Unequal Allelic Expression of Wild-Type and Mutated B-Myosin in Familial Hypertrophic Cardiomyopathy

Total Page:16

File Type:pdf, Size:1020Kb

Unequal Allelic Expression of Wild-Type and Mutated B-Myosin in Familial Hypertrophic Cardiomyopathy Basic Res Cardiol (2011) 106:1041–1055 DOI 10.1007/s00395-011-0205-9 ORIGINAL CONTRIBUTION Unequal allelic expression of wild-type and mutated b-myosin in familial hypertrophic cardiomyopathy Snigdha Tripathi • Imke Schultz • Edgar Becker • Judith Montag • Bianca Borchert • Antonio Francino • Francisco Navarro-Lopez • Andreas Perrot • Cemil O¨ zcelik • Karl-Josef Osterziel • William J. McKenna • Bernhard Brenner • Theresia Kraft Received: 26 May 2011 / Revised: 29 June 2011 / Accepted: 7 July 2011 / Published online: 19 July 2011 Ó The Author(s) 2011. This article is published with open access at Springerlink.com Abstract Familial hypertrophic cardiomyopathy (FHC) genotyped and clinically well-characterized FHC patients is an autosomal dominant disease, which in about 30% of were analyzed. The fraction of mutated MYH7-mRNA in the patients is caused by missense mutations in one allele five patients with mutation R723G averaged to 66 and 68% of the b-myosin heavy chain (b-MHC) gene (MYH7). To of total MYH7-mRNA in soleus and myocardium, respec- address potential molecular mechanisms underlying the tively. For mutations I736T, R719W and V606M, fractions family-specific prognosis, we determined the relative of mutated MYH7-mRNA in M. soleus were 39, 57 and expression of mutant versus wild-type MYH7-mRNA. We 29%, respectively. For all mutations, unequal abundance found a hitherto unknown mutation-dependent unequal was similar at the protein level. Importantly, fractions of expression of mutant to wild-type MYH7-mRNA, which is mutated transcripts were comparable among siblings, in paralleled by similar unequal expression of b-MHC at the younger relatives and unrelated carriers of the same protein level. Relative abundance of mutated versus wild- mutation. Hence, the extent of unequal expression of type MYH7-mRNA was determined by a specific restriction mutated versus wild-type transcript and protein is charac- digest approach and by real-time PCR (RT-qPCR). Four- teristic for each mutation, implying cis-acting regulatory teen samples from M. soleus and myocardium of 12 mechanisms. Bioinformatics suggest mRNA stability or splicing effectors to be affected by certain mutations. Intriguingly, we observed a correlation between disease Electronic supplementary material The online version of this expression and fraction of mutated mRNA and protein. article (doi:10.1007/s00395-011-0205-9) contains supplementary material, which is available to authorized users. S. Tripathi Á I. Schultz Á E. Becker Á J. Montag Á B. Borchert Á A. Perrot Á C. O¨ zcelik B. Brenner Á T. Kraft (&) Charite´-Unversita¨tsmedizin Berlin, Experimental and Clinical Institute of Molecular and Cell Physiology, Research Center (ECRC) am Max-Delbru¨ck-Centrum fu¨r Hannover Medical School, Carl Neuberg Str. 1, Molekulare Medizin, Kardio-Genetisches Labor, 30625 Hannover, Germany 13125 Berlin, Germany e-mail: [email protected] C. O¨ zcelik Á K.-J. Osterziel Present Address: Charite´-Universita¨tsmedizin Berlin, Kardiologie am Campus I. Schultz Virchow-Klinikum, 13353 Berlin, Germany Niederwiesenring 4, 63110 Rodgau, Germany Present Address: Present Address: K.-J. Osterziel B. Borchert Kardiologische Gemeinschaftspraxis, Marienstraße 9, Department of Cardiac, Thoracic, Transplantation and Vascular 92224 Amberg, Germany Surgery, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany W. J. McKenna Institute of Cardiovascular Science, University College London, A. Francino Á F. Navarro-Lopez London WC1E 6BT, United Kingdom Hospital Clinic/IDIBAPS, University of Barcelona, 08036 Barcelona, Spain 123 1042 Basic Res Cardiol (2011) 106:1041–1055 This strongly suggests that mutation-specific allelic expression of different genes in humans [8, 13, 48]. Thus, imbalance represents a new pathogenic factor for FHC. allelic imbalance could well be quite significant for disease expression in genetic disorders [29], as has been shown, Keywords Hypertrophic cardiomyopathy Á Allelic e.g., for hyperkalemic periodic paralysis in horses [50]. imbalance Á Cardiac b-myosin heavy chain Á Myosin Evidence for allelic imbalance in FHC arises from our missense mutation Á mRNA quantification previous work on functional effects of b-MHC missense mutations. Since model systems of FHC often do not reveal the same mutation effect as it may occur in humans [19, 25], Introduction we study these mutations in M. soleus fibers and