Numerous Brugada syndrome-associated genetic variants have no effect on J-point elevation, syncope susceptibility, malignant cardiac arrhythmia, and all-cause mortality

Genet Med. 2017 May;19(5):521-528. doi: 10.1038/gim.2016.151. Epub 2016 Oct 6.

Abstract

Purpose: We investigated whether Brugada syndrome (BrS)-associated variants identified in the general population have an effect on J-point elevation as well as whether carriers of BrS variants were more prone to experience syncope and malignant ventricular arrhythmia and had increased mortality compared with noncarriers.

Methods: All BrS-associated variants were identified using the Human Gene Mutation Database (HGMD). Individuals were randomly selected from a general population study using whole-exome sequencing data (n = 870) and genotype array data (n = 6,161) and screened for BrS-associated variants. Electrocardiograms (ECG) were analyzed electronically, and data on syncope, ventricular arrhythmias, and mortality were obtained from administrative health-care registries.

Results: In HGMD, 382 BrS-associated genetic variants were identified. Of these, 28 variants were identified in the study cohort. None of the carriers presented with type 1 BrS ECG pattern. Mean J-point elevation in V1 and V2 were within normal guideline limits for carriers and noncarriers. There was no difference in syncope susceptibility (carriers 8/624; noncarriers 98/5,562; P = 0.51), ventricular arrhythmia (carriers 4/620; noncarriers 9/5,524; P = 0.24), or overall mortality (hazard ratio 0.93, 95% CI 0.63-1.4).

Conclusions: Our data indicate that a significant number of BrS-associated variants are not the monogenic cause of BrS.Genet Med advance online publication 06 October 2016.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Arrhythmias, Cardiac / epidemiology*
  • Arrhythmias, Cardiac / etiology
  • Brugada Syndrome / complications
  • Brugada Syndrome / genetics*
  • Brugada Syndrome / mortality*
  • Brugada Syndrome / physiopathology
  • Denmark / epidemiology
  • Exome Sequencing / methods
  • Female
  • Genetic Predisposition to Disease
  • Genetic Variation*
  • Heart / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Oligonucleotide Array Sequence Analysis / methods
  • Random Allocation
  • Registries
  • Syncope / epidemiology*
  • Syncope / etiology