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Eur J Med Genet. 2017 Sep;60(9):485-488. doi: 10.1016/j.ejmg.2017.06.008. Epub 2017 Jun 19.

Digenic inheritance of mutations in the cardiac troponin (TNNT2) and cardiac beta myosin heavy chain (MYH7) as the cause of severe dilated cardiomyopathy.

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Cardiovascular and Cell Sciences Institute, St George's University of London, Cranmer Terrace, London, UK.
Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Science, Yazd, Iran.
University of Exeter Medical School, RILD Wellcome Wolfson Centre, Royal Devon & Exeter NHS Foundation Trust, Exeter, UK.
Cardiovascular and Cell Sciences Institute, St George's University of London, Cranmer Terrace, London, UK. Electronic address:


Familial dilated cardiomyopathy (DCM) is characterized by ventricular dilation and depressed myocardial performance. It is a genetically heterogeneous disorder associated with mutations in over 60 genes. We carried out whole exome sequencing in combination with cardiomyopathy-related gene-filtering on two affected family members to identify the possible causative mutation in a consanguineous Iranian family with DCM. Two novel variants in cardiomyopathy-related genes were identified: c.247 A > C; p.N83H in the Troponin T Type 2 gene (TNNT2) and c.2863G > A; p.D955N in the Myosin Heavy Polypeptide 7 gene (MYH7). Sanger sequencing and co-segregation analysis in the remaining family members supported the coexistence of these digenic mutations in affected members of the family. Carriers of either variant alone were asymptomatic. In summary, we find that digenic inheritance of two novel variants in DCM related genes is associated with a severe form of DCM. Exome sequencing has been shown to be very useful in identifying pathogenic mutations in cardiomyopathy families, and this report emphasizes the importance of comprehensive screening of DCM related genes, even after the identification of a single disease-causing mutation.


Cardiomyopathy; Digenic; Dilated; Exome; MYH7; TNNT2

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