Actionable variants of unknown significance in inherited arrhythmogenic syndromes: a further step forward in genetic diagnosis

Background/Objectives: Inherited arrhythmogenic syndromes comprise a heterogenic group of genetic entities that lead to malignant arrhythmias and sudden cardiac death. Genetic testing has become crucial to understand the disease etiology and allow for the early identification of relatives at risk; h...

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Detalhes bibliográficos
Autores: Martínez-Barrios, Estefanía, Greco, Andrea, Cruzalegui, José, Cesar, Sergi, Díez-Escuté, Nuria, Cerralbo, Patricia, Chipa, Freddy, Zschaeck, Irene, Fogaça da Mata, Miguel, Diez, Carles, Arbelo, Elena, Grassi, Simone, Oliva, Antonio, Toro, Rocío, Sarquella Brugada, Geòrgia, Campuzano Larrea, Oscar
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Recursos:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10256/28401
Acesso em linha:http://hdl.handle.net/10256/28401
https://hdl.handle.net/10256/28401
Access Level:acceso abierto
Palavra-chave:Genètica
Genetics
Arrítmia -- Aspectes genètics
Arrhythmia -- Genetic aspects
Diagnòstic
Diagnosis
Mort sobtada
Sudden death
Variació (Biologia)
Variation (Biology)
Descrição
Resumo:Background/Objectives: Inherited arrhythmogenic syndromes comprise a heterogenic group of genetic entities that lead to malignant arrhythmias and sudden cardiac death. Genetic testing has become crucial to understand the disease etiology and allow for the early identification of relatives at risk; however, it requires an accurate interpretation of the data to achieve a clinically actionable outcome. This is particularly challenging for the large number of rare variants obtained by current high-throughput techniques, which are mostly classified as of unknown significance. Methods: In this work, we present a new algorithm for the genetic interpretation of the remaining rare variants in order to shed light on their potential clinical implications and reduce the burden of unknown significance. Results: Our study illustrates the potential utility of our individualized comprehensive stepwise analyses focused on the rare variants associated with IAS, which are currently classified as ambiguous, to further determine their trends towards pathogenicity or benign traits. Conclusions: We advocate for personalized disease-focused population frequency data and family segregation analyses for all rare variants that remain ambiguous to further clarify their role. The current ambiguity should not influence medical decisions, but a potential deleterious role would suggest a closer clinical follow-up and frequent genetic data review for a more personalized clinical approach