Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Feb 25;85(7):727-740.
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

Affiliations

Genes Associated With Hypertrophic Cardiomyopathy: A Reappraisal by the ClinGen Hereditary Cardiovascular Disease Gene Curation Expert Panel

Sophie Hespe et al. J Am Coll Cardiol. .

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.

PubMed Disclaimer

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.

Figures

FIGURE 1:
FIGURE 1:. Comparison of original and updated classifications.
Hypertrophic cardiomyopathy (HCM) gene-disease classifications showing the genetic and experimental evidence point totals and final classification counts from the original curation (left) compared to the re-curation (right). Including 17 changes of classification (bottom right box); 3 upgraded from moderate to definitive, 1 upgraded from no evidence to limited, and 13 downgraded to disputed. There are 7 new curations; 5 new genes and 2 existing genes with new modes of inheritance. The figure key is located in the bottom right box.
FIGURE 2:
FIGURE 2:. Updated list of genes with moderate, strong or definitive hypertrophic cardiomyopathy (HCM) association.
We highlight the genetic architecture of HCM, or genocopies causing left ventricular hypertrophy (innermost circle), spanning numerous gene ontologies (middle circle). Genes classified as definitive or strong evidence are emphasized in bold.
FIGURE 3:
FIGURE 3:
Overview of genetic sub-types of hypertrophic cardiomyopathy and associated genes with moderate, strong or definitive evidence.

Update of

Similar articles

Cited by

References

    1. Ommen SR, Mital S, Burke MA, Day SM, Deswal A, Elliott P, Evanovich LL, Hung J, Joglar JA, Kantor P, Kimmelstiel C, Kittleson M, Link MS, Maron MS, Martinez MW, Miyake CY, Schaff HV, Semsarian C, Sorajja P. 2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2020;142:e533–e557. - PubMed
    1. Arbelo E, Protonotarios A, Gimeno JR, Arbustini E, Barriales-Villa R, Basso C, Bezzina CR, Biagini E, Blom NA, de Boer RA, De Winter T, Elliott PM, Flather M, Garcia-Pavia P, Haugaa KH, Ingles J, Jurcut RO, Klaassen S, Limongelli G, Loeys B, Mogensen J, Olivotto I, Pantazis A, Sharma S, Van Tintelen JP, Ware JS, Kaski JP, ESC Scientific Document Group. 2023 ESC Guidelines for the management of cardiomyopathies. Eur Heart J. 2023;ehad194. - PubMed
    1. McGurk KA, Zhang X, Theotokis P, Thomson K, Harper A, Buchan RJ, Mazaika E, Ormondroyd E, Wright WT, Macaya D, Pua CJ, Funke B, MacArthur DG, Prasad SK, Cook SA, Allouba M, Aguib Y, Yacoub MH, O’Regan DP, Barton PJR, Watkins H, Bottolo L, Ware JS. The penetrance of rare variants in cardiomyopathy-associated genes: A cross-sectional approach to estimating penetrance for secondary findings. Am J Hum Genet. 2023;110:1482–1495. - PMC - PubMed
    1. Wilde AAM, Semsarian C, Márquez MF, Sepehri Shamloo A, Ackerman MJ, Ashley EA, Sternick EB, Barajas-Martinez H, Behr ER, Bezzina CR, Breckpot J, Charron P, Chockalingam P, Crotti L, Gollob MH, Lubitz S, Makita N, Ohno S, Ortiz-Genga M, Sacilotto L, Schulze-Bahr E, Shimizu W, Sotoodehnia N, Tadros R, Ware JS, Winlaw DS, Kaufman ES, Document Reviewers, Aiba T, Bollmann A, Choi J-I, Dalal A, Darrieux F, Giudicessi J, Guerchicoff M, Hong K, Krahn AD, MacIntyre C, Mackall JA, Mont L, Napolitano C, Ochoa JP, Peichl P, Pereira AC, Schwartz PJ, Skinner J, Stellbrink C, Tfelt-Hansen J, Deneke T. European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) Expert Consensus Statement on the State of Genetic Testing for Cardiac Diseases. Heart Rhythm. 2022;19:e1–e60. - PubMed
    1. Tuohy CV, Kaul S, Song HK, Nazer B, Heitner SB. Hypertrophic cardiomyopathy: the future of treatment. Eur J Heart Fail. 2020;22:228–240. - PubMed

MeSH terms