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Chang YH, Lin P, Lin JL, Huang HY, Hsu CK, Hsu CH. Case Report: A novel desmoplakin mutation in a taiwanese woman with familial dilated cardiomyopathy that necessitated heart transplantation. Front Genet 2022; 13:954931. [PMID: 36212137 PMCID: PMC9538354 DOI: 10.3389/fgene.2022.954931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/08/2022] [Indexed: 11/13/2022] Open
Abstract
Around one-third of patients diagnosed with idiopathic dilated cardiomyopathy (DCM) turn out to be familial cases, in only a few of which the identification of a pathogenic/likely pathogenic variant could be achieved. Cardiomyopathy caused by desmoplakin gene mutations represents a distinct form with a high prevalence of left ventricle involvement. We report a novel desmoplakin mutation carried by two individuals in a Taiwanese family, in which the proband recovered well after heart transplantation and under medical control, while her son had received an implantable cardioverter defibrillator and has been under guideline-directed medical therapy. The present study broadens the genetic spectrum of this disease entity and strengthens the notion that a detailed family history with genetic study contributes to the early detection and treatment of inherited diseases.
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Affiliation(s)
- Yi-Han Chang
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Education Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- International Research Center of Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan
| | - Pei Lin
- Division of Cardiology, Department of Internal Medicine, Tainan Municipal An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Jia-Ling Lin
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital Dou-Liou Branch, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Hsin-Yu Huang
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chao-Kai Hsu
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- International Research Center of Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Hsin Hsu
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
- Division of Critical Care, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- *Correspondence: Chih-Hsin Hsu,
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Connell PS, Berkman AM, Souder BM, Pirozzi EJ, Lovin JJ, Rosenfeld JA, Liu P, Tunuguntla H, Allen HD, Denfield SW, Kim JJ, Landstrom AP. Amino Acid-Level Signal-to-Noise Analysis Aids in Pathogenicity Prediction of Incidentally Identified TTN-Encoded Titin Truncating Variants. CIRCULATION. GENOMIC AND PRECISION MEDICINE 2021; 14:e003131. [PMID: 33226272 PMCID: PMC7887062 DOI: 10.1161/circgen.120.003131] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/14/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND TTN, the largest gene in the human body, encodes TTN (titin), a protein that plays key structural, developmental, and regulatory roles in skeletal and cardiac muscle. Variants in TTN, particularly truncating variants (TTNtvs), have been implicated in the pathogenicity of cardiomyopathy. Despite this link, there is also a high burden of TTNtvs in the ostensibly healthy general population. This complicates the diagnostic interpretation of incidentally identified TTNtvs, which are of increasing abundance given expanding clinical exome sequencing. METHODS Incidentally identified TTNtvs were obtained from a large referral database of clinical exome sequencing (Baylor Genetics) and compared with rare population variants from genome aggregation database and cardiomyopathy-associated variants from cohort studies in the literature. A subset of TTNtv-positive children evaluated for cardiomyopathy at Texas Children's Hospital was retrospectively reviewed for clinical features of cardiomyopathy. Amino acid-level signal-to-noise analysis was performed. RESULTS Pathological hotspots were identified within the A-band and N-terminal I-band that closely correlated with regions of high percent-spliced in of exons. Incidental TTNtvs and population TTNtvs did not localize to these regions. Variants were reclassified based on current American College of Medical Genetics and Genomics criteria with incorporation of signal-to-noise analysis among Texas Children's Hospital cases. Those reclassified as likely pathogenic or pathogenic were more likely to have evidence of cardiomyopathy on echocardiography than those reclassified as variants of unknown significance. CONCLUSIONS Incidentally found TTNtvs are common among clinical exome sequencing referrals. Pathological hotspots within the A-band of TTN may be informative in determining variant pathogenicity when incorporated into current American College of Medical Genetics and Genomics guidelines.
