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Results of clinical genetic testing of 2,912 probands with hypertrophic cardiomyopathy: expanded panels offer limited additional sensitivity
Hypertrophic cardiomyopathy (HCM) is caused primarily by pathogenic variants in genes encoding sarcomere proteins. We report genetic testing results for HCM in 2,912 unrelated individuals with nonsyndromic presentations from a broad referral population over 10 years. Genetic testing was performed by...
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| Published in: | Genetics in medicine 2015-11, Vol.17 (11), p.880-888 |
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| container_title | Genetics in medicine |
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| creator | Alfares, Ahmed A Kelly, Melissa A McDermott, Gregory Funke, Birgit H Lebo, Matthew S Baxter, Samantha B Shen, Jun McLaughlin, Heather M Clark, Eugene H Babb, Larry J Cox, Stephanie W DePalma, Steven R Ho, Carolyn Y Seidman, J G Seidman, Christine E Rehm, Heidi L |
| description | Hypertrophic cardiomyopathy (HCM) is caused primarily by pathogenic variants in genes encoding sarcomere proteins. We report genetic testing results for HCM in 2,912 unrelated individuals with nonsyndromic presentations from a broad referral population over 10 years.
Genetic testing was performed by Sanger sequencing for 10 genes from 2004 to 2007, by HCM CardioChip for 11 genes from 2007 to 2011 and by next-generation sequencing for 18, 46, or 51 genes from 2011 onward.
The detection rate is ~32% among unselected probands, with inconclusive results in an additional 15%. Detection rates were not significantly different between adult and pediatric probands but were higher in females compared with males. An expanded gene panel encompassing more than 50 genes identified only a very small number of additional pathogenic variants beyond those identifiable in our original panels, which examined 11 genes. Familial genetic testing in at-risk family members eliminated the need for longitudinal cardiac evaluations in 691 individuals. Based on the projected costs derived from Medicare fee schedules for the recommended clinical evaluations of HCM family members by the American College of Cardiology Foundation/American Heart Association, our data indicate that genetic testing resulted in a minimum cost savings of about $0.7 million.
Clinical HCM genetic testing provides a definitive molecular diagnosis for many patients and provides cost savings to families. Expanded gene panels have not substantively increased the clinical sensitivity of HCM testing, suggesting major additional causes of HCM still remain to be identified. |
| doi_str_mv | 10.1038/gim.2014.205 |
| format | article |
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Genetic testing was performed by Sanger sequencing for 10 genes from 2004 to 2007, by HCM CardioChip for 11 genes from 2007 to 2011 and by next-generation sequencing for 18, 46, or 51 genes from 2011 onward.
The detection rate is ~32% among unselected probands, with inconclusive results in an additional 15%. Detection rates were not significantly different between adult and pediatric probands but were higher in females compared with males. An expanded gene panel encompassing more than 50 genes identified only a very small number of additional pathogenic variants beyond those identifiable in our original panels, which examined 11 genes. Familial genetic testing in at-risk family members eliminated the need for longitudinal cardiac evaluations in 691 individuals. Based on the projected costs derived from Medicare fee schedules for the recommended clinical evaluations of HCM family members by the American College of Cardiology Foundation/American Heart Association, our data indicate that genetic testing resulted in a minimum cost savings of about $0.7 million.