ventricular biopsies of FHC patients. In muscle fibers from individuals Familial hypertrophic cardiomyopathy (FHC), the most who were essentially asymptomatic but carried b-MHC common genetic heart disease, is characterized by hyper- mutations G584R or V606M, respectively, we did not detect trophy of the left ventricle and the inter-ventricular septum any effects on sarcomere function. The fraction of mutated (IVS), in the absence of overt etiological factors [23]. The b-MHC for mutations V606M and G584R was only 12 and hypertrophy is often asymmetric and variable in severity 23% of the total b-MHC in the sarcomeres, respectively [16]. The prevalence of hypertrophic cardiomyopathy is 1 [26]. This raised several questions: (1) Is the deviation from in 500; it affects individuals at every age [22]. FHC is often the expected 50-to-50 ratio of wild-type versus mutated associated with arrhythmias, syncope and progression to myosin at the protein level paralleled by similar changes at heart failure or sudden cardiac death even at young age [23]. the mRNA level due to allelic imbalance? (2) Is an unequal The genetically heterogeneous disease is transmitted as ratio of mutant versus wild-type protein and mRNA a an autosomal dominant trait [38]. Mutations in more than common feature in FHC caused by myosin mutations and 18 genes, mostly encoding sarcomeric proteins, have been how is it correlated to the severity of the disease? linked to this disease in humans (Human Gene Mutation In the present study, we addressed these questions by Database at http://www.hgmd.cf.ac.uk/ac/index.php). To measuring the relative abundance of mutated and wild-type date, approximately 30% of all genotyped cases were found MYH7-mRNA (RefSeq accession NM_000257) as well as to be associated with missense mutations in the b-myosin of the encoded protein for several different mutations in M. heavy chain (b-MHC) gene (MYH7) with chromosomal soleus and cardiac muscle biopsies of FHC patients with localization 14q12 [34]. Notably, the human b-MHC iso- different disease severity. Wild-type and mutated MYH7- form (UniProt ID P12883), besides being the principal mRNAs are co-expressed in the same cells/muscle fibers ventricular myosin isoform, is also expressed in the slow and therefore are subjected to identical conditions. Thus, skeletal muscle fibers, e.g., of musculus soleus [35]. variations due to confounding factors such as environ- Several mutations in the b-MHC are associated with early mental influences and drugs, of hormones, or differences in onset and high incidence of sudden cardiac death, while tissue sampling or experimental procedures could be min- others have a less severe disease expression and outcome imized. For all five MYH7 missense mutations studied, we [3]. This is usually explained by the type and location of the found a deviation from the usually expected equimolar mutations within the molecule and their different effects on ratio of wild-type versus mutated b-MHC. The deviation structure and function of the encoded protein [32]. Fur- was very similar at the protein- and mRNA level and was thermore, even among affected members of the same family, identical in myocardial tissue and M. soleus. Most inter- variability in the clinical manifestations of FHC has been estingly, the unequal abundance appears to be directly observed, which points to additional risk factors [23]. related to the particular missense mutation, because it is A further mechanism for different clinical prognosis of found to be essentially the same in all carriers of a given FHC-related mutations, however, could be the relative level mutation, including relatives of different generations and of mutated versus wild-type protein in patients with dif- unrelated individuals. Our results suggest that unequal ferent mutations or even in patients with the same mutation. allelic expression of b-MHC contributes to the complex Nearly all FHC patients are heterozygous for the respective phenotype of FHC. mutation, and both mutated and wild-type proteins are assumed to be co-dominantly expressed from the corre- sponding alleles. Equal proportions of the allelic messages Materials and methods of the MYH7 gene and thus of the encoded protein are assumed to be present in every muscle cell. Yet, a higher or Patients and muscle biopsies lower expression of the two allelic transcripts and proteins resulting in a deviation from an expected 50-to-50 ratio, The present study was performed on muscle biopsies from known as allelic imbalance, has been shown previously for individuals previously characterized clinically as FHC 123 Basic Res Cardiol (2011) 106:1041–1055 1043 patients and genetically as carriers of point mutations in the RNA isolation, synthesis of sscDNA and PCR b-MHC head domain. All patients were heterozygous for the mutations they carried. In Table 1, clinical details For mutations I736T, R719W and V606M, total RNA was available to us and the age of all patients at the time of isolated from approximately 3 mg pieces of frozen muscle biopsy are given. using Trizol (GIBCO, Karlsruhe, Germany). Isolated RNA For all patients,