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Affiliation(s)
- Patrick S. Connell
- Department of Pediatrics, Section of Pediatric Cardiology, Baylor College of Medicine, Houston, TX
| | - Amy M. Berkman
- Department of Pediatrics, Division of Cardiology, Duke University School of Medicine, Durham, NC
| | - BriAnna M. Souder
- Department of Pediatrics, Section of Pediatric Cardiology, Baylor College of Medicine, Houston, TX
- Department of Pediatrics, Division of Cardiology, Duke University School of Medicine, Durham, NC
| | - Elisa J. Pirozzi
- Department of Pediatrics, Division of Cardiology, Duke University School of Medicine, Durham, NC
| | - Julia J. Lovin
- Department of Pediatrics, Section of Pediatric Cardiology, Baylor College of Medicine, Houston, TX
| | - Jill A Rosenfeld
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX
- Baylor Genetics Laboratories, Houston, TX
| | - Pengfei Liu
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX
- Baylor Genetics Laboratories, Houston, TX
| | - Hari Tunuguntla
- Department of Pediatrics, Section of Pediatric Cardiology, Baylor College of Medicine, Houston, TX
| | - Hugh D. Allen
- Department of Pediatrics, Section of Pediatric Cardiology, Baylor College of Medicine, Houston, TX
| | - Susan W. Denfield
- Department of Pediatrics, Section of Pediatric Cardiology, Baylor College of Medicine, Houston, TX
| | - Jeffrey J. Kim
- Department of Pediatrics, Section of Pediatric Cardiology, Baylor College of Medicine, Houston, TX
| | - Andrew P. Landstrom
- Department of Pediatrics, Division of Cardiology, Duke University School of Medicine, Durham, NC
- Department of Cell Biology, Duke University School of Medicine, Durham, NC
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Wen MS, Wang CY, Yeh JK, Chen CC, Tsai ML, Ho MY, Hung KC, Hsieh IC. The role of Asprosin in patients with dilated cardiomyopathy. BMC Cardiovasc Disord 2020; 20:402. [PMID: 32894050 PMCID: PMC7487662 DOI: 10.1186/s12872-020-01680-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/23/2020] [Indexed: 12/25/2022] Open
Abstract
Background Asprosin is a novel fasting glucogenic adipokine discovered in 2016. Asprosin induces rapid glucose releases from the liver. However, its molecular mechanisms and function are still unclear. Adaptation of energy substrates from fatty acid to glucose is recently considered a novel therapeutic target in heart failure treatment. We hypothesized that the asprosin is able to modulate cardiac mitochondrial functions and has important prognostic implications in dilated cardiomyopathy (DCM) patients. Methods We prospectively enrolled 50 patients (86% male, mean age 55 ± 13 years) with DCM and followed their 5-year major adverse cardiovascular events from 2012 to 2017. Comparing with healthy individuals, DCM patients had higher asprosin levels (191.2 versus 79.7 ng/mL, P < 0.01). Results During the 5-year follow-up in the study cohort, 16 (32.0%) patients experienced adverse cardiovascular events. Patients with lower asprosin levels (< 210 ng/mL) were associated with increased risks of adverse clinical outcomes with a hazard ratio of 7.94 (95% CI 1.88–33.50, P = 0.005) when compared patients with higher asprosin levels (≥ 210 ng/mL). Using cardiomyoblasts as a cellular model, we showed that asprosin prevented hypoxia-induced cell death and enhanced mitochondrial respiration and proton leak under hypoxia. Conclusions In patients with DCM, elevated plasma asprosin levels are associated with less adverse cardiovascular events in five years. The underlying protective mechanisms of asprosin may be linked to its functions relating to enhanced mitochondrial respiration under hypoxia.
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Affiliation(s)
- Ming-Shien Wen
- Department of Cardiology, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, 5 Fu-Hsing Street, Taoyuan, 333, Taiwan.
| | - Chao-Yung Wang
- Department of Cardiology, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, 5 Fu-Hsing Street, Taoyuan, 333, Taiwan. .,Institute of Cellular and System Medicine, National Health Research Institutes, Zhunan, 350, Taiwan.
| | - Jih-Kai Yeh
- Department of Cardiology, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, 5 Fu-Hsing Street, Taoyuan, 333, Taiwan
| | - Chun-Chi Chen
- Department of Cardiology, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, 5 Fu-Hsing Street, Taoyuan, 333, Taiwan
| | - Ming-Lung Tsai
- Department of Cardiology, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, 5 Fu-Hsing Street, Taoyuan, 333, Taiwan
| | - Ming-Yun Ho
- Department of Cardiology, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, 5 Fu-Hsing Street, Taoyuan, 333, Taiwan
| | - Kuo-Chun Hung
- Department of Cardiology, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, 5 Fu-Hsing Street, Taoyuan, 333, Taiwan
| | - I-Chang Hsieh
- Department of Cardiology, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, 5 Fu-Hsing Street, Taoyuan, 333, Taiwan
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Wang TD. Renin-Angiotensin System Inhibitors and COVID-19: Potential Therapeutics Rather Than Perpetrators. ACTA CARDIOLOGICA SINICA 2020; 36:179-182. [PMID: 32425432 PMCID: PMC7220966 DOI: 10.6515/acs.202005_36(3).20200430a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 04/30/2020] [Indexed: 01/05/2023]
Affiliation(s)
- Tzung-Dau Wang
- Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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