電子医療記録に記録された表型と不律に関連した遺伝的変異の関連
Sara L Van Driest1, Quinn S Wells1, Sarah Stallings1
1Vanderbilt University Medical Center, Nashville, Tennessee.
JAMA
|January 10, 2016
まとめ
不律性遺伝子SCN5AとKCNH2の希少な変異は11%の患者で発見されました. しかし,これらの遺伝的変異は,この研究集団における心臓発作現象と明確な関連を示さなかった.
科学分野:
- 遺伝学
- 心臓病科
- ファルマゲノミクス
背景:
- 大規模なDNAシーケンシングは メンデルの病気の遺伝子の 珍しい変異を頻繁に特定します
- 選択されていない集団におけるこれらの偶然の発見の臨床的関連性は不明である.
- 電子医療記録 (EMR) は,希少変異に関連する臨床現象を評価するための潜在的なリソースを提供します.
研究 の 目的:
- 不律性感受性遺伝子 (SCN5AとKCNH2) の病原性変異に関連する臨床的フェノタイプを調査する.
- EMRデータを用いて,これらの変異体を持つ個体における心臓現象の頻度を決定する.
主な方法:
- 2022人の前向きなコホート研究が行われました.
- SCN5AとKCNH2の変種は,専門の研究室とClinVarによって病原性について評価されました.
- フェノタイプはICD-9コード,ECGデータ,マニュアルEMRレビューによって特定されました.
主要な成果:
- 参加者の11%がSCN5AまたはKCNH2の希少変異を携えていた.
- 63人の 42の変種は潜在的病原性と考えられ,実験室間コンコンダンスが低い.
- これらの変異体と心拍不良やECGの表型 (修正されたQT区間期間を含む) の間に有意な関連性が見つかりませんでした.
結論:
- SCN5AとKCNH2の変種を病原体として分類する研究室の一致度は低い.
- これらの不律性遺伝子の病原性遺伝的変異は,未選択の集団における異常な表型と関連付けられませんでした.
- これらの発見は,不律症の感受性に関する偶然の遺伝的発見について患者に通知することの臨床的有用性を疑問視しています.
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