Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
Children's Hospital and Medical Center, University of Nebraska, Omaha, NE, USA.
Am J Hum Genet. 2024 Oct 3;111(10):2219-2231. doi: 10.1016/j.ajhg.2024.08.001. Epub 2024 Sep 2.
Bicuspid aortic valve (BAV) is the most common congenital heart lesion with an estimated population prevalence of 1%. We hypothesize that specific gene variants predispose to early-onset complications of BAV (EBAV). We analyzed whole-exome sequences (WESs) to identify rare coding variants that contribute to BAV disease in 215 EBAV-affected families. Predicted damaging variants in candidate genes with moderate or strong supportive evidence to cause developmental cardiac phenotypes were present in 107 EBAV-affected families (50% of total), including genes that cause BAV (9%) or heritable thoracic aortic disease (HTAD, 19%). After appropriate filtration, we also identified 129 variants in 54 candidate genes that are associated with autosomal-dominant congenital heart phenotypes, including recurrent deleterious variation of FBN2, MYH6, channelopathy genes, and type 1 and 5 collagen genes. These findings confirm our hypothesis that unique rare genetic variants drive early-onset presentations of BAV disease.
二叶式主动脉瓣 (BAV) 是最常见的先天性心脏病变,估计人群患病率为 1%。我们假设特定的基因变异使 BAV(早发型 BAV,EBAV)的早期并发症易于发生。我们分析了 215 个 EBAV 受累家族的全外显子组序列 (WES),以确定导致 BAV 疾病的罕见编码变异。在 107 个 EBAV 受累家族中(占总数的 50%)存在候选基因中有中等或强支持证据导致发育性心脏表型的预测性破坏性变异,包括导致 BAV(9%)或遗传性胸主动脉疾病(HTAD,19%)的基因。经过适当的过滤,我们还在 54 个候选基因中确定了 129 个与常染色体显性先天性心脏表型相关的变异,包括 FBN2、MYH6、通道病基因以及 1 型和 5 型胶原基因的复发性有害变异。这些发现证实了我们的假设,即独特的罕见遗传变异导致了 BAV 疾病的早发型表现。