The yield of postmortem genetic testing in sudden death cases with structural findings at autopsy

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Title: The yield of postmortem genetic testing in sudden death cases with structural findings at autopsy
Authors: Lahrouchi, N
Raju, H
Lodder, EM
Papatheodorou, S
Miles, C
Ware, JS
Papadakis, M
Tadros, R
Cole, D
Skinner, JR
Crawford, J
Love, DR
Pua, CJ
Soh, BY
Bhalshankar, JD
Govind, R
Tfelt-Hansen, J
Winkel, BG
Van der Werf, C
Wijeyeratne, YD
Mellor, G
Till, J
Cohen, M
Tome-Esteban, M
Sharma, S
Wilde, AAM
Cook, SA
Sheppard, MN
Bezzina, CR
Behr, ER
Item Type: Journal Article
Abstract: Sudden cardiac death (SCD) is often associated with structural abnormalities of the heart during autopsy. This study sought to compare the diagnostic yield of postmortem genetic testing in (1) cases with structural findings of uncertain significance at autopsy to (2) cases with autopsy findings diagnostic of cardiomyopathy. We evaluated 57 SCD cases with structural findings at cardiac autopsy. Next-generation sequencing using a panel of 77 primary electrical disorder and cardiomyopathy genes was performed. Pathogenic and likely pathogenic variants were classified using American College of Medical Genetics (ACMG) consensus guidelines. In 29 cases (51%) autopsy findings of uncertain significance were identified whereas in 28 cases (49%) a diagnosis of cardiomyopathy was established. We identified a pathogenic or likely pathogenic variant in 10 cases (18%); in 1 (3%) case with non-specific autopsy findings compared with 9 (32%) cases with autopsy findings diagnostic of cardiomyopathy (p = 0.0054). The yield of genetic testing in SCD cases with autopsy findings consistent with cardiomyopathy is comparable with the yield in cardiomyopathy patients that are alive. Genetic testing in cases with findings of uncertain significance offers lower clinical utility than in cardiomyopathy, with lower yields than detected previously. This highlights the need for stringent evaluation of variant pathogenicity.
Issue Date: 18-Sep-2019
Date of Acceptance: 12-Aug-2019
DOI: 10.1038/s41431-019-0500-8
ISSN: 1018-4813
Publisher: Springer Nature [academic journals on]
Journal / Book Title: European Journal of Human Genetics
Copyright Statement: © The Author(s), under exclusive licence to European Society of Human Genetics 2019
Keywords: Genetics & Heredity
0604 Genetics
Publication Status: Published online
Conference Place: England
Embargo Date: 2020-03-18
Online Publication Date: 2019-09-18
Appears in Collections:National Heart and Lung Institute

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