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J Hypertens Manag. 2017;3(1). pii: 025. doi: 10.23937/2474-3690/1510025. Epub 2017 Jul 20.

Whole exome analyses to examine the impact of rare variants on left ventricular traits in African American participants from the HyperGEN and GENOA studies.

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Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL.
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI.
Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL.
Department of Neurology, University of Alabama at Birmingham, Birmingham, AL.
Division of Cardiology, Department of Medicine, Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.
Division of Biostatistics, Washington University in St. Louis, St. Louis, MO.
College of Public Health, University of Kentucky, Lexington, KY.


Left ventricular (LV) hypertrophy, highest in prevalence among African Americans, is an established risk factor heart failure. Several genome wide association studies have identified common variants associated with LV-related quantitative-traits in African Americans. To date, however, the effect of rare variants on these traits has not been extensively studied, especially in minority groups. We therefore investigated the association between rare variants and LV traits among 1,934 African Americans using exome chip data from the Hypertension Genetic Epidemiology Network (HyperGEN) study, with replication in 1,090 African American from the Genetic Epidemiology Network of Arteriopathy (GENOA) study. We used single-variant analyses and gene-based tests to investigate the association between 86,927 variants and six structural and functional LV traits including LV mass, LV internal dimension-diastole, relative wall thickness, left atrial dimension (LAD), fractional shortening (FS), and the ratio of LV early-to-late transmitral velocity (E/A ratio). Only rare variants (MAF <1% and <5%) were considered in gene-based analyses. In gene-based analyses, we found a statistically significant association between potassium voltage-gated channel subfamily H member 4 (KCNH4) and E/A ratio (P=8.7*10-8 using a burden test). Endonuclease G (ENDOG) was associated with LAD using the Madsen Browning weighted burden (MB) test (P=1.4*10-7). Neither gene result was replicated in GENOA, but the direction of effect of single variants in common was comparable. G protein-coupled receptor 55 (GPR55) was marginally associated with LAD in HyperGEN (P=3.2*10-5 using the MB test) and E/A ratio in GENOA, but with opposing directions of association for variants in common (P=0.03 for the MB test). No single variant was statistically significantly associated with any trait after correcting for multiple testing. The findings in this study highlight the potential cumulative contributions of rare variants to LV traits which, if validated, could improve our understanding of heart failure in African Americans.


African Americans; echocardiography; epidemiology; genetics; left ventricular traits; rare variants

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