Recommended publications
  • Genetic Mutations and Mechanisms in Dilated Cardiomyopathy
    Genetic mutations and mechanisms in dilated cardiomyopathy Elizabeth M. McNally, … , Jessica R. Golbus, Megan J. Puckelwartz J Clin Invest. 2013;123(1):19-26. https://doi.org/10.1172/JCI62862. Review Series Genetic mutations account for a significant percentage of cardiomyopathies, which are a leading cause of congestive heart failure. In hypertrophic cardiomyopathy (HCM), cardiac output is limited by the thickened myocardium through impaired filling and outflow. Mutations in the genes encoding the thick filament components myosin heavy chain and myosin binding protein C (MYH7 and MYBPC3) together explain 75% of inherited HCMs, leading to the observation that HCM is a disease of the sarcomere. Many mutations are “private” or rare variants, often unique to families. In contrast, dilated cardiomyopathy (DCM) is far more genetically heterogeneous, with mutations in genes encoding cytoskeletal, nucleoskeletal, mitochondrial, and calcium-handling proteins. DCM is characterized by enlarged ventricular dimensions and impaired systolic and diastolic function. Private mutations account for most DCMs, with few hotspots or recurring mutations. More than 50 single genes are linked to inherited DCM, including many genes that also link to HCM. Relatively few clinical clues guide the diagnosis of inherited DCM, but emerging evidence supports the use of genetic testing to identify those patients at risk for faster disease progression, congestive heart failure, and arrhythmia. Find the latest version: https://jci.me/62862/pdf Review series Genetic mutations and mechanisms in dilated cardiomyopathy Elizabeth M. McNally, Jessica R. Golbus, and Megan J. Puckelwartz Department of Human Genetics, University of Chicago, Chicago, Illinois, USA. Genetic mutations account for a significant percentage of cardiomyopathies, which are a leading cause of conges- tive heart failure.
    [Show full text]
  • Genome Editing for the Understanding and Treatment of Inherited Cardiomyopathies
    International Journal of Molecular Sciences Review Genome Editing for the Understanding and Treatment of Inherited Cardiomyopathies 1, 1, 1,2, Quynh Nguyen y , Kenji Rowel Q. Lim y and Toshifumi Yokota * 1 Department of Medical Genetics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G2H7, Canada; [email protected] (Q.N.); [email protected] (K.R.Q.L.) 2 The Friends of Garrett Cumming Research & Muscular Dystrophy Canada, HM Toupin Neurological Science Research Chair, Edmonton, AB T6G2H7, Canada * Correspondence: [email protected]; Tel.: +1-780-492-1102 These authors contributed equally to the work. y Received: 28 December 2019; Accepted: 19 January 2020; Published: 22 January 2020 Abstract: Cardiomyopathies are diseases of heart muscle, a significant percentage of which are genetic in origin. Cardiomyopathies can be classified as dilated, hypertrophic, restrictive, arrhythmogenic right ventricular or left ventricular non-compaction, although mixed morphologies are possible. A subset of neuromuscular disorders, notably Duchenne and Becker muscular dystrophies, are also characterized by cardiomyopathy aside from skeletal myopathy. The global burden of cardiomyopathies is certainly high, necessitating further research and novel therapies. Genome editing tools, which include zinc finger nucleases (ZFNs), transcription activator-like effector nucleases (TALENs) and clustered regularly interspaced short palindromic repeats (CRISPR) systems have emerged as increasingly important technologies in studying
    [Show full text]
  • Hypertrophic Cardiomyopathy (HCM)
