ゲノミクス - チチンの縮小型変異と関連した心臓病の最初の評価
Christopher M Haggerty1, Scott M Damrauer2,3, Michael G Levin2
1Geisinger, Danville, PA (C.M.H., D.J.C., A.M.G., D.N.H., Y.H., M.A.K., H.L.K., J.B.L., Z.N., T.N.P., A.P., D.T.S., R.C.S., A.C.S., M.F.M., B.K.F.).
Circulation
|June 21, 2019
まとめ
Titin遺伝子 (TTNtvs) の縮小型変異は,ヨーロッパ人の拡張性心筋病 (DCM) に関連しているが,アフリカ系の人ではそうではない. これらの変異は,DCMの診断なしに,心機能の低下と心不全のリスクの増加と関連しています.
科学分野:
- 遺伝学
- 心臓病科
- ゲノミクス
背景:
- ティチン遺伝子 (TTNtvs) の縮小変異は,イディオパシー拡張心筋病 (DCM) と診断された個体で頻繁に観察されます.
- 多様な臨床シナリオにおけるTTNtvsの影響と遺伝的祖先変異因子の影響に関する包括的な,ゲノム学第一の評価は欠けている.
研究 の 目的:
- 大規模な保健イニシアチブにおける TTNtvsのゲノム解析を 実施する.
- TTNtvsとDCMと心臓機能の関連性を評価する.
- これらの関連性を修正する遺伝的祖先の役割を調査する.
主な方法:
- GeisingerとPennMedicine BioBankからの71,000人以上のエクソームシーケンシングデータを分析した.
- 高い心表現エクソン (hiPSI) のTTNtvsを持つ個体を選びました.
- リンクされた電子医療記録とジャクソン心臓研究からのデータは,診断,エコーカルディオグラフィの測定,遺伝的祖先との関連を評価するために使用されました.
主要な成果:
- hiPSI TTNtvsは1. 2% (PennMedicine) と0. 6% (Geisinger) の個体で発見されました.
- hiPSI TTNtvsは,ヨーロッパの祖先の個体におけるDCMの確率を大幅に増加させた (OR: 18. 7 PennMedicine, 10. 8 Geisinger).
- hiPSI TTNtvsとDCMの関連性はアフリカ系個体では見つかりませんでした (OR: 1. 8).
- ヨーロッパ系DCMの個体では,hiPSI TTNtvキャリアのエジェクション分数 (β=12%) が低く,心室直径 (β=0. 65cm) が増加した.
- DCMのないゲーシンガーコホート患者では,hiPSI TTNtvsは心房細動 (OR: 2. 4),心不全 (OR: 3. 8),低射出分数 (β = - 3. 4%) と関連していました.
結論:
- hiPSI TTNtvのキャリアは,臨床心筋病の診断に関係なく,エジェクション分数の低下を含む異常な心臓フェノタイプを示します.
- 心筋病を考慮しても,心房細動のような不律症との関連が観察された.
- hiPSI TTNtvsとDCMの関連性は,アフリカ系の人では確認されなかった.
- hiPSI TTNtv キャリアの臨床的識別は,患者管理戦略にインフォームすることができます.
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