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Reclassification of genetic variants in children with long QT syndrome.
Mol. Genet. Genomic Med. 8:e1300 (2020)
Background: Genes encoding cardiac ion channels or regulating proteins have been associated with the inherited form of long QT syndrome (LQTS). Complex pathophysiology and missing functional studies, however, often bedevil variant interpretation and classification. We aimed to evaluate the rate of change in variant classification based on current interpretation standards and dependent on clinical findings. Methods: Medical charts of children with a molecular genetic diagnosis of LQTS presenting at our centers were retrospectively reviewed. Reinterpretation of originally reported variants in genes associated with LQTS was performed based on current knowledge (March 2019) and according to the “Standards and Guidelines for the Interpretation of Sequence Variants” by the ACMG 2015. Results: About 84 distinct (likely) pathogenic variants identified in 127 patients were reinterpreted. In 12 variants (12/84, 14.3%), classification changed from (likely) pathogenic to variant of unknown significance (VUS). One of these variants was a hypomorphic allele escaping the standard variant classification. Individuals with variants that downgraded to VUS after reevaluation showed significantly lower Schwartz scores and QTc intervals compared to individuals with unchanged variant characterization. Conclusion: This finding confirms genetic variant interpretation as a dynamic process and underlines the importance of ongoing genetic counseling, especially in LQTS patients with minor clinical criteria.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Acmg ; Cardiogenetics ; Long Qt Syndrome ; Schwartz Score ; Variant Classification; Founder Mutations; Risk
ISSN (print) / ISBN
2324-9269
e-ISSN
2324-9269
Quellenangaben
Volume: 8,
Issue: 9,
Article Number: e1300
Publisher
Wiley
Publishing Place
[Hoboken, NJ]
Non-patent literature
Publications
Reviewing status
Peer reviewed
Institute(s)
Institute of Human Genetics (IHG)