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Boeykens F, Abitbol M, Anderson H, Dargar T, Ferrari P, Fox PR, Hayward JJ, Häggström J, Davison S, Kittleson MD, van Steenbeek F, Ljungvall I, Lyons LA, Longeri M, Ohlsson Å, Peelman L, Dufaure de Citres C, Smets P, Turba ME, Broeckx BJG. Classification of feline hypertrophic cardiomyopathy-associated gene variants according to the American College of Medical Genetics and Genomics guidelines. Front Vet Sci 2024; 11:1327081. [PMID: 38371598 PMCID: PMC10873919 DOI: 10.3389/fvets.2024.1327081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/08/2024] [Indexed: 02/20/2024] Open
Abstract
Introduction The correct labeling of a genetic variant as pathogenic is important as breeding decisions based on incorrect DNA tests can lead to the unwarranted exclusion of animals, potentially compromising the long-term health of a population. In human medicine, the American college of Medical Genetics (ACMG) guidelines provide a framework for variant classification. This study aims to apply these guidelines to six genetic variants associated with hypertrophic cardiomyopathy (HCM) in certain cat breeds and to propose a modified criterion for variant classification. Methods Genetic samples were sourced from five cat breeds: Maine Coon, Sphynx, Ragdoll, Devon Rex, and British Short- and Longhair. Allele frequencies were determined, and in the subset with phenotypes available, odds ratios to determine the association with HCM were calculated. In silico evaluation followed with joint evidence and data from other publications assisting in the classification of each variant. Results Two variants, MYBPC3:c.91G > C [A31P] and MYBPC3:c.2453C > T [R818W], were designated as pathogenic. One variant, MYH7:c.5647G > A [E1883K], was found likely pathogenic, while the remaining three were labeled as variants of unknown significance. Discussion Routine genetic testing is advised solely for the MYBPC3:c.91G > C [A31P] in the Maine Coon and MYBPC3:c.2453C > T [R818W] in the Ragdoll breed. The human ACMG guidelines serve as a suitable foundational tool to ascertain which variants to include; however, refining them for application in veterinary medicine might be beneficial.
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Affiliation(s)
- Fréderique Boeykens
- Laboratory Animal Genetics, Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Marie Abitbol
- Univ Lyon, VetAgro Sup, Marcy-l’Etoile, France & Institut NeuroMyoGène INMG-PNMG, CNRS UMR5261, INSERM U1315, Faculté de Médicine, Rockefeller, Université Claude Bernard Lyon 1, Lyon, France
| | - Heidi Anderson
- Wisdom Panel, Mars Petcare Science & Diagnostics, Helsinki, Finland
| | - Tanushri Dargar
- Univ Lyon, VetAgro Sup, Marcy-l’Etoile, France & Institut NeuroMyoGène INMG-PNMG, CNRS UMR5261, INSERM U1315, Faculté de Médicine, Rockefeller, Université Claude Bernard Lyon 1, Lyon, France
| | - Paolo Ferrari
- Osservatorio Veterinario Italiano Cardiopatie, Azzano San Paolo, Italy
- Bis Clinica Veterinaria Orobica Anicura, Bergamo, Italy
| | - Philip R. Fox
- The Animal Medical Center, New York, NY, United States
| | - Jessica J. Hayward
- Department of Biomedical Sciences and Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Jens Häggström
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Stephen Davison
- Wisdom Panel, Mars Petcare Science & Diagnostics, Leicestershire, United Kingdom
| | - Mark D. Kittleson
- Veterinary Information Network and School of Veterinary Medicine and Epidemiology, University of California, Davis, Davis, CA, United States
| | - Frank van Steenbeek
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Ingrid Ljungvall
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Leslie A. Lyons
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, United States
| | - Maria Longeri
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Lodi, Italy
| | - Åsa Ohlsson
- Department of Animal Breeding and Genetics, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Luc Peelman
- Laboratory Animal Genetics, Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | | | - Pascale Smets
- Small Animal Department, Ghent University, Merelbeke, Belgium
| | | | - Bart J. G. Broeckx
- Laboratory Animal Genetics, Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Abstract
Practical relevance: Hypertrophic cardiomyopathy (HCM) is the most common form of feline
cardiomyopathy observed clinically and may affect up to approximately 15% of
the domestic cat population, primarily as a subclinical disease.
Fortunately, severe HCM, leading to heart failure or arterial
thromboembolism (ATE), only occurs in a small proportion of these cats. Patient group: Domestic cats of any age from 3 months upward, of either sex and of any
breed, can be affected. A higher prevalence in male and domestic shorthair
cats has been reported. Diagnostics: Subclinical feline HCM may or may not produce a heart murmur or gallop sound.
Substantial left atrial enlargement can often be identified radiographically
in cats with severe HCM. Biomarkers should not be relied on solely to
diagnose the disease. While severe feline HCM can usually be diagnosed via
echocardiography alone, feline HCM with mild to moderate left ventricular
(LV) wall thickening is a diagnosis of exclusion, which means there is no
definitive test for HCM in these cats and so other disorders that can cause
mild to moderate LV wall thickening (eg, hyperthyroidism, systemic
hypertension, acromegaly, dehydration) need to be ruled out. Key findings: While a genetic cause of HCM has been identified in two breeds and is
suspected in another, for most cats the cause is unknown. Systolic anterior
motion of the mitral valve (SAM) is the most common cause of dynamic left
ventricular outflow tract obstruction (DLVOTO) and, in turn, the most common
cause of a heart murmur with feline HCM. While severe DLVOTO is probably
clinically significant and so should be treated, lesser degrees probably are
not. Furthermore, since SAM can likely be induced in most cats with HCM, the
distinction between HCM without obstruction and HCM with obstruction (HOCM)
is of limited importance in cats. Diastolic dysfunction, and its
consequences of abnormally increased atrial pressure leading to signs of
heart failure, and sluggish atrial blood flow leading to ATE, is the primary
abnormality that causes clinical signs and death in affected cats. Treatment
(eg, loop diuretics) is aimed at controlling heart failure. Preventive
treatment (eg, antithrombotic drugs) is aimed at reducing the risk of
complications (eg, ATE). Conclusions: Most cats with HCM show no overt clinical signs and live a normal or
near-normal life despite this disease. However, a substantial minority of
cats develop overt clinical signs referable to heart failure or ATE that
require treatment. For most cats with clinical signs caused by HCM, the
long-term prognosis is poor to grave despite therapy. Areas of uncertainty: Genetic mutations (variants) that cause HCM have been identified in a few
breeds, but, despite valiant efforts, the cause of HCM in the vast majority
of cats remains unknown. No treatment currently exists that reverses or even
slows the cardiomyopathic process in HCM, again despite valiant efforts. The
search goes on.
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Affiliation(s)
- Mark D Kittleson
- School of Veterinary Medicine, Department of Medicine and Epidemiology, University of California, Davis, and Veterinary Information Network, 777 West Covell Boulevard, Davis, CA 95616, USA
| | - Etienne Côté
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
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