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Circulation. 2003;107:2227-2232
Published online before print April 21, 2003, doi: 10.1161/01.CIR.0000066323.15244.54
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(Circulation. 2003;107:2227.)
© 2003 American Heart Association, Inc.


Clinical Investigation and Reports

Hypertrophic Cardiomyopathy

Distribution of Disease Genes, Spectrum of Mutations, and Implications for a Molecular Diagnosis Strategy

Pascale Richard, PhD; Philippe Charron, MD, PhD; Lucie Carrier, PhD; Céline Ledeuil; Theary Cheav; Claire Pichereau; Abdelaziz Benaiche, MD; Richard Isnard, MD; Olivier Dubourg, MD; Marc Burban, MD; Jean-Pierre Gueffet, MD; Alain Millaire, MD; Michel Desnos, MD; Ketty Schwartz, PhD; Bernard Hainque, PhD; Michel Komajda, MD, for the EUROGENE Heart Failure Project

From the UF Cardio-Myogénétique, Service de Biochimie (P.R., C.L., T.C., C.P., B.H.), the Département de Génétique (P.C.), INSERM U582 (P.R., L.C., K.S., B.H.), and Institut de Cardiologie (P.C., A.B., R.I., M.K.), Hôpital de la Salpêtrière, Paris, France; the Service de Cardiologie, Hôpital Ambroise Paré, Boulogne, France (O.D.); the Service de Cardiologie, Nantes, France (M.B., J.-P.G.); the Service de Cardiologie, Lilles, France (A.M.); and Service de Cardiologie, Hôpital Européen Georges Pompidou, Paris, France (M.D.). P.R., P.C., C.L., T.C., C.P., A.B., R.I., B.H., and M.K. are members of Assistance Publique, Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière; P.R., P.C., L.C., C.L., T.C., C.P., A.B., R.I., K.S., B.H., and M.K. are members of Institut Fédératif de Recherche 14 "Coeur, Muscle, Vaisseaux," Groupe Hospitalier Pitié-Salpêtrière, France.

Correspondence to Dr P. Richard, UF de Cardiogénétique et Myogénétique, Service de Biochimie B, Hôpital de la Salpêtrière, 47 Bld de l’Hôpital, 75651 Paris Cedex 13, France. E-mail pascale.richard{at}psl.ap-hop-paris.fr

Background— Hypertrophic cardiomyopathy is an autosomal-dominant disorder in which 10 genes and numerous mutations have been reported. The aim of the present study was to perform a systematic screening of these genes in a large population, to evaluate the distribution of the disease genes, and to determine the best molecular strategy in clinical practice.

Methods and Results— The entire coding sequences of 9 genes (MYH7, MYBPC3, TNNI3, TNNT2, MYL2, MYL3, TPM1, ACTC, andTNNC1) were analyzed in 197 unrelated index cases with familial or sporadic hypertrophic cardiomyopathy. Disease-causing mutations were identified in 124 index patients ({approx}63%), and 97 different mutations, including 60 novel ones, were identified. The cardiac myosin-binding protein C (MYBPC3) and ß-myosin heavy chain (MYH7) genes accounted for 82% of families with identified mutations (42% and 40%, respectively). Distribution of the genes varied according to the prognosis (P=0.036). Moreover, a mutation was found in 15 of 25 index cases with "sporadic" hypertrophic cardiomyopathy (60%). Finally, 6 families had patients with more than one mutation, and phenotype analyses suggested a gene dose effect in these compound-heterozygous, double-heterozygous, or homozygous patients.

Conclusion— These results might have implications for genetic diagnosis strategy and, subsequently, for genetic counseling. First, on the basis of this experience, the screening of already known mutations is not helpful. The analysis should start by testing MYBPC3 and MYH7 and then focus on TNNI3, TNNT2, and MYL2. Second, in particularly severe phenotypes, several mutations should be searched. Finally, sporadic cases can be successfully screened.


Key Words: hypertrophy • cardiomyopathy • genetics • prognosis


Related Article:

To Screen or Not Is Not the Question— It Is When and How to Screen
A.J. Marian and R. Roberts
Circulation 2003 107: 2171-2174. [Extract] [Full Text]