    case example: Hypertrophic Cardiomyopathy (HCM) who is the patient? • 24 year-old male with no cardiac symptoms; assessed due to family history • Normal ECG (no left ventricular hypertrophy or conduction disease), cardiac echocardiogram, cardiac MRI • No prior cardiovascular genetic testing what is the SCA 60 family history? • Family history of sudden cardiac arrest d.60 (SCA) and hypertrophic obstructive cardiomyopathy N • Father died at age 45 from SCA: HCM found on requested autopsy report No other SCA 45 reported d.45 • Paternal grandfather died at age 60 SCA HCM dx autopsy from SCA • No prior cardiovascular genetic testing - + done on family members MYH7 variant - 24 MYH7 variant + what happened with genetic testing? • Cardiologist ordered HCMFirst panel (MYH7 and MYBPC3 genes) with reflex option on patient (clinical rationale below): - Up to 50% of HCM due to a mutation in one of the HCMFirst genes, which represent ~80% of known genetic causes of HCM - Tiered approach: HCMFirst panel reflexes to larger HCMNext panel, only if needed • Positive finding: MYH7 variant, likely pathogenic: p.G584S • This alteration is reported in multiple patients with HCM.1,2,3 MYH7 mutations account for ~40% of HCM and 5-8% of dilated cardiomyopathy (DCM). MYH7 mutations can also cause left ventricular non-compaction (LVNC) and skeletal myopathies, with/ without cardiac involvement.4,5 how did genetic testing help the patient and family? • Confirmed patient to be at risk for HCM and sudden cardiac arrest, despite negative clinical presentation • Tiered
    [Show full text]
  • Cardiogenetics Testing Reference Guide December 2018
    Cardiogenetics Testing reference guide December 2018 Why Choose Ambry More than 1 in 200 people have an inherited cardiovascular condition. Ambry’s mission is to provide the most advanced genetic testing information available to help you identity those at-risk and determine the best treatment options. If we know a patient has a disease-causing genetic change, not only does it mean better disease management, it also indicates that we can test others in the family and provide them with potentially life-saving information. Diseases and Testing Options cardiomyopathies arrhythmias Hypertrophic Cardiomyopathy (HCMNext) Catecholaminergic Polymorphic Ventricular Dilated Cardiomyopathy (DCMNext) Tachycardia (CPVTNext) Arrhythmogenic Right Ventricular Long QT Syndrome, Short QT Syndrome, Cardiomyopathy (ARVCNext) Brugada Syndrome (LongQTNext, RhythmNext) Cardiomyopathies (CMNext, CardioNext) Arrhythmias (RhythmNext, CardioNext) other cardio conditions Transthyretin Amyloidosis (TTR) familial hypercholesterolemia Noonan Syndrome (NoonanNext) and lipid disorders Hereditary Hemorrhagic Telangiectasia Familial Hypercholesterolemia (FHNext) (HHTNext) Sitosterolemia (Sitosterolemia Panel) Comprehensive Lipid Menu thoracic aortic aneurysms (CustomNext-Cardio) and dissections Familial Chylomicronemia Syndrome (FCSNext) Thoracic Aneurysms and Dissections, aortopathies (TAADNext) Marfan Syndrome (TAADNext) Ehlers-Danlos Syndrome (TAADNext) Targeted Panels Gene Comparison ALL PANELS HAVE A TURNAROUND TIME OF 2-3 WEEKS arrhythmias CPVTNext CPVTNext CASQ2,
    [Show full text]
  • Microrna Regulatory Pathways in the Control of the Actin–Myosin Cytoskeleton
    cells Review MicroRNA Regulatory Pathways in the Control of the Actin–Myosin Cytoskeleton , , Karen Uray * y , Evelin Major and Beata Lontay * y Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; [email protected] * Correspondence: [email protected] (K.U.); [email protected] (B.L.); Tel.: +36-52-412345 (K.U. & B.L.) The authors contributed equally to the manuscript. y Received: 11 June 2020; Accepted: 7 July 2020; Published: 9 July 2020 Abstract: MicroRNAs (miRNAs) are key modulators of post-transcriptional gene regulation in a plethora of processes, including actin–myosin cytoskeleton dynamics. Recent evidence points to the widespread effects of miRNAs on actin–myosin cytoskeleton dynamics, either directly on the expression of actin and myosin genes or indirectly on the diverse signaling cascades modulating cytoskeletal arrangement. Furthermore, studies from various human models indicate that miRNAs contribute to the development of various human disorders. The potentially huge impact of miRNA-based mechanisms on cytoskeletal elements is just starting to be recognized. In this review, we summarize recent knowledge about the importance of microRNA modulation of the actin–myosin cytoskeleton affecting physiological processes, including cardiovascular function, hematopoiesis, podocyte physiology, and osteogenesis. Keywords: miRNA; actin; myosin; actin–myosin complex; Rho kinase; cancer; smooth muscle; hematopoiesis; stress fiber; gene expression; cardiovascular system; striated muscle; muscle cell differentiation; therapy 1. Introduction Actin–myosin interactions are the primary source of force generation in mammalian cells. Actin forms a cytoskeletal network and the myosin motor proteins pull actin filaments to produce contractile force. All eukaryotic cells contain an actin–myosin network inferring contractile properties to these cells.
