Key result
Gene-centric exome reanalysis in HCM improves variant identification by ~9% via three newly associated genes.
Why the study?
Approximately half of hypertrophic cardiomyopathy patients lack a precise genetic diagnosis, while the likelihood of identifying clinically relevant variants has increased over time.
Does gene-centric reanalysis of exome data improve the identification of clinically relevant variants in patients with hypertrophic cardiomyopathy?
Cohort (n=200)
Yes
Does gene-centric reanalysis of exome data improve the identification of clinically relevant variants in patients with hypertrophic cardiomyopathy?
Reanalysis of exome data in HCM patients 5 years after initial testing can increase the diagnostic yield by identifying variants in newly discovered disease-associated genes.
May support reanalysis of exome data to raise HCM diagnostic yield; leaves open clinical utility pending validation.
Background Approximately half of hypertrophic cardiomyopathy (HCM) patients lack a precise genetic diagnosis. The likelihood of identifying clinically relevant variants increased over time. Methods In this study, we conducted a gene-centric reanalysis of exome data of 200 HCM cases 5 years after the initial analysis. This reanalysis prioritized genes with a matched HCM entry in the OMIM database and recently emerging HCM-associated genes gathered using a text mining-based literature review. Further classification of the identified genes and variants was performed using the Clinical Genome Resource (ClinGen) resource and American College of Medical Genetics and Genomics (ACMG) guidelines to assess the robustness of gene–disease association and the clinical actionability of the prioritized variants. Results As expected, the majority of patients carried variants in MYBPC3 and MYH7 genes, 26% (n = 51) and 8% (n = 16), respectively, in accordance with the initial analysis. The vast majority of pathogenic (P) and likely pathogenic (LP) variants were found in MYBPC3 (22 out of 40 variants) and MYH7 (8 out of 16 variants) genes. Three genes—not included in the initial analysis—were identified: SVIL, FHOD3, and TRIM63. Considering only patients with unique variants in the last three genes, there was a 9% enhancement in variant identification. Importantly, SVIL variant carriers presented apical and septal HCM, aortopathies, and severe scoliosis for one patient. Ten patients (5%) carried variants in the FHOD3 gene, six in hotspot regions (exons 12 and 15). We identified seven variants within the TRIM63 gene in 12 patients (6%). Homozygous variants were detected in 2.5% of the cohort in MYBPC3 (n = 1), MYL3 (n = 1), and TRIM63 (n = 3) genes. Conclusion Our study revealed that no variants were found in the ACTC1, TPM1, and TNNI3 genes in the HYPERGEN cohort. However, we identified variants in five out of the eight HCM core genes, with a high prevalence in young patients. We identified variants in three recent HCM-associated genes (SVIL, FHOD3, and TRIM63) in 35 patients, with 18 patients carrying unique variants (9%). Our results further emphasize the usefulness of exome data reanalysis, particularly in genotype-negative patients.
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Jaouadi et al. (2024) conducted a cohort in Hypertrophic cardiomyopathy (n=200). Exome sequencing data reanalysis vs. Initial analysis was evaluated on Enhancement in variant identification (unique variants in SVIL, FHOD3, and TRIM63). Gene-centric reanalysis of exome sequencing data from 200 hypertrophic cardiomyopathy patients identified variants in three recently associated genes (SVIL, FHOD3, and TRIM63), yielding a 9% enhancement in variant identification.
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