Phenotypic variability of filamin C–related cardiomyopathy: Insights from a novel Dutch founder variant

Stephan A.C. Schoonvelde, Claudine W.B. Ruijmbeek, Alexander Hirsch, Marjon A. van Slegtenhorst, Marja W. Wessels, Jan H. von der Thüsen, Annette F. Baas, Sophie L.V.M. Stroeks, Job A.J. Verdonschot, Paul A. van der Zwaag, Judith M.A. Verhagen, Michelle Michels*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)

Abstract

Background: 

Dilated cardiomyopathy (DCM) can be caused by truncating variants in the filamin C gene (FLNC). A new pathogenic FLNC variant, c.6864_6867dup, p.(Val2290Argfs∗23), was recently identified in Dutch patients with DCM. Objectives: The report aimed to evaluate the phenotype of FLNC variant carriers and to determine whether this variant is a founder variant. 

Methods: 

Clinical and genetic data were retrospectively collected from variant carriers. Cardiovascular magnetic resonance studies were reassessed. Haplotypes were reconstructed to determine a founder effect. The geographical distribution and age of the variant were determined. 

Results: 

Thirty-three individuals (of whom 23 [70%] were female) from 9 families were identified. Sudden cardiac death was the first presentation in a carrier at the age of 28 years. The median age at diagnosis was 41 years (range 19–67 years). The phenotype was heterogeneous. DCM with left ventricular dilation and reduced ejection fraction (<45%) was present in 11 (33%) individuals, 3 (9%) of whom underwent heart transplantation. Cardiovascular magnetic resonance showed late gadolinium enhancement in 13 (65%) of the assessed individuals, primarily in a ringlike distribution. Nonsustained ventricular arrhythmias were detected in 6 (18%), and 5 (15%) individuals received an implantable cardioverter-defibrillator. A shared haplotype spanning 2.1 Mb was found in all haplotyped individuals. The variant originated between 275 and 650 years ago. 

Conclusion: 

The pathogenic FLNC variant c.6864_6867dup, p.(Val2290Argfs∗23) is a founder variant originating from the south of the Netherlands. Carriers are susceptible to developing heart failure and ventricular arrhythmias. The cardiac phenotype is characterized by ringlike late gadolinium enhancement, even in individuals without significantly reduced left ventricular function.

Original languageEnglish
Pages (from-to)1512-1521
Number of pages10
JournalHeart Rhythm
Volume20
Issue number11
Early online date9 Aug 2023
DOIs
Publication statusPublished - Nov 2023

Bibliographical note

Funding Information:
We acknowledge the support from the Dutch CardioVascular Alliance, an initiative with support of the Dutch Heart Foundation (grant number 2020B005), as part of the Double Dose project.

Publisher Copyright:
© 2023

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