    [Show full text]
  • Sarcomeres Regulate Murine Cardiomyocyte Maturation Through MRTF-SRF Signaling
    Sarcomeres regulate murine cardiomyocyte maturation through MRTF-SRF signaling Yuxuan Guoa,1,2,3, Yangpo Caoa,1, Blake D. Jardina,1, Isha Sethia,b, Qing Maa, Behzad Moghadaszadehc, Emily C. Troianoc, Neil Mazumdara, Michael A. Trembleya, Eric M. Smalld, Guo-Cheng Yuanb, Alan H. Beggsc, and William T. Pua,e,2 aDepartment of Cardiology, Boston Children’s Hospital, Boston, MA 02115; bDepartment of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA 02215; cDivision of Genetics and Genomics, The Manton Center for Orphan Disease Research, Boston Children’s Hospital and Harvard Medical School, Boston, MA 02115; dAab Cardiovascular Research Institute, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642; and eHarvard Stem Cell Institute, Harvard University, Cambridge, MA 02138 Edited by Janet Rossant, The Gairdner Foundation, Toronto, ON, Canada, and approved November 24, 2020 (received for review May 6, 2020) The paucity of knowledge about cardiomyocyte maturation is a Mechanisms that orchestrate ultrastructural and transcrip- major bottleneck in cardiac regenerative medicine. In develop- tional changes in cardiomyocyte maturation are beginning to ment, cardiomyocyte maturation is characterized by orchestrated emerge. Serum response factor (SRF) is a transcription factor that structural, transcriptional, and functional specializations that occur is essential for cardiomyocyte maturation (3). SRF directly acti- mainly at the perinatal stage. Sarcomeres are the key cytoskeletal vates key genes regulating sarcomere assembly, electrophysiology, structures that regulate the ultrastructural maturation of other and mitochondrial metabolism. This transcriptional regulation organelles, but whether sarcomeres modulate the signal trans- subsequently drives the proper morphogenesis of mature ultra- duction pathways that are essential for cardiomyocyte maturation structural features of myofibrils, T-tubules, and mitochondria.
    [Show full text]
  • Illuminating the Divergent Role of Filamin C Mutations in Human Cardiomyopathy
    Journal of Clinical Medicine Review Cardiac Filaminopathies: Illuminating the Divergent Role of Filamin C Mutations in Human Cardiomyopathy Matthias Eden 1,2 and Norbert Frey 1,2,* 1 Department of Internal Medicine III, University of Heidelberg, 69120 Heidelberg, Germany; [email protected] 2 German Centre for Cardiovascular Research, Partner Site Heidelberg, 69120 Heidelberg, Germany * Correspondence: [email protected] Abstract: Over the past decades, there has been tremendous progress in understanding genetic alterations that can result in different phenotypes of human cardiomyopathies. More than a thousand mutations in various genes have been identified, indicating that distinct genetic alterations, or combi- nations of genetic alterations, can cause either hypertrophic (HCM), dilated (DCM), restrictive (RCM), or arrhythmogenic cardiomyopathies (ARVC). Translation of these results from “bench to bedside” can potentially group affected patients according to their molecular etiology and identify subclinical individuals at high risk for developing cardiomyopathy or patients with overt phenotypes at high risk for cardiac deterioration or sudden cardiac death. These advances provide not only mechanistic insights into the earliest manifestations of cardiomyopathy, but such efforts also hold the promise that mutation-specific pathophysiology might result in novel “personalized” therapeutic possibilities. Recently, the FLNC gene encoding the sarcomeric protein filamin C has gained special interest since FLNC mutations were found in several distinct and possibly overlapping cardiomyopathy phenotypes. Specifically, mutations in FLNC were initially only linked to myofibrillar myopathy (MFM), but are now increasingly found in various forms of human cardiomyopathy. FLNC thereby Citation: Eden, M.; Frey, N. Cardiac represents another example for the complex genetic and phenotypic continuum of these diseases.
