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Updated: Feb 28, 2026

Investigating the Pathogenesis of MYH7 Mutation Gly823Glu in Familial Hypertrophic Cardiomyopathy using a Mouse Model
Published on: August 8, 2022
Next-generation sequencing identifies pathogenic and modifier mutations in a consanguineous Chinese family with
Xinlin Zhang1, Jun Xie, Suhui Zhu
1Department of Cardiology, Affiliated Drum Tower Hospital, Nanjing University School of Medicine, Nanjing, China.
Insights
Genetic modifiers influence hypertrophic cardiomyopathy (HCM) severity. A CACNB2 mutation may worsen MYBPC3-associated HCM, highlighting potential genetic interactions in this complex heart disease.
Area of Science:
- Cardiovascular Genetics
- Molecular Cardiology
- Genetic Epidemiology
Background:
- Hypertrophic cardiomyopathy (HCM) exhibits significant phenotypic variability, suggesting the influence of genetic modifiers.
- MYBPC3 mutations are a common cause of familial HCM, yet disease presentation varies widely even within families.
Purpose of the Study:
- To investigate genetic factors contributing to phenotypic heterogeneity in MYBPC3-associated HCM.
- To identify potential modifier genes influencing disease severity in a large Chinese family.
Main Methods:
- Targeted next-generation sequencing was employed to screen for variants in known cardiomyopathy and channelopathy genes.
- Genotyping was performed to assess the presence of specific mutations in affected and unaffected family members.
- Exclusion of renin-angiotensin-aldosterone system variants as modifiers.
Main Results:
- Identified the MYBPC3 c.3624delC mutation in 8 family members with diverse HCM phenotypes.
- Discovered a novel CACNB2 c.1598C>T (p.Ser533Leu) mutation exclusively in severely affected HCM patients.
- This CACNB2 mutation was absent in moderately affected individuals, genotype-positive/phenotype-negative individuals, and 550 healthy controls.
Conclusions:
- The CACNB2 p.Ser533Leu mutation is a potential genetic modifier of MYBPC3-associated familial HCM.
- Further genetic and functional studies are required to confirm CACNB2's role in HCM pathogenesis.
- This finding opens new avenues for understanding genetic interactions in hypertrophic cardiomyopathy.
Abstract:
Hypertrophic cardiomyopathy (HCM) is a highly heterogeneous disease displaying considerable interfamilial and intrafamilial phenotypic variation, including disease severity, age of onset, and disease progression. This poorly understood variance raises the possibility of genetic modifier effects, particularly in MYBPC3-associated HCM.In a large consanguineous Chinese HCM family, we identified 8 members harboring the MYBPC3 c.3624delC (p.Lys1209Serfs) disease-causing mutation, but with very disparate phenotypes. Genotyping ruled out the modifying effect of previously described variants in renin-angiotensin-aldosterone system. Afterwards, we screened for modifying variants in all known causing genes and closely related genes for cardiomyopathy and channelopathy by performing targeted next-generation sequencing. For first time, we showed that a c.1598C>T (p.Ser533Leu) mutation in voltage-dependent l-type calcium channel subunit beta-2 (CACNB2) was present in all severely affected HCM patients, but not in those moderately affected or genotype-positive phenotype-negative patients. This CACNB2 p.Ser533Leu mutation is extremely conserved in evolution, and was not found in 550 healthy controls.Our results suggest that CACNB2 is a possible candidate genetic modifier of MYBPC3-associated familial HCM, but more genetic evidence and functional experiments are needed to confirm.
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