Wolff-Parkinson-White syndrome: De novo variants and evidence for mutational burden in genes associated with atrial fibrillation.

TitleWolff-Parkinson-White syndrome: De novo variants and evidence for mutational burden in genes associated with atrial fibrillation.
Publication TypeJournal Article
Year of Publication2020
AuthorsCoban-Akdemir, ZH, Charng, W-L, Azamian, M, Paine, IS, Punetha, J, Grochowski, CM, Gambin, T, Valdes, SO, Cannon, B, Zapata, G, Hernandez, PP, Jhangiani, S, Doddapaneni, H, Hu, J, Boricha, F, Muzny, DM, Boerwinkle, E, Yang, Y, Gibbs, RA, Posey, JE, Wehrens, XHT, Belmont, JW, Kim, JJ, Miyake, CY, Lupski, JR, Lalani, SR
JournalAm J Med Genet A
Volume182
Issue6
Pagination1387-1399
Date Published2020 06
ISSN1552-4833
Abstract

BACKGROUND: Wolff-Parkinson-White (WPW) syndrome is a relatively common arrhythmia affecting ~1-3/1,000 individuals. Mutations in PRKAG2 have been described in rare patients in association with cardiomyopathy. However, the genetic basis of WPW in individuals with a structurally normal heart remains poorly understood. Sudden death due to atrial fibrillation (AF) can also occur in these individuals. Several studies have indicated that despite ablation of an accessory pathway, the risk of AF remains high in patients compared to general population.

METHODS: We applied exome sequencing in 305 subjects, including 65 trios, 80 singletons, and 6 multiple affected families. We used de novo analysis, candidate gene approach, and burden testing to explore the genetic contributions to WPW.

RESULTS: A heterozygous deleterious variant in PRKAG2 was identified in one subject, accounting for 0.6% (1/151) of the genetic basis of WPW in this study. Another individual with WPW and left ventricular hypertrophy carried a known pathogenic variant in MYH7. We found rare de novo variants in genes associated with arrhythmia and cardiomyopathy (ANK2, NEBL, PITX2, and PRDM16) in this cohort. There was an increased burden of rare deleterious variants (MAF ≤ 0.005) with CADD score ≥ 25 in genes linked to AF in cases compared to controls (P = .0023).

CONCLUSIONS: Our findings show an increased burden of rare deleterious variants in genes linked to AF in WPW syndrome, suggesting that genetic factors that determine the development of accessory pathways may be linked to an increased susceptibility of atrial muscle to AF in a subset of patients.

DOI10.1002/ajmg.a.61571
Alternate JournalAm. J. Med. Genet. A
PubMed ID32233023
PubMed Central IDPMC7275694
Grant ListR35 NS105078 / NS / NINDS NIH HHS / United States
K08 HG008986 / HG / NHGRI NIH HHS / United States
R01 NS058529 / NS / NINDS NIH HHS / United States
K23 HL136932 / HL / NHLBI NIH HHS / United States
UM1 HG006542 / HG / NHGRI NIH HHS / United States