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Investigation of de novo variation in pediatric cardiomyopathy
Author(s) -
Parrott Ashley,
Khoury Philip R.,
Shikany Amy R.,
Lorts Angela,
Villa Chet R.,
Miller Erin M.
Publication year - 2020
Publication title -
american journal of medical genetics part c: seminars in medical genetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.419
H-Index - 101
eISSN - 1552-4876
pISSN - 1552-4868
DOI - 10.1002/ajmg.c.31764
Subject(s) - hypertrophic cardiomyopathy , medicine , genetic testing , family history , dilated cardiomyopathy , genetics , genetic variation , gene , biology , heart failure
Pediatric cardiomyopathies can be caused by variants in genes encoding the sarcomere and cytoskeleton in cardiomyocytes. Variants are typically inherited in an autosomal dominant manner with variable expressivity. De novo variants have been reported, however their overall frequency is largely unknown. We sought to determine the rate of de novo, pathogenic and likely pathogenic (P/LP) variants in children with a diagnosis of hypertrophic, dilated, or restrictive cardiomyopathy (HCM, DCM, or RCM), and to compare disease outcomes between individuals with and without a de novo variant. A retrospective record review identified 126 individuals with HCM (55%), DCM (37%), or RCM (8%) ≤18 years of age who had genetic testing. Overall, 50 (40%) had positive genetic testing and 18% of P/LP variants occurred de novo. The rate of de novo variation in those with RCM (80%) was higher than in those with HCM (9%) or DCM (20%). There was evidence of germline mosaicism in one family with RCM. Individuals with de novo variants were more likely than those without to have a history of arrhythmia ( p = .049), sudden cardiac arrest ( p = .024), hospitalization ( p = .041), and cardiac transplantation ( p = .030). The likelihood of de novo variation and impact on family risk and screening should be integrated into genetic counseling.