technologies is challenging. The aim of this study was to explore the clinical implications of a HTS strategy for patients with hypertrophic cardiomyopathy (HCM) using a targeted HTS methodology and workflow developed for patients with a range of inherited cardiovascular diseases. By comparing the sequencing results with published findings and with sequence data from a large-scale exome sequencing screen of UK individuals, we sought to quantify the strength of the evidence supporting causality for detected candidate variants.
    Methods and results: 223 unrelated patients with HCM (46±15 years at diagnosis, 74% males) were studied. In order to analyse coding, intronic and regulatory regions of 41 cardiovascular genes, we used solution-based sequence capture followed by massive parallel resequencing on Illumina GAIIx. Average read-depth in the 2.1 Mb target region was 120. Rare (frequency<0.5%) non-synonymous, loss-of-function and splice-site variants were defined as candidates. Excluding titin, we identified 152 distinct candidate variants in sarcomeric or associated genes (89 novel) in 143 patients (64%). Four sarcomeric genes (MYH7, MYBPC3, TNNI3, TNNT2) showed an excess of rare single non-synonymous single-nucleotide polymorphisms (nsSNPs) in cases compared to controls. The estimated probability that a nsSNP in these genes is pathogenic varied between 57% and near certainty depending on the location. We detected an additional 94 candidate variants (73 novel) in desmosomal, and ion-channel genes in 96 patients (43%).
    Conclusions: This study provides the first large-scale quantitative analysis of the prevalence of sarcomere protein gene variants in patients with HCM using HTS technology. Inclusion of other genes implicated in inherited cardiac disease identifies a large number of non-synonymous rare variants of unknown clinical significance.
    MeSH term(s) Adult ; Amino Acid Substitution/genetics ; Cardiomyopathy, Hypertrophic/genetics ; Cardiomyopathy, Hypertrophic/pathology ; Female ; High-Throughput Nucleotide Sequencing ; Humans ; Male ; Middle Aged ; Mutation ; Pedigree ; Polymorphism, Single Nucleotide ; Sarcomeres/genetics ; Sarcomeres/metabolism
    Language English
    Publishing date 2013-02-08
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 220881-7
    ISSN 1468-6244 ; 0022-2593
    ISSN (online) 1468-6244
    ISSN 0022-2593
    DOI 10.1136/jmedgenet-2012-101270
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Heritability of QT interval: how much is explained by genes for resting heart rate?

    Dalageorgou, Chrysoula / Ge, Dongliang / Jamshidi, Yalda / Nolte, Ilja M / Riese, Harriëtte / Savelieva, Irina / Carter, Nicholas D / Spector, Tim D / Snieder, Harold

    Journal of cardiovascular electrophysiology

    2008  Volume 19, Issue 4, Page(s) 386–391

    Abstract: Introduction: Objective of this study was to determine the optimal (most heritable) phenotype for gene finding studies of QT interval in the general population. We also studied the extent to which heritability of QT interval can be explained by genes ... ...

    Abstract Introduction: Objective of this study was to determine the optimal (most heritable) phenotype for gene finding studies of QT interval in the general population. We also studied the extent to which heritability of QT interval can be explained by genes that also influence resting heart rate.
    Methods and results: Subjects in this classic twin study were 105 monozygotic and 256 dizygotic female twin pairs (mean age: 49.9 +/- 11.5). ECG parameters were measured electronically using the Cardiofax ECG-9020. Quantitative genetic modeling was performed with Mx software. Best-fitting univariate models showed significant heritabilities for resting heart rate (0.55, 95% CI: 0.44-0.65), uncorrected QT interval (0.60, 95% CI: 0.49-0.69), and the Framingham QTc interval (0.50, 95% CI: 0.39-0.60). Familial resemblance of Bazett's QTc was best explained by shared environmental factors (0.34, 95% CI: 0.24-0.43) rather than genes. Simultaneously modeling heart rate and the uncorrected QT interval confirmed considerable heritabilities of 56% and 60%, respectively. Forty-four percent of the variance in QT interval was due to genes in common with heart rate, whereas 16% was due to genes specific to QT interval. The heritability of QT interval after the removal of effects shared with heart rate within the bivariate model (cf. QTc) was 51%.
    Conclusion: About a quarter of the QT interval heritability is due to genes specific for QT interval, while the majority is shared with genes for heart rate. Differences in QTc heritability estimates indicate that use of correction formulae is best avoided in gene finding studies to avoid erroneous results.
    MeSH term(s) Electrocardiography/statistics & numerical data ; Female ; Genetic Predisposition to Disease/epidemiology ; Genetic Predisposition to Disease/genetics ; Heart Rate/genetics ; Humans ; Long QT Syndrome/epidemiology ; Long QT Syndrome/genetics ; Male ; Middle Aged ; Netherlands/epidemiology ; Prevalence ; Quantitative Trait, Heritable ; Risk Assessment/methods ; Risk Factors ; Twins
    Language English
    Publishing date 2008-04
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Twin Study
    ZDB-ID 1025989-2
    ISSN 1540-8167 ; 1045-3873
    ISSN (online) 1540-8167
    ISSN 1045-3873
    DOI 10.1111/j.1540-8167.2007.01030.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Yield of screening for CADASIL mutations in lacunar stroke and leukoaraiosis.

