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The yield of postmortem genetic testing in sudden death cases with structural findings at autopsy

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  • Najim Lahrouchi
  • Hariharan Raju
  • Elisabeth M Lodder
  • Stathis Papatheodorou
  • Chris Miles
  • James S Ware
  • Michael Papadakis
  • Rafik Tadros
  • Della Cole
  • Jonathan R Skinner
  • Jackie Crawford
  • Donald R Love
  • Chee J Pua
  • Bee Y Soh
  • Jaydutt D Bhalshankar
  • Risha Govind
  • Jacob Tfelt-Hansen
  • Bo G Winkel
  • Christian van der Werf
  • Yanushi D Wijeyeratne
  • Greg Mellor
  • Janice Till
  • Marta Cohen
  • Maria Tome-Esteban
  • Sanjay Sharma
  • Arthur A M Wilde
  • Stuart A Cook
  • Mary N Sheppard
  • Connie R Bezzina
  • Elijah R Behr
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Sudden cardiac death (SCD) is often associated with structural abnormalities of the heart during autopsy. This study sought to compare the diagnostic yield of postmortem genetic testing in (1) cases with structural findings of uncertain significance at autopsy to (2) cases with autopsy findings diagnostic of cardiomyopathy. We evaluated 57 SCD cases with structural findings at cardiac autopsy. Next-generation sequencing using a panel of 77 primary electrical disorder and cardiomyopathy genes was performed. Pathogenic and likely pathogenic variants were classified using American College of Medical Genetics (ACMG) consensus guidelines. In 29 cases (51%) autopsy findings of uncertain significance were identified whereas in 28 cases (49%) a diagnosis of cardiomyopathy was established. We identified a pathogenic or likely pathogenic variant in 10 cases (18%); in 1 (3%) case with non-specific autopsy findings compared with 9 (32%) cases with autopsy findings diagnostic of cardiomyopathy (p = 0.0054). The yield of genetic testing in SCD cases with autopsy findings consistent with cardiomyopathy is comparable with the yield in cardiomyopathy patients that are alive. Genetic testing in cases with findings of uncertain significance offers lower clinical utility than in cardiomyopathy, with lower yields than detected previously. This highlights the need for stringent evaluation of variant pathogenicity.

Original languageEnglish
JournalEuropean journal of human genetics : EJHG
Volume28
Issue number1
Pages (from-to)17-22
Number of pages6
ISSN1018-4813
DOIs
Publication statusPublished - Jan 2020

    Research areas

  • Adult, Autopsy, Cardiomyopathies/epidemiology, Death, Sudden, Cardiac/epidemiology, Female, Forensic Genetics/standards, Genetic Testing/standards, Humans, Male, Sensitivity and Specificity

ID: 62109150