Open AccessClinical heterogeneity of Pulmonary Arterial Hypertension associated with variants in TBX4
Author(s) -
Ignacio Hernández-González,
Jair Tenorio,
Julián Palomino-Doza,
Amaya Martínez Meñaca,
Rafael Morales Ruiz,
Mauro Lago-Docampo,
Mónica Gómez,
Javier Gómez-Román,
Ana Belén Enguita Valls,
Carmen PérezOlivares,
Diana Valverde,
Joan Gil Carbonell,
Elvira Garrido-Lestache Rodríguez-Monte,
María Jesús del Cerro,
Pablo Lapunzina,
Pilar Escribano
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0232216
Subject(s) - pulmonary hypertension , medicine , cardiology , biology
Background The knowledge of hereditary predisposition has changed our understanding of Pulmonary Arterial Hypertension. Genetic testing has been widely extended and the application of Pulmonary Arterial Hypertension specific gene panels has allowed its inclusion in the diagnostic workup and increase the diagnostic ratio compared to the traditional sequencing techniques. This is particularly important in the differential diagnosis between Pulmonary Arterial Hypertension and Pulmonary Venoocclusive Disease. Methods Since November 2011, genetic testing is offered to all patients with idiopathic, hereditable and associated forms of Pulmonary Arterial Hypertension or Pulmonary Venoocclusive Disease included in the Spanish Registry of Pulmonary Arterial Hypertension. Herein, we present the clinical phenotype and prognosis of all Pulmonary Arterial Hypertension patients with disease-associated variants in TBX4 . Results Out of 579 adults and 45 children, we found in eight patients from seven families, disease-causing associated variants in TBX4 . All adult patients had a moderate-severe reduction in diffusion capacity. However, we observed a wide spectrum of clinical presentations, including Pulmonary Venoocclusive Disease suspicion, interstitial lung disease, pulmonary vascular abnormalities and congenital heart disease. Conclusions Genetic testing is now essential for a correct diagnosis work-up in Pulmonary Arterial Hypertension. TBX4 -associated Pulmonary Arterial Hypertension has marked clinical heterogeneity. In this regard, a genetic study is extremely useful to obtain an accurate diagnosis and provide appropriate management.