Clinical HCM genetic testing provides a definitive molecular diagnosis for many patients and provides cost savings to families. Expanded gene panels have not substantively increased the clinical sensitivity of HCM testing, suggesting major additional causes of HCM still remain to be identified.</description><identifier>ISSN: 1098-3600</identifier><identifier>EISSN: 1530-0366</identifier><identifier>DOI: 10.1038/gim.2014.205</identifier><identifier>PMID: 25611685</identifier><language>eng</language><publisher>United States: Elsevier Limited</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cardiomyopathy, Hypertrophic - diagnosis ; Cardiomyopathy, Hypertrophic - epidemiology ; Cardiomyopathy, Hypertrophic - genetics ; Child ; Child, Preschool ; Costs and Cost Analysis ; Female ; Genetic Predisposition to Disease ; Genetic Testing - economics ; Genetic Testing - methods ; Genetic Testing - standards ; Genetic Variation ; High-Throughput Nucleotide Sequencing ; Humans ; Male ; Middle Aged ; Oligonucleotide Array Sequence Analysis - economics ; Oligonucleotide Array Sequence Analysis - methods ; Oligonucleotide Array Sequence Analysis - standards ; Sensitivity and Specificity ; Young Adult</subject><ispartof>Genetics in medicine, 2015-11, Vol.17 (11), p.880-888</ispartof><rights>Copyright Nature Publishing Group Nov 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2725-1ab2c18d262504a54b0b3272ce73cb8da8339719b051d88102b17feacdd2e3a63</citedby><orcidid>0000-0002-9733-5207 ; 0000-0002-7334-7924 ; 0000-0002-6025-0015 ; 0000-0003-4708-2261 ; 0000-0001-8362-7535</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25611685$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alfares, Ahmed A</creatorcontrib><creatorcontrib>Kelly, Melissa A</creatorcontrib><creatorcontrib>McDermott, Gregory</creatorcontrib><creatorcontrib>Funke, Birgit H</creatorcontrib><creatorcontrib>Lebo, Matthew S</creatorcontrib><creatorcontrib>Baxter, Samantha B</creatorcontrib><creatorcontrib>Shen, Jun</creatorcontrib><creatorcontrib>McLaughlin, Heather M</creatorcontrib><creatorcontrib>Clark, Eugene H</creatorcontrib><creatorcontrib>Babb, Larry J</creatorcontrib><creatorcontrib>Cox, Stephanie W</creatorcontrib><creatorcontrib>DePalma, Steven R</creatorcontrib><creatorcontrib>Ho, Carolyn Y</creatorcontrib><creatorcontrib>Seidman, J G</creatorcontrib><creatorcontrib>Seidman, Christine E</creatorcontrib><creatorcontrib>Rehm, Heidi L</creatorcontrib><title>Results of clinical genetic testing of 2,912 probands with hypertrophic cardiomyopathy: expanded panels offer limited additional sensitivity</title><title>Genetics in medicine</title><addtitle>Genet Med</addtitle><description>Hypertrophic cardiomyopathy (HCM) is caused primarily by pathogenic variants in genes encoding sarcomere proteins. We report genetic testing results for HCM in 2,912 unrelated individuals with nonsyndromic presentations from a broad referral population over 10 years.
Genetic testing was performed by Sanger sequencing for 10 genes from 2004 to 2007, by HCM CardioChip for 11 genes from 2007 to 2011 and by next-generation sequencing for 18, 46, or 51 genes from 2011 onward.
The detection rate is ~32% among unselected probands, with inconclusive results in an additional 15%. Detection rates were not significantly different between adult and pediatric probands but were higher in females compared with males. An expanded gene panel encompassing more than 50 genes identified only a very small number of additional pathogenic variants beyond those identifiable in our original panels, which examined 11 genes. Familial genetic testing in at-risk family members eliminated the need for longitudinal cardiac evaluations in 691 individuals. Based on the projected costs derived from Medicare fee schedules for the recommended clinical evaluations of HCM family members by the American College of Cardiology Foundation/American Heart Association, our data indicate that genetic testing resulted in a minimum cost savings of about $0.7 million.