    Dong, Yanbin / Hassan, Ahamad / Zhang, Zhongyi / Huber, Dionne / Dalageorgou, Chrysoula / Markus, Hugh S

    Stroke

    2003  Volume 34, Issue 1, Page(s) 203–205

    Abstract: Background and purpose: Cerebral autosomal dominant arteriopathy subcortical infarcts and leukoencephalopathy (CADASIL) is a monogenic disorder typified by early onset lacunar strokes, subcortical dementia, psychiatric disturbances, and migraine. ... ...

    Abstract Background and purpose: Cerebral autosomal dominant arteriopathy subcortical infarcts and leukoencephalopathy (CADASIL) is a monogenic disorder typified by early onset lacunar strokes, subcortical dementia, psychiatric disturbances, and migraine. Mutations in the Notch3 gene are responsible. Atypical phenotypes have been recognized, and the disease is probably underdiagnosed in the wider stroke population. Therefore, we determined the yield of screening for Notch3 mutations in lacunar stroke with or without leukoaraiosis.
    Methods: Two hundred eighteen consecutive patients were studied. All had brain and carotid imaging. Polymerase chain reaction-single-stranded conformational polymorphism analysis was used to screen exons 3, 4, 5, and 6 of the Notch3 gene for mutations and polymorphisms.
    Results: A single mutation in exon 4 (C697T) was identified in a young patient, giving an overall carrier frequency of 0.05% (95% CI, 0.0 to 2.0). For patients with onset of lacunar stroke at < or =65 years and leukoaraiosis, the yield was 2.0% (95% CI, 0.4 to 10.9).
    Conclusions: Notch3 mutations are rare in patients with typical strokes due to cerebral small-vessel disease. In the absence of classic features suggestive of CADASIL, screening for Notch3 mutations has a low yield.
    MeSH term(s) Adult ; Aged ; Cerebral Cortex/abnormalities ; Dementia, Multi-Infarct/complications ; Dementia, Multi-Infarct/diagnosis ; Dementia, Multi-Infarct/genetics ; Female ; Genetic Testing ; Humans ; Male ; Middle Aged ; Mutation ; Polymorphism, Genetic ; Proto-Oncogene Proteins/genetics ; Receptor, Notch3 ; Receptors, Cell Surface ; Receptors, Notch ; Stroke/complications
    Chemical Substances NOTCH3 protein, human ; Proto-Oncogene Proteins ; Receptor, Notch3 ; Receptors, Cell Surface ; Receptors, Notch
    Language English
    Publishing date 2003-01
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80381-9
    ISSN 1524-4628 ; 0039-2499 ; 0749-7954
    ISSN (online) 1524-4628
    ISSN 0039-2499 ; 0749-7954
    DOI 10.1161/01.str.0000048162.16852.88
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Obesity reveals an association between blood pressure and the G-protein beta3-subunit gene: a study of female dizygotic twins.

    Dong, Yanbin / Zhu, Haidong / Wang, Xiaoling / Dalageorgou, Chrysoula / Carter, Nick / Spector, Tim D / Snieder, Harold

    Pharmacogenetics

    2004  Volume 14, Issue 7, Page(s) 419–427

    Abstract: The 825C>T polymorphism of the G-protein beta3-subunit gene (GNB3) has been associated with hypertension, although results are not entirely consistent. In a sample of 282 female Caucasian dizygotic twins aged 21-80 years, we aimed to investigate the ... ...

