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Published on: August 8, 2022
Genetic and Clinical Characterization of FLNC Variants in Chinese Patients with Cardiomyopathy
Guofeng Xing1, Li Chen2, Lizhi Lv1
1Department of Pediatric Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Street, Chaoyang District, Beijing 100029, China.
Insights
Filamin C (FLNC) mutations are linked to inherited cardiomyopathies in Chinese patients. These mutations, particularly nonsense variants, correlate with severe heart conditions and poorer prognosis, emphasizing FLNC
Area of Science:
- Cardiovascular Genetics
- Molecular Cardiology
- Genetic Basis of Heart Disease
Background:
- Inherited cardiomyopathies are significant causes of heart failure.
- Filamin C (FLNC) mutations are implicated in myofibrillar myopathy and dilated cardiomyopathy (DCM).
- Missense FLNC variants are associated with hypertrophic cardiomyopathy (HCM) and protein aggregation.
Purpose of the Study:
- To investigate the spectrum of FLNC mutations in Chinese cardiomyopathy patients.
- To correlate FLNC mutation types with clinical phenotypes and outcomes.
- To understand the genetic basis of inherited cardiomyopathies in this population.
Main Methods:
- Whole-exome sequencing (WES) was performed on 25 Chinese cardiomyopathy patients.
- Variants were classified using American College of Medical Genetics and Genomics (ACMG) guidelines.
- Clinical data, including echocardiography and follow-up, were analyzed using SPSS.
Main Results:
- Twenty-five FLNC mutations were identified, including pathogenic, likely pathogenic, and variants of uncertain significance (VUS).
- Diagnoses included dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), and left ventricular non-compaction.
- Nonsense FLNC mutations were associated with higher tricuspid regurgitation prevalence and reduced left ventricular ejection fraction (LVEF).
- Frameshift mutations co-segregated with familial DCM and severe phenotypes, including sudden cardiac death.
Conclusions:
- FLNC mutations are a significant genetic cause of cardiomyopathies in the studied Chinese cohort.
- Specific FLNC mutation types correlate with distinct clinical presentations and disease severity.
- Genetic screening for FLNC mutations is crucial for diagnosing and managing inherited cardiomyopathies.
Abstract:
This study investigates FLNC mutations in Chinese cardiomyopathy patients. Background: Inherited cardiomyopathies, including dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), restrictive cardiomyopathy (RCM), and arrhythmogenic right ventricular cardiomyopathy (ARVC) are major heart failure causes. FLNC, critical for muscle structure, is implicated in myofibrillar myopathy and isolated DCM (3-4% cases) with ventricular arrhythmias. Missense variants are linked to HCM and protein aggregation. A cohort of 25 patients with pathogenic/likely pathogenic FLNC mutations (2022-2025, Beijing Anzhen Hospital) underwent whole-exome sequencing (WES) using IDT kit 1.0/Hiseq 4000. Variants were classified via the American College of Medical Genetics and Genomics (ACMG) guidelines. Clinical data (echocardiography, CMR, labs) and follow-up data (prognosis, meds, and family history) were collected. The statistics used SPSS (p < 0.05). The mean age was 38 ± 14.6 years (13 males). There were 25 FLNC mutations: 12 single nucleotide polymorphisms (SNPs), 5 deletions, 2 duplications, and 3 deletion-insertions, classified as 6 pathogenic, 16 likely pathogenic, and 3 variants of uncertain significance (VUS). Diagnoses: 24% dilated cardiomyopathy (DCM), 8% hypertrophic cardiomyopathy (HCM), and 4% left ventricular non-compaction. Nonsense mutation carriers exhibited significantly higher tricuspid regurgitation prevalence compared to frameshift mutation carriers (6/9 vs. 2/10; p = 0.04). Echocardiography revealed reduced left ventricular ejection fraction (LVEF) (41.5 ± 14.1%), with statistically significant differences in fractional shortening (p = 0.024) and aortic root diameter (p = 0.028). Pedigree analysis confirmed that a frameshift mutation (LP) co-segregated with familial DCM and was associated with severe phenotypes, including sudden cardiac death. Furthermore, nonsense FLNC mutations correlated with increased tricuspid regurgitation severity, smaller aortic root dimensions, and reduced pulmonary artery flow velocity.
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