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Published on: January 16, 2019
Genetic Research on Cardiac Channelopathies in African and African-Descent Populations: A Scoping Review
Choshiman Taib1,2, Nada El Makhzen1,3,4,5, Hugues Abriel1,3,5
1Ion Channels and Channelopathies Laboratory, Institute for Biochemistry and Molecular Medicine University of Bern Bern Switzerland.
Insights
Genetic research on inherited heart arrhythmias, or cardiac channelopathies, in African populations is limited. This underrepresentation hinders accurate diagnosis and treatment, emphasizing the need for broader African inclusion in genetic studies.
Area of Science:
- Genetics
- Cardiology
- Genomic Medicine
Background:
- Cardiac channelopathies are inherited arrhythmias linked to sudden cardiac death.
- African and African-descent populations are underrepresented in genetic research, impacting variant interpretation and clinical care.
Purpose of the Study:
- To map the scope and identify gaps in genetic research on cardiac channelopathies within African and African-descent populations.
- To highlight geographic, thematic, and methodological limitations in current research.
Main Methods:
- A scoping review using Joanna Briggs Institute methodology and the Population-Concept-Context framework.
- Systematic searches across PubMed, Embase, and Web of Science for original human genetic studies on cardiac channelopathies.
- Extraction of study characteristics, population demographics, channelopathy types, and reported genes/variants from 44 included studies.
Main Results:
- Research predominantly focused on US Black individuals and South Africans, with significant underrepresentation from West, Central, and East Africa.
- Long QT syndrome was the most studied channelopathy, with SCN5A, KCNQ1, and KCNH2 as the most frequently analyzed genes.
- Many identified genetic variants lacked clear significance due to limited functional validation and underrepresentation in reference databases.
Conclusions:
- Limited genetic research on cardiac channelopathies in African ancestries restricts variant interpretation, genetic counseling, and risk prediction.
- Expanded inclusion of diverse African populations, broader gene screening, and functional studies are crucial for diagnostic improvement.
- Addressing these gaps is essential for promoting equity in genomic medicine and improving cardiovascular health outcomes.
Abstract:
Cardiac channelopathies are inherited arrhythmias that can lead to sudden cardiac death. Despite Africa's extensive genomic diversity, African and African-descent populations remain underrepresented in genetic research, creating gaps in variant interpretation and clinical care. This scoping review aims to map the extent, range, and nature of genetic research on cardiac channelopathies in these populations and to identify key geographic, thematic, and methodological gaps. Using the Joanna Briggs Institute scoping review methodology and the Population-Concept-Context framework, systematic searches in PubMed, Embase, and Web of Science identified original human studies on cardiac channelopathies with genetic data. Extracted variables included study characteristics, populations, types of channelopathies, and reported genes and variants. Forty-four studies met the inclusion criteria. Most studies originated from the United States and South Africa, while West, Central, and East Africa were largely underrepresented. US Black individuals and South African individuals of continental African or African-descended ancestry (excluding populations of European descent such as Cape Afrikaner people) were the most studied groups, with other continental African groups rarely included. Long QT syndrome was the predominant focus, and SCN5A, KCNQ1, and KCNH2 were the most frequently analyzed genes. Many of the genetic variants discussed remained of uncertain significance due to limited functional validation and the underrepresentation of African genomes in reference databases. Genetic research on cardiac channelopathies in populations of African ancestry is limited, restricting variant interpretation, counseling, and risk prediction. Broader African inclusion, expanded gene screening, and functional studies are essential to improve diagnostics and promote equity in genomic medicine.
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