    Abstract The 825C>T polymorphism of the G-protein beta3-subunit gene (GNB3) has been associated with hypertension, although results are not entirely consistent. In a sample of 282 female Caucasian dizygotic twins aged 21-80 years, we aimed to investigate the associations between blood pressure and five single nucleotide polymorphisms (SNPs) including the 825C>T and haplotypes of the GNB3 gene. The polymorphisms (-350A>G, 657A>T, 814G>A, 825C>T and 1429C>T) were genotyped by polymerase chain reaction-restriction enzyme assays. Regular association tests did not show a significant effect on blood pressure for any of the five SNPs. However, strongly significant interactions between the -350A>G, 825C>T and 1429C>T loci and adiposity (both body mass index and waist circumference) were observed for systolic blood pressure (Ps < 0.01) as well as diastolic blood pressure (Ps < 0.05), suggesting increases in adiposity amplify the effects of the SNPs on blood pressure. Haplotype analyses confirmed the effects of the GNB3 gene-obesity interaction on hypertension risk. Additionally, sib-transmission disequilibrium tests (sib-TDTs) showed significant associations with blood pressure for the 825C>T and 1429C>T loci. In summary, the presence of obesity reveals an association between blood pressure and the GNB3 gene in White females. Our data suggest that adiposity is a final pathway through which gene-lifestyle interactions may exert their effects on the development of hypertension. Our results from the combined SNP, haplotype and sib-TDT analyses also support the hypothesis that the 825C>T is a susceptibility locus for hypertension, whereas effects of other loci on blood pressure may result from their strong linkage disequilibrium with the 825C>T locus.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Blood Pressure/physiology ; Body Mass Index ; Body Size ; European Continental Ancestry Group/genetics ; Female ; Heterotrimeric GTP-Binding Proteins/genetics ; Humans ; Hypertension/epidemiology ; Hypertension/genetics ; Middle Aged ; Obesity/genetics ; Polymorphism, Single Nucleotide/genetics ; Risk Factors ; Twins, Dizygotic
    Chemical Substances G-protein beta3 subunit ; Heterotrimeric GTP-Binding Proteins (EC 3.6.5.1)
    Language English
    Publishing date 2004-02-15
    Publishing country England
    Document type Journal Article ; Twin Study
    ZDB-ID 1146969-9
    ISSN 0960-314X
    ISSN 0960-314X
    DOI 10.1097/01.fpc.0000114748.08559.ad
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Diagnostic yield of molecular autopsy in patients with sudden arrhythmic death syndrome using targeted exome sequencing.

    Nunn, Laurence M / Lopes, Luis R / Syrris, Petros / Murphy, Cian / Plagnol, Vincent / Firman, Eileen / Dalageorgou, Chrysoula / Zorio, Esther / Domingo, Diana / Murday, Victoria / Findlay, Iain / Duncan, Alexis / Carr-White, Gerry / Robert, Leema / Bueser, Teofila / Langman, Caroline / Fynn, Simon P / Goddard, Martin / White, Anne /
    Bundgaard, Henning / Ferrero-Miliani, Laura / Wheeldon, Nigel / Suvarna, Simon K / O'Beirne, Aliceson / Lowe, Martin D / McKenna, William J / Elliott, Perry M / Lambiase, Pier D

    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

    2016  Volume 18, Issue 6, Page(s) 888–896

    Abstract: Aims: The targeted genetic screening of Sudden Arrhythmic Death Syndrome (SADS) probands in a molecular autopsy has a diagnostic yield of up to 35%. Exome sequencing has the potential to improve this yield. The primary aim of this study is to examine ... ...

