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van der Meulen MH, Herkert JC, den Boer SL, du Marchie Sarvaas GJ, Blom N, ten Harkel AD, Breur HM, Rammeloo LA, Tanke R, Marcelis C, van de Laar IM, Verhagen JM, Lekanne dit Deprez RH, Barge-Schaapveld DQ, Baas A, Sammani A, Christiaans I, van Tintelen JP, Dalinghaus M. Genetic Evaluation of A Nation-Wide Dutch Pediatric DCM Cohort: The Use of Genetic Testing in Risk Stratification. Circ Genom Precis Med 2022; 15:e002981. [DOI: 10.1161/circgen.120.002981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
This study aimed to describe the current practice and results of genetic evaluation in Dutch children with dilated cardiomyopathy and to evaluate genotype-phenotype correlations that may guide prognosis.
Methods:
We performed a multicenter observational study in children diagnosed with dilated cardiomyopathy, from 2010 to 2017.
Results:
One hundred forty-four children were included. Initial diagnostic categories were idiopathic dilated cardiomyopathy in 67 children (47%), myocarditis in 23 (16%), neuromuscular in 7 (5%), familial in 18 (13%), inborn error of metabolism in 4 (3%), malformation syndrome in 2 (1%), and “other” in 23 (16%). Median follow-up time was 2.1 years [IQR 1.0–4.3]. Hundred-seven patients (74%) underwent genetic testing. We found a likely pathogenic or pathogenic variant in 38 children (36%), most often in
MYH7
(n = 8). In 1 patient initially diagnosed with myocarditis, a pathogenic
LMNA
variant was found. During the study, 39 patients (27%) reached study endpoint (SE: all-cause death or heart transplantation). Patients with a likely pathogenic or pathogenic variant were more likely to reach SE compared with those without (hazard ratio 2.8; 95% CI 1.3–5.8,
P
= 0.007), while transplant-free survival was significantly lower (
P
= 0.006). Clinical characteristics at diagnosis did not differ between the 2 groups.
Conclusions:
Genetic testing is a valuable tool for predicting prognosis in children with dilated cardiomyopathy, with carriers of a likely pathogenic or pathogenic variant having a worse prognosis overall. Genetic testing should be incorporated in clinical work-up of all children with dilated cardiomyopathy regardless of presumed disease pathogenesis.
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Affiliation(s)
| | - Johanna C. Herkert
- Dept of Genetics, Univ of Groningen, Univ Medical Center Groningen, Groningen (J.C.H., I.C.)
| | | | | | - Nico Blom
- Dept of Pediatric Cardiology, Univ of Leiden, Leiden Univ Medical Center, Leiden (N.B., A.D.J.H.)
| | - Arend D.J. ten Harkel
- Dept of Pediatric Cardiology, Univ of Leiden, Leiden Univ Medical Center, Leiden (N.B., A.D.J.H.)
- Dept of Pediatric Cardiology, Univ of Amsterdam, Academic Medical Center, Amsterdam (A.D.J.H.)
| | - Hans M.P.J. Breur
- Dept of Pediatric Cardiology, Univ of Utrecht, Wilhelmina Children’s Hospital, Univ Medical Center Utrecht, Utrecht (H.M.P.J.B.)
| | - Lukas A.J. Rammeloo
- Dept of Pediatric Cardiology, Amsterdam Univ Medical Center, location Free Univ Medical Center, Amsterdam (L.A.J.R.)
| | - Ronald Tanke
- Dept of Pediatric Cardiology, Radboud Univ Medical Center, Nijmegen (R.T.)
| | - Carlo Marcelis
- Dept of Genetics, Radboud Univ Medical Center, Nijmegen (C.M.)
| | - Ingrid M.B.H. van de Laar
- Dept of Clinical Genetics, Erasmus MC, Univ Medical Center Rotterdam, Rotterdam (I.M.B.H.L., J.M.A.V.)
| | - Judith M.A. Verhagen
- Dept of Clinical Genetics, Erasmus MC, Univ Medical Center Rotterdam, Rotterdam (I.M.B.H.L., J.M.A.V.)
| | | | | | - Annette Baas
- Dept of Genetics, Univ of Utrecht, University Medical Center Utrecht, Utrecht, the Netherlands (A.B., A.S., J.P.T.)
| | - Arjan Sammani
- Dept of Genetics, Univ of Utrecht, University Medical Center Utrecht, Utrecht, the Netherlands (A.B., A.S., J.P.T.)
| | - Imke Christiaans
- Dept of Genetics, Univ of Groningen, Univ Medical Center Groningen, Groningen (J.C.H., I.C.)
- Dept of Clinical Genetics, Univ of Leiden, Leiden Univ Medical Center, Leiden (D.Q.C.M.B-S., I.C.)
| | - J. Peter van Tintelen
- Dept of Clinical Genetics, Amsterdam Univ Medical Center, location AMC, Amsterdam (R.H.L.D., J.P.T.)
- Dept of Genetics, Univ of Utrecht, University Medical Center Utrecht, Utrecht, the Netherlands (A.B., A.S., J.P.T.)
| | - Michiel Dalinghaus
- Dept of Pediatric Cardiology, Erasmus MC, Univ Medical Center Rotterdam, Rotterdam (M.H.M., M.D.)
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