Genetic evaluation in a cohort of 126 dutch pulmonary arterial hypertension patients

Lieke M. van den Heuvel, Samara M. A. Jansen, Suzanne I. M. Alsters, Marco C. Post, Jasper J. van der Smagt, Frances S. Handoko-de Man, J. Peter van Tintelen, Hans Gille, Imke Christiaans, Anton Vonk Noordegraaf, Harmjan Bogaard, Arjan C. Houweling

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Abstract

Pulmonary arterial hypertension (PAH) is a severe, life-threatening disease, and in some cases is caused by genetic defects. This study sought to assess the diagnostic yield of genetic testing in a Dutch cohort of 126 PAH patients. Historically, genetic testing in the Netherlands consisted of the analysis of BMPR2 and SMAD9. These genes were analyzed in 70 of the 126 patients. A (likely) pathogenic (LP/P) variant was detected in 22 (31%) of them. After the identification of additional PAH associated genes, a next generation sequencing (NGS) panel consisting of 19 genes was developed in 2018. Additional genetic testing was offered to the 48 BMPR2 and SMAD9 negative patients, out of which 28 opted for NGS analysis. In addition, this gene panel was analyzed in 56 newly identified idiopathic (IPAH) or pulmonary veno occlusive disease (PVOD) patients. In these 84 patients, NGS panel testing revealed LP/P variants in BMPR2 (N = 4), GDF2 (N = 2), EIF2AK4 (N = 1), and TBX4 (N = 3). Furthermore, 134 relatives of 32 probands with a LP/P variant were tested, yielding 41 carriers. NGS panel screening offered to IPAH/PVOD patients led to the identification of LP/P variants in GDF2, EIF2AK4, and TBX4 in six additional patients. The identification of LP/P variants in patients allows for screening of at-risk relatives, enabling the early identification of PAH.
Original languageEnglish
Article number1191
Pages (from-to)1-12
Number of pages12
JournalGenes
Volume11
Issue number10
DOIs
Publication statusPublished - 1 Oct 2020

Keywords

  • BMPR2
  • EIF2AK4
  • GDF2
  • Genetic analysis
  • NGS gene panel
  • Pulmonary arterial hypertension
  • TBX4

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