    [Show full text]
  • Genetic Cardiomyopathies: the Lesson Learned from Hipscs
    Journal of Clinical Medicine Review Genetic Cardiomyopathies: The Lesson Learned from hiPSCs Ilaria My 1,2 and Elisa Di Pasquale 2,3,* 1 Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy; [email protected] 2 Humanitas Clinical and Research Center—IRCCS, Rozzano, 20089 Milan, Italy 3 Institute of Genetic and Biomedical Research (IRGB)—UOS of Milan, National Research Council (CNR), 20138 Milan, Italy * Correspondence: [email protected] Abstract: Genetic cardiomyopathies represent a wide spectrum of inherited diseases and constitute an important cause of morbidity and mortality among young people, which can manifest with heart failure, arrhythmias, and/or sudden cardiac death. Multiple underlying genetic variants and molecular pathways have been discovered in recent years; however, assessing the pathogenicity of new variants often needs in-depth characterization in order to ascertain a causal role in the disease. The application of human induced pluripotent stem cells has greatly helped to advance our knowledge in this field and enabled to obtain numerous in vitro patient-specific cellular models useful to study the underlying molecular mechanisms and test new therapeutic strategies. A milestone in the research of genetically determined heart disease was the introduction of genomic technologies that provided unparalleled opportunities to explore the genetic architecture of cardiomyopathies, thanks to the generation of isogenic pairs. The aim of this review is to provide an overview of the main research that helped elucidate the pathophysiology of the most common genetic cardiomyopathies: hypertrophic, dilated, arrhythmogenic, and left ventricular noncompaction cardiomyopathies. A special focus is provided on the application of gene-editing techniques in understanding key disease characteristics and on the therapeutic approaches that have been tested.
    [Show full text]
  • A Novel Pathogenicity and Phenotype Predictor for Functional Evaluation Of
    A novel pathogenicity and phenotype predictor for functional evaluation of beta-myosin heavy chain missense variants and distinguishing between HCM and DCM associated mutations Nouf S. Al-Numair1, Luis Lopes2, Petros Syrris2, Lorenzo Monserrat3, Perry Elliott2 and Andrew C.R. Martin1,∗ 1Institute of Structural and Molecular Biology, Division of Biosciences, University College London, Darwin Building, Gower Street, London WC1E 6BT 2Institute of Cardiovascular Science, UCL, London. 3Complejo Hospitalario Universitario de A Coruna,˜ Insituto de Investigacion´ Biomedica´ ∗Corresponding author Abstract High-throughput sequencing platforms are increasingly used to screen pa- tients with genetic disease for pathogenic mutations, but prediction of the effects of mutations on protein structure and phenotype remains challenging. Previ- ously we developed SAAPdap (Single Amino Acid Polymorphism Data Analysis Pipeline) and SAAPpred (Single Amino Acid Polymorphism Predictor) that use a combination of rule-based structural measures to predict the effect of missense generic variants on protein function. Here we determine the ability of SAAPpred to predict the pathogenicity of single missense mutations in the beta-myosin heavy chain (MYH7) gene product (Myosin-7) and extend the system to predict the major associated clinical phenotypes. Final prediction results had an accu- racy of 92.7% for all MYH7 mutations considered together, 99.1% for dilated cardiomyopathy (DCM) mutations and 91.4% for hypertrophic cardiomyopathy (HCM) mutations. The novel predictor using multiple random forest models to distinguish between HCM and DCM mutations using SAAPdap analysis had a best performance accuracy of 75% and a post hoc removal of models that per- formed particularly badly, raised the accuracy of 79%. These results suggest that SAAPdap analysis improves on existing tools used to predict pathogenicity of MYH7 mutations in clinical practice.
