Department of Pulmonary Medicine, Amsterdam University Medical Center (UMC) (Vrije Universiteit), 1081 HV Amsterdam, The Netherlands.
Department of Human Genetics, Amsterdam University Medical Center (UMC) (Vrije Universiteit), 1081 HV Amsterdam, The Netherlands.
Genes (Basel). 2021 Sep 28;12(10):1540. doi: 10.3390/genes12101540.
Pulmonary arterial hypertension (PAH) has an identifiable genetic cause in 5% of all PAH cases. Due to health benefits conferred by the early detection of PAH and the recent identification of additional PAH-associated genes, we decided to offer (extended) genetic testing to all incident and prevalent idiopathic PAH (iPAH) and pulmonary veno-occlusive disease (PVOD) patients in our clinic. Here, we report the lessons learned from (re-)contacting iPAH/PVOD patients concerning the uptake and analysis of identified PAH-associated genes and patient perspectives of the approach.
Between January 2018 and April 2020, all iPAH/PVOD patients who were not previously genetically tested (contact group) and those who tested negative on prior analysis of and variants (re-contact group) were (re-)contacted for (additional) genetic testing.
With our approach, 58% of patients (84 out of 165) opted for genetic counselling, and a pathogenic variant was found in 12% of cases ( = 10) (re-contact group, 11%, and contact group, 13%). Eighty-six percent of participants of the survey study appreciated being (re-)contacted for genetic testing. Mild psychosocial impacts were observed.
Our report shows the importance of (re-)contact and interest of patients (as indicated by the uptake, mild psychosocial impact and appreciation) in PAH.
5%的肺动脉高压(PAH)病例存在可识别的遗传原因。由于早期发现 PAH 和最近确定的其他 PAH 相关基因带来的健康益处,我们决定为我们诊所的所有新发和现患特发性 PAH(iPAH)和肺静脉闭塞性疾病(PVOD)患者提供(扩展)基因检测。在此,我们报告了在与 iPAH/PVOD 患者(重新)联系时,从识别出的 PAH 相关基因的接受和分析以及患者对该方法的看法中吸取的经验教训。
在 2018 年 1 月至 2020 年 4 月期间,对所有先前未接受基因检测的 iPAH/PVOD 患者(联系组)和先前在 和 变体分析中检测为阴性的患者(重新联系组)进行了(额外的)基因检测。
通过我们的方法,58%的患者(165 名患者中的 84 名)选择了遗传咨询,12%的患者(=10 名)发现了致病性变异(重新联系组 11%,联系组 13%)。调查研究的 86%的参与者赞赏(重新)联系他们进行基因检测。观察到轻微的心理社会影响。
我们的报告表明了(重新)联系和患者的兴趣的重要性(如接受程度、轻微的心理社会影响和赞赏所表明的)在 PAH 中。