1. ADAMTS19-associated heart valve defects: Novel genetic variants consolidating a recognizable cardiac phenotype
- Author
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Suliman Khan, Aida M. Bertoli-Avella, Atia Sheereen, Iman Almohammed, Ingrid M.E. Frohn-Mulder, Peter Bauer, Salam Massadeh, Ingrid M.B.H. van de Laar, Farah Chaikhouni, Amal Alhashem, Manal Alaamery, Fahad Alhabshan, Mohamed S. Kabbani, Bader Alghamdi, Natalia Ordonez, Salem Alawbathani, Marja W. Wessels, Christian Beetz, Salim Ahmad, Clinical Genetics, and Pediatrics
- Subjects
Heart Defects, Congenital ,Heart Septal Defects, Ventricular ,Male ,0301 basic medicine ,medicine.medical_specialty ,Heart Ventricles ,Heart Valve Diseases ,030105 genetics & heredity ,Heart Septal Defects, Atrial ,03 medical and health sciences ,ADAMTS Proteins ,Internal medicine ,medicine.artery ,Ascending aorta ,Genetics ,Discrete Subaortic Stenosis ,Humans ,Medicine ,Heart valve ,Child ,Aorta ,Genetics (clinical) ,Exome sequencing ,Atrioventricular valve ,business.industry ,Genetic Variation ,medicine.disease ,Heart Valves ,Stenosis ,Phenotype ,030104 developmental biology ,medicine.anatomical_structure ,Child, Preschool ,Aortic valve stenosis ,Pulmonary valve ,cardiovascular system ,Cardiology ,Female ,business - Abstract
Recently, ADAMTS19 was identified as a novel causative gene for autosomal recessive heart valve disease (HVD), affecting mainly the aortic and pulmonary valves. Exome sequencing and data repository (CentoMD) analyses were performed to identify patients with ADAMTS19 variants (two families). A third family was recognized based on cardiac phenotypic similarities and SNP array homozygosity. Three novel loss of function (LoF) variants were identified in six patients from three families. Clinically, all patients presented anomalies of the aortic/pulmonary valves, which included thickening of valve leaflets, stenosis and insufficiency. Three patients had (recurrent) subaortic membrane, suggesting that ADAMTS19 is the first gene identified related to discrete subaortic stenosis. One case presented a bi-commissural pulmonary valve. All patients displayed some degree of atrioventricular valve insufficiency. Other cardiac anomalies included atrial/ventricular septal defects, persistent ductus arteriosus, and mild dilated ascending aorta. Our findings confirm that biallelic LoF variants in ADAMTS19 are causative of a specific and recognizable cardiac phenotype. We recommend considering ADAMTS19 genetic testing in all patients with multiple semilunar valve abnormalities, particularly in the presence of subaortic membrane. ADAMTS19 screening in patients with semilunar valve abnormalities is needed to estimate the frequency of the HVD related phenotype, which might be not so rare.
- Published
- 2020