    [Show full text]
  • MYH7 Gene-Related Mutation P.V878L Identified in a Chinese Family with Hypertrophic Cardiomyopathy
    EXPERIMENTAL STUDY MYH7 Gene-Related Mutation p.V878L Identified in a Chinese Family with Hypertrophic Cardiomyopathy Yuan Du, 1 MD, Ya Wang,1 MD, Xiu Han,1 MD, Zhanbin Feng,2 MD and Aiqun Ma,1,3,4 MD Summary Hypertrophic cardiomyopathy (HCM) is one of the most common inherited cardiovascular diseases and possesses a high risk for sudden cardiac death. Although mutations in more than 20 genes have been reported to be associated with HCM thus far, the genetic backgrounds of most HCM patients are not fully understood. We performed a genetic analysis in a Chinese family that presented with HCM using next-generation sequenc- ing (NGS). Clinical data, family histories, and blood samples were collected from the proband and family mem- bers. Five patients showed typical clinical symptoms of HCM. One subject was the victim of sudden cardiac death. By NGS, we determined that these subjects with HCM symptoms carried a missense heterozygous ge- netic mutation c.2632C>A (p.V878L) in the myosin heavy chain 7 (MYH7) gene with an autosomal dominant pattern of inheritance. Individuals without this mutation showed no symptoms or cardiac structural abnormali- ties related to HCM. Bioinformatics evaluation predicted this mutant as “damaging” and “disease causing”. Ad- ditionally, sequence alignment showed that this mutant is located in an evolutionarily conserved region of MYH 7 in multiple species. Our results describe a potentially pathogenic mutation associated with HCM, which may extend the spectrum of HCM phenotypes related to MYH7 gene mutations. (Int
    [Show full text]
  • MYH7 - Hypertrophic Cardiomyopathy Testing
    MYH7 - Hypertrophic Cardiomyopathy Testing Hypertrophic Cardiomyopathy (HCM) is relatively common, with a prevalence of 1 in 500 adults (1). HCM is a primary disorder of heart muscle characterized by left ventricular hypertrophy. The most classic finding in HCM is asymmetric septal hypertrophy, with or without left ventricular outflow tract obstruction. The disease demonstrates extensive clinical variability with regard to age of onset, severity and progression of disease. HCM can affect infants and children although it is more typically identified in adolescence or adulthood (1,2). The MYH7 gene contains 38 exons and is located at chromosome 14q12. Up to 30% of individuals with a clinical diagnosis of HCM have MYH7 mutations (1-3). MYH7 mutations are inherited in an autosomal dominant manner. The majority of individuals inherit the MYH7 from a parent, although, de novo mutations do occur. Approximately 50-65% of individuals with a known or suspected diagnosis of familial HCM have a mutation in one of a number of genes encoding components of the sarcomere and cytoskeleton (1). Compound heterozygous mutations have been reported in MYH7 and other genes associated with HCM (1,2). Mutations in the MYH7 gene have been primarily associated with HCM, but can also be associated with other types of heart muscle disease including dilated cardiomyopathy, restrictive cardiomyopathy and left-ventricular non- compaction (1). Indication MYH7 testing is utilized to confirm a diagnosis of HCM in patients with clinically evident disease. Genetic testing also allows for early identification and diagnosis of individuals at greatest risk prior to the expression of typical clinical manifestations. If a mutation is identified in an asymptomatic individual, regular and routine outpatient follow up is indicated.
    [Show full text]
  • MYH7 Gene Myosin Heavy Chain 7
    MYH7 gene myosin heavy chain 7 Normal Function The MYH7 gene provides instructions for making a protein known as the beta (b )- myosin heavy chain. This protein is found in heart (cardiac) muscle and in type I skeletal muscle fibers. (Skeletal muscle are the muscles used for movement.) Type I fibers, which are also known as slow-twitch fibers, are one of two types of fibers that make up skeletal muscles. Type I fibers are the primary component of skeletal muscles that are resistant to fatigue. For example, muscles involved in posture, such as the neck muscles that hold the head steady, are made predominantly of type I fibers. In cardiac and skeletal muscle cells, the b -myosin heavy chain forms part of a larger protein called type II myosin. Each type II myosin protein consists of two heavy chains ( produced from the MYH7 gene) and two pairs of regulatory light chains (produced from several other genes). The heavy chains each have two parts: a head region and a tail region. The head region, called the motor domain, interacts with a protein called actin, which is important for cell movement and shape. The long tail region interacts with other proteins, including the tail regions of other myosin proteins. Type II myosin generates the mechanical force that is needed for muscles to contract. It is integral to muscle cell structures called sarcomeres, which are the basic units of muscle contraction. Sarcomeres are composed of thick filaments made up of type II myosin and thin filaments made up of actin. The overlapping thick and thin filaments attach to each other and release, which allows the filaments to move relative to one another so that muscles can contract.
    [Show full text]