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Pathogenic variants in cardiomyopathy disorder genes underlie pediatric myocarditis - Further impact of heterozygous immune disorder gene variants?

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Item Type:Article
Title:Pathogenic variants in cardiomyopathy disorder genes underlie pediatric myocarditis - Further impact of heterozygous immune disorder gene variants?
Creators Name:Seidel, F. and Laser, K.T. and Klingel, K. and Dartsch, J. and Theisen, S. and Pickardt, T. and Holtgrewe, M. and Gärtner, A. and Berger, F. and Beule, D. and Milting, H. and Schubert, S. and Klaassen, S. and Kühnisch, J.
Abstract:Myocarditis is an inflammatory disease of the heart. Pediatric myocarditis with the dilated cardiomyopathy (DCM) phenotype may be caused by likely pathogenic or pathogenic genetic variants [(L)P] in cardiomyopathy (CMP) genes. Systematic analysis of immune disorder gene defects has not been performed so far. We analyzed 12 patients with biopsy-proven myocarditis and the DCM phenotype together with their parents using whole-exome sequencing (WES). The WES data were filtered for rare pathogenic variants in CMP (n = 89) and immune disorder genes (n = 631). Twelve children with a median age of 2.9 (1.0–6.8) years had a mean left ventricular ejection fraction of 28% (22–32%) and myocarditis was confirmed by endomyocardial biopsy. Patients with primary immunodeficiency were excluded from the study. Four patients underwent implantation of a ventricular assist device and subsequent heart transplantation. Genetic analysis of the 12 families revealed an (L)P variant in the CMP gene in 8/12 index patients explaining DCM. Screening of recessive immune disorder genes identified a heterozygous (L)P variant in 3/12 index patients. This study supports the genetic impact of CMP genes for pediatric myocarditis with the DCM phenotype. Piloting the idea that additional immune-related genetic defects promote myocarditis suggests that the presence of heterozygous variants in these genes needs further investigation. Altered cilium function might play an additional role in inducing inflammation in the context of CMP.
Keywords:Dilated Cardiomyopathy, Myocarditis, Genetic, Immune, Pathogenic Variant
Source:Journal of Cardiovascular Development and Disease
ISSN:2308-3425
Publisher:MDPI
Volume:9
Number:7
Page Range:216
Date:5 July 2022
Official Publication:https://doi.org/10.3390/jcdd9070216
PubMed:View item in PubMed

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