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M. J. Hardman, A. Waite, L. Zeef, M. Burow, T. Nakayama, and G. S. Ashcroft
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Am. J. Pathol., December 1, 2005; 167(6): 1561 - 1574.
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CirculationHome page
M. Arad, M. Penas-Lado, L. Monserrat, B. J. Maron, M. Sherrid, C. Y. Ho, S. Barr, A. Karim, T. M. Olson, M. Kamisago, et al.
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Circulation, November 1, 2005; 112(18): 2805 - 2811.
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J Ingles, A Doolan, C Chiu, J Seidman, C Seidman, and C Semsarian
Compound and double mutations in patients with hypertrophic cardiomyopathy: implications for genetic testing and counselling
J. Med. Genet., October 1, 2005; 42(10): e59 - e59.
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Eur Heart JHome page
J. F. Forissier, P. Charron, S. T. du Montcel, A. Hagege, R. Isnard, L. Carrier, P. Richard, M. Desnos, J. B. Bouhour, K. Schwartz, et al.
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Eur. Heart J., September 2, 2005; 26(18): 1882 - 1886.
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D. Szczesna-Cordary, G. Guzman, J. Zhao, O. Hernandez, J. Wei, and Z. Diaz-Perez
The E22K mutation of myosin RLC that causes familial hypertrophic cardiomyopathy increases calcium sensitivity of force and ATPase in transgenic mice
J. Cell Sci., August 15, 2005; 118(16): 3675 - 3683.
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J. Mogensen and W. J. McKenna
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J. Am. Coll. Cardiol., July 5, 2005; 46(1): 181 - 181.
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CirculationHome page
E. Carniel, M. R.G. Taylor, G. Sinagra, A. Di Lenarda, L. Ku, P. R. Fain, M. M. Boucek, J. Cavanaugh, S. Miocic, D. Slavov, et al.
{alpha}-Myosin Heavy Chain: A Sarcomeric Gene Associated With Dilated and Hypertrophic Phenotypes of Cardiomyopathy
Circulation, July 5, 2005; 112(1): 54 - 59.
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Vet PatholHome page
M. F. Cesta, C. J. Baty, B. W. Keene, I. W. Smoak, and D. E. Malarkey
Pathology of End-stage Remodeling in a Family of Cats with Hypertrophic Cardiomyopathy
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S. L. Van Driest, S. R. Ommen, A. J. Tajik, B. J. Gersh, and M. J. Ackerman
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Mayo Clin. Proc., June 1, 2005; 80(6): 739 - 744.
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Hum Mol GenetHome page
C. Grey, A. Mery, and M. Puceat
Fine-tuning in Ca2+ homeostasis underlies progression of cardiomyopathy in myocytes derived from genetically modified embryonic stem cells
Hum. Mol. Genet., May 15, 2005; 14(10): 1367 - 1377.
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Eur Heart JHome page
E. Villard, L. Duboscq-Bidot, P. Charron, A. Benaiche, V. Conraads, N. Sylvius, and M. Komajda
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Eur. Heart J., April 2, 2005; 26(8): 794 - 803.
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Cardiovasc ResHome page
H.-P. Vosberg
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Cardiovasc Res, April 1, 2005; 66(1): 1 - 3.
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A. Sarikas, L. Carrier, C. Schenke, D. Doll, J. Flavigny, K. S. Lindenberg, T. Eschenhagen, and O. Zolk
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S. L. Van Driest, S. R. Ommen, A. J. Tajik, B. J. Gersh, and M. J. Ackerman
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N. R. Alpert, S. A. Mohiddin, D. Tripodi, J. Jacobson-Hatzell, K. Vaughn-Whitley, C. Brosseau, D. M. Warshaw, and L. Fananapazir
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Am J Physiol Heart Circ Physiol, March 1, 2005; 288(3): H1097 - H1102.
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NeurologyHome page
N. G. Laing, C. Ceuterick-de Groote, D. E. Dye, K. Liyanage, R. M. Duff, B. Dubois, W. Robberecht, R. Sciot, J-J. Martin, and H. H. Goebel
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Hum Mol GenetHome page
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Expression of cardiac myosin-binding protein-C (cMyBP-C) in Drosophila as a model for the study of human cardiomyopathies
Hum. Mol. Genet., January 1, 2005; 14(1): 7 - 17.
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BloodHome page
J. D. Franke, F. Dong, W. L. Rickoll, M. J. Kelley, and D. P. Kiehart
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J. Am. Coll. Cardiol., December 21, 2004; 44(12): 2326 - 2328.
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Proposal for contemporary screening strategies in families with hypertrophic cardiomyopathy
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S. P. Harris, E. Rostkova, M. Gautel, and R. L. Moss
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Circ. Res., October 29, 2004; 95(9): 930 - 936.
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CirculationHome page
A. H. Maass, K. Ikeda, S. Oberdorf-Maass, S. K.G. Maier, and L. A. Leinwand
Hypertrophy, Fibrosis, and Sudden Cardiac Death in Response to Pathological Stimuli in Mice With Mutations in Cardiac Troponin T
Circulation, October 12, 2004; 110(15): 2102 - 2109.
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B. J. Maron, B. R. Chaitman, M. J. Ackerman, A. Bayes de Luna, D. Corrado, J. E. Crosson, B. J. Deal, D. J. Driscoll, N.A. M. Estes III, C. G. S. Araujo, et al.
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Circulation, June 8, 2004; 109(22): 2807 - 2816.
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E. Flashman, C. Redwood, J. Moolman-Smook, and H. Watkins
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