Genes Associated With Hypertrophic Cardiomyopathy: A Reappraisal by the ClinGen Hereditary Cardiovascular Disease Gene Curation Expert Panel
- PMID: 39971408
- PMCID: PMC12079304
- DOI: 10.1016/j.jacc.2024.12.010
Genes Associated With Hypertrophic Cardiomyopathy: A Reappraisal by the ClinGen Hereditary Cardiovascular Disease Gene Curation Expert Panel
Abstract
Background: Hypertrophic cardiomyopathy (HCM) is an inherited cardiac condition affecting ∼1 in 500 and exhibits marked genetic heterogeneity. Previously published in 2019, 57 HCM-associated genes were curated providing the first systematic evaluation of gene-disease validity.
Objectives: The authors report work by the Clinical Genome Resource Hereditary Cardiovascular Disease (HCVD) Gene Curation Expert Panel (GCEP) to reappraise the clinical validity of previously curated and new putative HCM genes.
Methods: The Clinical Genome Resource systematic gene curation framework was used to reclassify the gene-disease relationships for HCM and related syndromic entities involving left ventricular hypertrophy. Genes previously curated were included if their classification was not definitive, and if the time since curation was >2 to 3 years. New genes with literature assertions for HCM were included for initial evaluation. Existing genes were curated for new inheritance patterns where evidence existed. Curations were presented on twice monthly calls, with the HCVD GCEP composed of 29 individuals from 21 institutions across 6 countries.
Results: Thirty-one genes were recurated and an additional 5 new potential HCM-associated genes were curated. Among the recurated genes, 17 (55%) genes changed classification: 1 limited and 4 disputed (from no known disease relationship), 9 disputed (from limited), and 3 definitive (from moderate). Among these, 3 (10%) genes had a clinically relevant upgrade, including TNNC1, a 9th sarcomere gene with definitive HCM association. With new evidence, 2 genes were curated for multiple inheritance patterns (TRIM63, disputed for autosomal dominant but moderate for autosomal recessive; ALPK3, strong for autosomal dominant and definitive for recessive). CSRP3 was curated for a semidominant mode of inheritance (definitive). Nine (29%) genes were downgraded to disputed, further discouraging clinical reporting of variants in these genes. Five genes recently reported to cause HCM were curated: RPS6KB1 and RBM20 (limited), KLHL24 and MT-TI (moderate), and FHOD3 (definitive).
Conclusions: We report 29 genes with definitive, strong, or moderate evidence of causation for HCM or isolated left ventricular hypertrophy, including sarcomere, sarcomere-associated, and syndromic conditions.
Keywords: genetic testing; hypertrophic cardiomyopathy; sarcomere; variant classification.
Copyright © 2025 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Conflict of interest statement
Funding Support and Author Disclosures Supported in part by the National Human Genome Research Institute of the National Institutes of Health through grant U24HG009650. Dr Astrayan has received the 2022 Research Fellowship for aspiring electrophysiologists from the Swiss Heart Rhythm Foundation, and a postdoctoral research fellowship grant from the Gottfried und Julia Bangerter-Rhyner-Stiftung (Switzerland). Dr Callewaert is a senior clinical investigator of the Research Foundation-Flanders. Dr McNally has received grants from NIH HL128075, HG011169, the Leducq Foundation, and the American Heart Association; has been an advisor to Amgen, Cytokinetics, PepGen, and Tenaya; and is a founder of Ikaika Therapeutics. Dr Ware has received grants from the Medical Research Council (UK), Sir Jules Thorn Charitable Trust [21JTA], British Heart Foundation [RE/18/4/34215], the NIHR Imperial College Biomedical Research Centre, and Bristol Myers Squibb; and has received consulting fees from MyoKardia, Inc, Pfizer, Foresite Labs, Health Lumen, and Tenaya Therapeutics. Dr Ingles has received a National Heart Foundation of Australia Future Leader Fellowship (#106732); and has received grants from Bristol Myers Squibb unrelated to this work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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Update of
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ClinGen Hereditary Cardiovascular Disease Gene Curation Expert Panel: Reappraisal of Genes associated with Hypertrophic Cardiomyopathy.medRxiv [Preprint]. 2024 Jul 31:2024.07.29.24311195. doi: 10.1101/2024.07.29.24311195. medRxiv. 2024. Update in: J Am Coll Cardiol. 2025 Feb 25;85(7):727-740. doi: 10.1016/j.jacc.2024.12.010. PMID: 39132495 Free PMC article. Updated. Preprint.
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