    Abstract Aims: The targeted genetic screening of Sudden Arrhythmic Death Syndrome (SADS) probands in a molecular autopsy has a diagnostic yield of up to 35%. Exome sequencing has the potential to improve this yield. The primary aim of this study is to examine the feasibility and diagnostic utility of targeted exome screening in SADS victims, utilizing familial clinical screening whenever possible.
    Methods and results: To determine the feasibility and diagnostic yield of targeted exome sequencing deoxyribonucleic acid (DNA) was isolated from 59 SADS victims (mean age 25 years, range 1-51 years). Targeted exome sequencing of 135 genes associated with cardiomyopathies and ion channelopathies was performed on the Illumina HiSeq2000 platform. Non-synonymous, loss-of-function, and splice-site variants with a minor allele frequency <0.02% in the NHLBI exome sequencing project and an internal set of control exomes were prioritized for analysis followed by <0.5% frequency threshold secondary analysis. First-degree relatives were offered clinical screening for inherited cardiac conditions. Seven probands (12%) carried very rare (<0.02%) or novel non-sense candidate mutations and 10 probands (17%) had previously published rare (0.02-0.5%) candidate mutations-a total yield of 29%. Co-segregation fully confirmed two private SCN5A Na channel mutations. Variants of unknown significance were detected in a further 34% of probands.
    Conclusion: Molecular autopsy using targeted exome sequencing has a relatively low diagnostic yield of very rare potentially disease causing mutations. Candidate pathogenic variants with a higher frequency in control populations are relatively common and should be interpreted with caution.
    MeSH term(s) Adolescent ; Adult ; Autopsy ; Brugada Syndrome/diagnosis ; Brugada Syndrome/genetics ; Case-Control Studies ; Child ; Child, Preschool ; Cohort Studies ; Death, Sudden, Cardiac/prevention & control ; Exome/genetics ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genetic Testing ; Humans ; Infant ; Long QT Syndrome/diagnosis ; Long QT Syndrome/genetics ; Male ; Middle Aged ; Mutation ; NAV1.5 Voltage-Gated Sodium Channel/genetics ; Pedigree ; Sequence Analysis, DNA ; United Kingdom ; Young Adult
    Chemical Substances NAV1.5 Voltage-Gated Sodium Channel ; SCN5A protein, human
    Language English
    Publishing date 2016-06
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/euv285
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Sudden arrhythmic death syndrome: familial evaluation identifies inheritable heart disease in the majority of families.

    Behr, Elijah R / Dalageorgou, Chrysoula / Christiansen, Michael / Syrris, Petros / Hughes, Sian / Tome Esteban, Maria T / Rowland, Edward / Jeffery, Steve / McKenna, William J

    European heart journal

    2008  Volume 29, Issue 13, Page(s) 1670–1680

    Abstract: Aims: At least 4% of sudden deaths are unexplained at autopsy [sudden arrhythmic death syndrome (SADS)] and a quarter may be due to inherited cardiac disease. We hypothesized that comprehensive clinical investigation of SADS families would identify more ...

    Abstract Aims: At least 4% of sudden deaths are unexplained at autopsy [sudden arrhythmic death syndrome (SADS)] and a quarter may be due to inherited cardiac disease. We hypothesized that comprehensive clinical investigation of SADS families would identify more susceptible individuals and causes of death.
    Methods and results: Fifty seven consecutively referred families with SADS death underwent evaluation including resting 12 lead, 24 h and exercise ECG and 2D echocardiography. Other investigations included signal averaged ECG, ajmaline testing, cardiac magnetic resonance imaging, and mutation analysis. First-degree relatives [184/262 (70%)] underwent evaluation, 13 (7%) reporting unexplained syncope. Seventeen (30%) families had a history of additional unexplained premature sudden death(s). Thirty families (53%) were diagnosed with inheritable heart disease: 13 definite long QT syndrome (LQTS), three possible/probable LQTS, five Brugada syndrome, five arrhythmogenic right ventricular cardiomyopathy (ARVC), and four other cardiomyopathies. One SCN5A and four KCNH2 mutations (38%) were identified in 13 definite LQTS families, one SCN5A mutation (20%) in five Brugada syndrome families and one (25%) PKP2 (plakophyllin2) mutation in four ARVC families.
    Conclusion: Over half of SADS deaths were likely to be due to inherited heart disease; accurate identification is vital for appropriate prophylaxis amongst relatives who should undergo comprehensive cardiological evaluation, guided and confirmed by mutation analysis.
    MeSH term(s) Adult ; Algorithms ; Arrhythmias, Cardiac/genetics ; Cardiomyopathies/genetics ; Child ; Child, Preschool ; DNA Mutational Analysis ; Death, Sudden, Cardiac/etiology ; Female ; Genetic Testing ; Humans ; Male ; Middle Aged ; Mutation/genetics ; Pedigree
    Language English
    Publishing date 2008-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 603098-1
    ISSN 1522-9645 ; 0195-668X
    ISSN (online) 1522-9645
    ISSN 0195-668X
    DOI 10.1093/eurheartj/ehn219
    Database MEDical Literature Analysis and Retrieval System OnLINE

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