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A Systematic Analysis of the Clinical Outcome Associated with Multiple Reclassified Desmosomal Gene Variants in Arrhythmogenic Right Ventricular Cardiomyopathy Patients

Title: A Systematic Analysis of the Clinical Outcome Associated with Multiple Reclassified Desmosomal Gene Variants in Arrhythmogenic Right Ventricular Cardiomyopathy Patients
Authors: Nagyova, E; Hoorntje, ET; Rijdt, WPT; Bosman, LP; Syrris, P; Protonotarios, A; Elliott, PM; Tsatsopoulou, A; Mestroni, L; Taylor, MRG; Sinagra, G; Merlo, M; Wada, Y; Horie, M; Mogensen, J; Christensen, AH; Gerull, B; Song, L; Yao, Y; Fan, S; Saguner, AM; Duru, F; Koskenvuo, JW; Cruz Marino, T; Tichnell, C; Judge, DP; Dooijes, D; Lekanne Deprez, RH; Basso, C; Pilichou, K; Bauce, B; Wilde, AAM; Charron, P; Fressart, V; van der Heijden, JF; van den Berg, MP; Asselbergs, FW; James, CA; Jongbloed, JDH; Harakalova, M; van Tintelen, JP
Source: Journal of Cardiovascular Translational Research (2023) (In press).
Publisher Information: Springer Science and Business Media LLC
Publication Year: 2023
Collection: University College London: UCL Discovery
Subject Terms: ARVC; Arrhythmia; Composite endpoint; Desmosomal genes; Genetics; Multiple variants
Description: The presence of multiple pathogenic variants in desmosomal genes (DSC2, DSG2, DSP, JUP, and PKP2) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) has been linked to a severe phenotype. However, the pathogenicity of variants is reclassified frequently, which may result in a changed clinical risk prediction. Here, we present the collection, reclassification, and clinical outcome correlation for the largest series of ARVC patients carrying multiple desmosomal pathogenic variants to date (n = 331). After reclassification, only 29% of patients remained carriers of two (likely) pathogenic variants. They reached the composite endpoint (ventricular arrhythmias, heart failure, and death) significantly earlier than patients with one or no remaining reclassified variant (hazard ratios of 1.9 and 1.8, respectively). Periodic reclassification of variants contributes to more accurate risk stratification and subsequent clinical management strategy. [Figure not available: see fulltext.].
Document Type: article in journal/newspaper
File Description: text
Language: English
Relation: https://discovery.ucl.ac.uk/id/eprint/10173573/
Availability: https://discovery.ucl.ac.uk/id/eprint/10173573/1/s12265-023-10403-8.pdf; https://discovery.ucl.ac.uk/id/eprint/10173573/
Rights: open
Accession Number: edsbas.E5971266
Database: BASE