Use of genetics in the clinical evaluation of cardiomyopathy.
Inherited forms of cardiomyopathy are frequently responsible for heart failure that is otherwise unexplained. Evaluation of familial cardiomyopathy should include not only the individual patient, but also the pattern of inheritance within the family and assessment for the presence of syndromic features. The last 10 years have seen remarkable advances in genetics. Improvements in technology have lowered costs, such that clinical use of genetic testing is rapidly expanding. Genetic counseling about the potential risks and benefits of such testing is an important part of the care of individuals and families with inherited heart disease. Among inherited types of cardiomyopathy, the likelihood of finding a responsible gene mutation varies. Both hypertrophic and right ventricular forms of cardiomyopathy have a relatively high likelihood of finding a responsible gene mutation when testing is properly applied. Because of prominent genetic heterogeneity in familial dilated cardiomyopathy, recognition of pathogenic mutations is more challenging. With or without genetic testing, screening of family members who are at risk for an inherited form of cardiomyopathy leads to earlier identification, earlier treatment, and improved outcomes.
Judge
Daniel P
DP
Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA. djudge@jhmi.edu
D002311:Cardiomyopathy, Dilated / Q000235:genetics*; D024741:Cardiomyopathy, Hypertrophic, Familial / Q000235:genetics*; D002352:Carrier Proteins / Q000235:genetics; D005260:Female; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010375:Pedigree; D016742:Preconception Care; D013577:Syndrome; D020107:Troponin T / Q000235:genetics; D055815:Young Adult; D000099163:Myosin Binding Protein C
D002352:Carrier Proteins; D020107:Troponin T; D000099163:Myosin Binding Protein C; C545568:TNNT2 protein, human