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Updated: May 28, 2026

Determining the Likelihood of Variant Pathogenicity Using Amino Acid-level Signal-to-Noise Analysis of Genetic Variation
Published on: January 16, 2019
Association of Common Ancestry-Enriched Variants With Cardiomyopathy and Arrhythmias
Temidayo A Abe1, Megan C Lancaster1,2, Dan M Roden3
1Division of Cardiovascular Medicine, Department of Medicine (T.A.A., M.C.L.), Vanderbilt University Medical Center, Nashville, TN.
Genetic variants of uncertain significance (VUS) enriched in individuals of African ancestry are linked to increased cardiovascular risk, including cardiomyopathies and arrhythmias. These risks are amplified by heart failure and other cardiovascular risk factors.
Area of Science:
- Genetics
- Cardiology
- Genomic Medicine
Background:
- Genetic studies disproportionately underrepresent individuals of African ancestry.
- This leads to higher rates of variants of uncertain significance (VUS) and fewer actionable results for cardiomyopathies and arrhythmias in this population.
- Understanding the cardiovascular risk associated with ancestry-enriched VUS is crucial.
Purpose of the Study:
- To determine if VUS enriched in individuals of African ancestry confer measurable cardiovascular risk.
- To assess the association of these VUS with cardiovascular phenotypes, including heart failure and arrhythmias.
- To investigate the impact of cardiovascular risk factors and heart failure status on these associations.
Main Methods:
- Identified 82 VUS enriched in individuals of African ancestry in 18 cardiomyopathy and arrhythmia genes.
- Analyzed associations with cardiovascular phenotypes in 96,897 individuals of African ancestry from the All of Us and BioVU biobanks.
- Utilized fixed-effects meta-analysis, stratified by heart failure status and cardiovascular risk factors.
Main Results:
- Identified 4 VUS associated with cardiovascular phenotypes in a pooled meta-analysis.
- PKP2 p.Val558Ile showed a 4-fold increased risk of ventricular arrhythmias or sudden cardiac death.
- ELAC2 p.Ile396Val was associated with heart failure and atrial arrhythmias; FLNC p.Gly11Ser and PKP2 p.Val842Ile were associated with heart failure.
- Cardiovascular risk factors were associated with earlier onset of heart failure and atrial arrhythmias in variant carriers.
Conclusions:
- Large-scale biobank analysis identified VUS conferring increased risk of cardiomyopathy and arrhythmia in individuals of African ancestry.
- The cardiovascular risk associated with these VUS is exacerbated by the presence of cardiovascular risk factors and heart failure.
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