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Clinical predictors of a positive genetic test in hypertrophic cardiomyopathy in the Brazilian population

机译:巴西人群肥厚型心肌病基因检测阳性的临床预测指标

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Background Hypertrophic cardiomyopathy is a genetic autosomal dominant disease characterized by left ventricular hypertrophy. The molecular diagnosis is important but still expensive. This work aimed to find clinical predictors of a positive genetic test in a Brazilian tertiary centre cohort of index cases with HCM. Methods In the study were included patients with HCM clinical diagnosis. For genotype x phenotype comparison we have evaluated echocardiographic, electrocardiographic, and nuclear magnetic resonance measures. All patients answered a questionnaire about familial history of HCM and/or sudden death. β-myosin heavy chain, myosin binding protein C, and troponin T genes were sequenced for genetic diagnosis. Results The variables related to a higher probability of a positive genetic test were familial history of HCM, higher mean heart frequency, presence of NSVT and lower age. Probabilities of having a positive molecular genetic test were calculated from the final multivariate logistic regression model and were used to identify those with a higher probability of a positive molecular diagnosis. Conclusions We developed an easy and fast screening method that takes into account only clinical data that can help to select the patients with a high probability of positive genetic results from molecular sequencing of Brazilian HCM patients.
机译:背景肥厚型心肌病是一种遗传性常染色体显性遗传疾病,其特征是左心室肥大。分子诊断很重要,但仍然很昂贵。这项工作的目的是在巴西三级中心HCM索引病例队列中寻找阳性基因检测的临床预测指标。方法本研究纳入HCM临床诊断患者。对于基因型x表型的比较,我们评估了超声心动图,心电图和核磁共振测量。所有患者均回答了有关HCM家族史和/或猝死的问卷。对β-肌球蛋白重链,肌球蛋白结合蛋白C和肌钙蛋白T基因进行测序,以进行基因诊断。结果与较高的基因检测阳性率相关的变量是HCM家族史,平均心脏频率较高,存在NSVT和年龄较低。从最终的多元逻辑回归模型计算出具有阳性分子遗传学测试的概率,并将其用于识别那些具有较高阳性分子诊断率的分子。结论我们开发了一种简便,快捷的筛选方法,该方法仅考虑可从巴西HCM患者的分子测序中选择具有高阳性遗传结果阳性可能性的患者的临床数据。

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