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Isolated Pulmonary Arteriovenous Malformations Associated With BMPR2 Pathogenic Variants
Mithum Kularatne1, Mélanie Eyries2, Laurent Savale3
1Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France; INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis Robinson, France; University of Calgary, Calgary, AB, Canada.
Pathogenic variants in BMPR2 may increase the risk of developing pulmonary arteriovenous malformations (AVMs), even without pulmonary arterial hypertension (PAH). This suggests BMPR2 variants could warrant screening for AVMs.
Area of Science:
- Cardiovascular Research
- Genetics
- Pulmonary Medicine
Background:
- Heritable pulmonary arterial hypertension (PAH) is primarily linked to BMPR2 gene variants.
- Previous research noted vascular abnormalities in pulmonary and bronchial arteries associated with BMPR2 variants.
Observation:
- Two patients with pulmonary arteriovenous malformations (AVMs) were found to carry BMPR2 variants.
- These patients did not exhibit signs of pulmonary arterial hypertension (PAH).
Findings:
- Pulmonary AVMs are typically associated with hereditary hemorrhagic telangiectasia, but are also rarely seen in heritable PAH.
- Growing evidence links BMP9 pathway abnormalities to both hereditary hemorrhagic telangiectasia and heritable PAH.
Implications:
- BMPR2 variants may confer an increased risk for pulmonary AVMs.
- Screening for pulmonary AVMs may be advisable in individuals with BMPR2 variants.
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