Clinical HCM genetic testing provides a definitive molecular diagnosis for many patients and provides cost savings to families. Expanded gene panels have not substantively increased the clinical sensitivity of HCM testing, suggesting major additional causes of HCM still remain to be identified.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cardiomyopathy, Hypertrophic - diagnosis</subject><subject>Cardiomyopathy, Hypertrophic - epidemiology</subject><subject>Cardiomyopathy, Hypertrophic - genetics</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Costs and Cost Analysis</subject><subject>Female</subject><subject>Genetic Predisposition to Disease</subject><subject>Genetic Testing - economics</subject><subject>Genetic Testing - methods</subject><subject>Genetic Testing - standards</subject><subject>Genetic Variation</subject><subject>High-Throughput Nucleotide Sequencing</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Oligonucleotide Array Sequence Analysis - 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Academic</collection><jtitle>Genetics in medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alfares, Ahmed A</au><au>Kelly, Melissa A</au><au>McDermott, Gregory</au><au>Funke, Birgit H</au><au>Lebo, Matthew S</au><au>Baxter, Samantha B</au><au>Shen, Jun</au><au>McLaughlin, Heather M</au><au>Clark, Eugene H</au><au>Babb, Larry J</au><au>Cox, Stephanie W</au><au>DePalma, Steven R</au><au>Ho, Carolyn Y</au><au>Seidman, J G</au><au>Seidman, Christine E</au><au>Rehm, Heidi L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Results of clinical genetic testing of 2,912 probands with hypertrophic cardiomyopathy: expanded panels offer limited additional sensitivity</atitle><jtitle>Genetics in medicine</jtitle><addtitle>Genet Med</addtitle><date>2015-11</date><risdate>2015</risdate><volume>17</volume><issue>11</issue><spage>880</spage><epage>888</epage><pages>880-888</pages><issn>1098-3600</issn><eissn>1530-0366</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Hypertrophic cardiomyopathy (HCM) is caused primarily by pathogenic variants in genes encoding sarcomere proteins. We report genetic testing results for HCM in 2,912 unrelated individuals with nonsyndromic presentations from a broad referral population over 10 years.
Genetic testing was performed by Sanger sequencing for 10 genes from 2004 to 2007, by HCM CardioChip for 11 genes from 2007 to 2011 and by next-generation sequencing for 18, 46, or 51 genes from 2011 onward.
The detection rate is ~32% among unselected probands, with inconclusive results in an additional 15%. Detection rates were not significantly different between adult and pediatric probands but were higher in females compared with males. An expanded gene panel encompassing more than 50 genes identified only a very small number of additional pathogenic variants beyond those identifiable in our original panels, which examined 11 genes. Familial genetic testing in at-risk family members eliminated the need for longitudinal cardiac evaluations in 691 individuals. Based on the projected costs derived from Medicare fee schedules for the recommended clinical evaluations of HCM family members by the American College of Cardiology Foundation/American Heart Association, our data indicate that genetic testing resulted in a minimum cost savings of about $0.7 million.
Clinical HCM genetic testing provides a definitive molecular diagnosis for many patients and provides cost savings to families. Expanded gene panels have not substantively increased the clinical sensitivity of HCM testing, suggesting major additional causes of HCM still remain to be identified.</abstract><cop>United States</cop><pub>Elsevier Limited</pub><pmid>25611685</pmid><doi>10.1038/gim.2014.205</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-9733-5207</orcidid><orcidid>https://orcid.org/0000-0002-7334-7924</orcidid><orcidid>https://orcid.org/0000-0002-6025-0015</orcidid><orcidid>https://orcid.org/0000-0003-4708-2261</orcidid><orcidid>https://orcid.org/0000-0001-8362-7535</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Cardiomyopathy, Hypertrophic - diagnosis Cardiomyopathy, Hypertrophic - epidemiology Cardiomyopathy, Hypertrophic - genetics Child Child, Preschool Costs and Cost Analysis Female Genetic Predisposition to Disease Genetic Testing - economics Genetic Testing - methods Genetic Testing - standards Genetic Variation High-Throughput Nucleotide Sequencing Humans Male Middle Aged Oligonucleotide Array Sequence Analysis - economics Oligonucleotide Array Sequence Analysis - methods Oligonucleotide Array Sequence Analysis - standards Sensitivity and Specificity Young Adult |
| title | Results of clinical genetic testing of 2,912 probands with hypertrophic cardiomyopathy: expanded panels offer limited additional sensitivity |
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